健康青年男性进驻更高海拔地区急性高原病分析

Analysis of acute mountain sickness in healthy young men after rapid ascent to plateau

目的:分析健康青年男性急进更高海拔地区急性高原病(acute mountain sickness,AMS)的发病特点及规律。方法:选取2017-04~06世居平原移居海拔2 815m地区非藏族健康青年男性196例,乘驾重型卡车从海拔2 815m地区急进到海拔4 547m地区,根据受试对象是否发生AMS,分为AMS组和非AMS组。收集人口学资料(身高、体质量、年龄、吸烟史、饮酒史、预服用红景天药物史),填写路易斯湖评分(lake louise scale,LLS)量表,分析高海拔地区AMS的发病特点。结果:海拔3 540 m、4 547 m地区AMS组与非AMS组的体质量指数(BMI)、年龄、吸烟史、饮酒史、预服用红景天药物史等资料比较,均无显著性差异(P>0.05);海拔3 540m地区的头痛发生率为34.69%、头晕(眩晕)发生率为46.94%、胃肠道症状发生率为24.49%、睡眠困难发生率为65.31%、疲劳(虚弱)发生率为67.35%,均显著低于海拔4 547m地区的63.27%、69.39%、42.86%、77.55%及73.47%,差异有统计学意义(P<0.05);海拔3 540m地区AMS患病率为32.65%,其中轻度AMS患病率为16.33%,重度AMS患病率为16.33%;海拔4 547m地区AMS患病率为57.14%,其中轻度AMS患病率为18.37%,重度AMS患病率为38.78%,海拔4 547m地区AMS患病率高于海拔3 540m地区(P<0.05)。结论:移居高原的非藏族健康青年男性急进更高海拔地区后,AMS的发生可能与BMI、年龄、吸烟、饮酒、预服用红景天无关;进驻海拔高度越高,头痛、头晕(眩晕)、胃肠道、睡眠困难、疲劳(虚弱)发生率越高,可为早期诊治AMS提供理论依据。

Objective：To analyze the characteristics and pathogenesis of acute mountain sickness（AMS）after rapid asent to plateau in healthy young men.Methods：A total of 196 healthy young men who had moved to an altitude of 2 815 mto 4 547 m by heavy truck were choosen from April to June in 2017.Accoring to whether or not having AMS,the subjects were divided into AMS group and non-AMS group.Demographic data including height,weight,age,smoking,alcohol consumption,history of rhodiola drugs,lake louise scale（LLS）were collected.The characteristics and pathogenesis of AMS were analyzed.Results：There were no significant differences in body mass index（BMI）,age,smoking,alcohol consumption,history of rhodiola drugs in AMS and non-AMS group at an altitude of 3 540 mand 4 547 m（P0.05）.There were significant differences in headache（34.69% vs 63.27%）,dizziness or lightheadedness（46.94% vs 69.39%）,gastrointestinal symptoms（24.49% vs 42.86%）,difficulty sleeping（65.31%vs 77.55%）and fatigueor weakness（67.35%vs 73.47%）between 3 540 mand 4 547 m altitude（P0.05）.The prevalence of AMS in 3 540 maltitude was 32.65%,mild AMS was16.33%,severe AMS was 16.33%,the prevalence of AMS in 4 547 maltitude was 57.14%,mild AMS was 18.37%,severe AMS was 38.78%,the difference were statistically significant（P0.05）.Conclusion：There may be no correlation between AMS and BMI,age,smoking,alcohol consumption,history of rhodiola drugs rapid asent to higher altitude in healthy Chinese young men.The incidence of headache,dizziness or lightheadedness,gastrointestinal symptoms,difficulty sleeping and fatigue or weakness is higher along with altitude.These observations can provide a theorital basis for early diagnosis and treatment of AMS.