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急性高原反应发生风险与高原自然地理因素相关性分析

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目的 探讨进驻海拔4 000m以上地区的急性高原反应(AMS)发生情况与高原自然地理因素的相关性.方法 于2020年4月跟踪调查不同时间出发的两组人员共292名,由新藏公路从叶城(1 300 m)至狮泉河(4 300 m),共计4 d.每日通过路易斯湖AMS自评问卷调查对象AMS发生情况,通过脉搏血氧仪测量血氧饱和度和心率等生理指标.从中国气象数据共享服务系统获取气象数据,通过Landsat卫星影像提取计算归一化植被指数(NDVI).结果 急性高原反应整体发病率为25.68%,两组人群均在进驻高原的第3日出现AMS发病高峰,明显高于其他时间(x2=60.03,P<0.001),第4日发病率明显降低(x2=27.06.P<0.001).组间比较显示,A组第1、2、3日AMS发病率与得分明显高于B组,差异有统计学意义(P<0.05).多因素logistic回归结果显示,气温与AMS发生明显相关(OR=0.842,95%CI:0.741~0.957).结论 进入海拔4 000m以上高原时,采用4 d逐步适应过程可有效降低AMS发病率,且气温是AMS发生的重要影响因素.
Correlation of acute mountain sickness risk with natural geographical factors of high altitude
Objective To understand the correlation between acute mountain sickness(AMS)and natural geographical factors at high altitude above 4 000 m.Methods Two groups of 292 individuals were tracked and investigated in April 2020,traveling from Yecheng(1 300 m)to Shiquan River(4 300 m)on the Xin-Zang Highway for a total of four days.Daily LLS-AMS self-assessment questionnaire was used to survey subjects'AMS,blood oxygen saturation and heart rate were measured by a pulse oximeter.The meteorological data were collected from the China Meteorological Data Sharing Service System,extracted and calculated the Normalized Difference Vegetation Index(NDVI)through Landsat satellite imagery.Results The overall incidence of AMS was 25.68%.The peak of AMS in both groups occurred on the third day after ascending to high altitude,which was significantly higher than other times(x2=60.03,P<0.001),and the incidence on the fourth day was significantly lower(x2=27.06,P<0.001).The comparison between groups showed that the incidence and score of AMS in Group A on the 1st,2nd and 3rd were significantly higher than Group B(P<0.05).The results of multiple logistic regression showed a significant correlation between temperature and AMS(OR:0.842,95%CI:0.741-0.957).Conclusion The 4-day gradual acclimatization can effectively reduce the incidence of AMS when ascending to high altitude above 4 000 m.The temperature is an important influencing factor for AMS.

High altitudeAcute mountain sicknessNatural geographical factorsAir temperature

吴玉、唐棚、崔建华、张钦桃、谢佳新、钟志凤

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陆军军医大学高原军事医学系高原作业医学教研室,重庆 400038

陆军军医大学极端环境医学教育部重点实验室/全军高原医学重点实验室

陆军军医大学高原军事医学系高原特需药品与器材研究室

高原 急性高原反应 自然地理因素 气温

2024

环境与健康杂志
中华预防医学会,天津市疾病预防控制中心

环境与健康杂志

CSTPCD
影响因子:0.658
ISSN:1001-5914
年,卷(期):2024.41(12)