Vargas Enrique, Spielvogel Hilde
Instituto Boliviano de Biología de Altura, Facultad de Medicina, Universidad Mayor de San Andrés, La Paz, Bolivia.
High Alt Med Biol. 2006 Summer;7(2):138-49. doi: 10.1089/ham.2006.7.138.
For the male inhabitants of La Paz, Bolivia (3200-4100 m), and other high altitude regions in America and Asia, chronic mountain sickness (CMS) is a major health problem. Since CMS was first described by Carlos Monge in the Peruvian Andes in 1925, numerous research papers have been devoted to this topic, but many unanswered questions still exist with respect to the beginning of the disease and its cause(s). The experience with CMS has shown that an excessively high hemoglobin concentration is not favorable for high altitude acclimatization, and the hypothesis of theoretically "optimal" hematocrit and "optimal" hemoglobin has been made. The calculated optimal hemoglobin concentration of 14.7 g/dL for resting men in the Andes is discussed as theoretical and not applicable in real life. The most frequent congenital and acquired heart diseases are discussed, such as patent ductus, atrial septum defect, ventricle septum defect among congenital heart diseases and the still very frequent rheumatic valve cardiopathies and Chagas disease as acquired cardiopathies. Among the typical acquired heart diseases of the high altitude dweller, special attention is given to chronic cor pulmonale as a consequence of severe CMS with pulmonary hypertension.
对于玻利维亚拉巴斯（海拔3200 - 4100米）以及美洲和亚洲其他高海拔地区的男性居民而言，慢性高山病（CMS）是一个主要的健康问题。自1925年卡洛斯·蒙赫在秘鲁安第斯山脉首次描述慢性高山病以来，众多研究论文都围绕这一主题展开，但在该疾病的发病起始及其病因方面，仍存在许多未解决的问题。慢性高山病的相关经验表明，过高的血红蛋白浓度不利于高海拔适应，因此提出了理论上“最佳”血细胞比容和“最佳”血红蛋白的假说。安第斯山脉静息男性的计算得出的最佳血红蛋白浓度为14.7克/分升，这一数值被认为只是理论上的，并不适用于现实生活。文中讨论了最常见的先天性和后天性心脏病，如先天性心脏病中的动脉导管未闭、房间隔缺损、室间隔缺损，以及作为后天性心脏病仍然非常常见的风湿性瓣膜病和恰加斯病。在高海拔居民典型的后天性心脏病中，特别关注了重度慢性高山病伴肺动脉高压导致的慢性肺源性心脏病。
