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[攀登至海拔3000米以上过程中肺量计参数及动脉血氧饱和度的变化]

[Changes in spirometric parameters and arterial oxygen saturation during a mountain ascent to over 3000 meters].

作者信息

Compte-Torrero L, Botella de Maglia J, de Diego-Damiá A, Gómez-Pérez L, Ramírez-Galleymore P, Perpiñá-Tordera M

机构信息

Servicio de Neumología, Hospital Universitario La Fe, Valencia, Spain.

出版信息

Arch Bronconeumol. 2005 Oct;41(10):547-52. doi: 10.1016/s1579-2129(06)60281-4.

Abstract

OBJECTIVE

To ascertain whether climbing a mountain over 3000 meters high produces any alterations in ventilation, whether such alterations are modified by acclimatization, and whether they correlate with changes in arterial oxygen saturation (SaO2) or the development of acute mountain sickness (AMS).

SUBJECTS AND METHODS

The following parameters were measured in 8 unacclimatized mountaineers who climbed Aneto (3404 m) and spent 3 days at the summit: forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), airway response to inhaled terbutaline, SaO2, and the symptoms of AMS.

RESULTS

At the summit, mean (SD) FEV1 declined by 12.3% (5.7%) and mean FVC by 7.6% (6.7%) while the ratio of FEV1 to FVC remained normal. The means for both parameters were higher on the following day. No airway response to bronchodilator treatment was observed. The restriction disappeared entirely on descent. At the peak, SaO2 increased progressively as the climbers became acclimatized. During the ascent, FEV1 correlated with SaO2 (r=0.79). One participant who suffered from AMS had a ratio of FEV1 to FVC less than 70% and the worst SaO2 during the 3 days on the summit. Obstruction preceded the AMS symptoms, did not respond to bronchodilator treatment, and disappeared when the climber descended.

CONCLUSIONS

The mountaineers who climbed over 3000 meters presented restriction that correlated with hypoxemia. This restriction did not respond to bronchodilator treatment, improved with acclimatization, and disappeared on descent. One person with AMS presented obstruction that did not respond to terbutaline and disappeared on descent.

摘要

目的

确定攀登海拔超过3000米的山峰是否会引起通气的任何改变,这种改变是否会因适应环境而改变,以及它们是否与动脉血氧饱和度(SaO2)的变化或急性高原病(AMS)的发生相关。

对象与方法

对8名未适应环境的登山者进行测量,他们攀登了阿内托峰(3404米)并在山顶停留3天,测量以下参数:用力肺活量(FVC)、一秒用力呼气容积(FEV1)、气道对吸入特布他林的反应、SaO2以及AMS的症状。

结果

在山顶时,平均(标准差)FEV1下降了12.3%(5.7%),平均FVC下降了7.6%(6.7%),而FEV1与FVC的比值保持正常。第二天这两个参数的平均值更高。未观察到气道对支气管扩张剂治疗的反应。下山时这种限制完全消失。在山顶时,随着登山者适应环境,SaO2逐渐升高。在攀登过程中,FEV1与SaO2相关(r = 0.79)。一名患有AMS的参与者在山顶停留的3天中,FEV1与FVC的比值低于70%,且SaO2最差。阻塞在AMS症状出现之前出现,对支气管扩张剂治疗无反应,当登山者下山时消失。

结论

攀登超过3000米的登山者出现了与低氧血症相关的限制。这种限制对支气管扩张剂治疗无反应,随着适应环境而改善,下山时消失。一名患有AMS的人出现了对特布他林无反应且下山时消失的阻塞。

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