Pradhan Santosh, Yadav Sanjay, Neupane Pritam, Subedi Prajan
Mountain Medicine Society of Nepal, Kathmandu, Nepal.
Wilderness Environ Med. 2009 Winter;20(4):359-63. doi: 10.1580/1080-6032-020.004.0359.
To determine the incidence of and risk factors for acute mountain sickness (AMS) in native Nepalese children during a pilgrimage trip to Gosaikunda Lake in the Langtang National Park Region of Nepal (elevation 4380 m).
A descriptive, noninterventional, cross-sectional study was completed on a group of children during the pilgrimage to Gosaikunda. Participants were interviewed about the symptoms of AMS using the Lake Louise Scoring System.
Thirty-six children between 3 and 15 years of age were interviewed after a rapid ascent (over 1 to 3 days) from 1950 m to 4380 m. Acute mountain sickness was diagnosed in 17 of 36 (47.2%) children. The sickness was seen in only 5 of 20 (25%) children who took 2 or more days to ascend, compared with 12 of 16 (75%) children who spent only 1 night (reaching the study site at Gosaikunda on the second day) to complete the same ascent (P < or = .01, odds ratio [OR] = 9.0, 1.61 < OR < 57.36). No significant correlation was found between the incidence of AMS and gender, previous exposure to high altitude, or concurrent illness.
Our results indicate that the incidence of AMS in this group of Nepalese children was high and associated with rapidity of ascent. Rapid ascent to high sleeping altitude and increased physical activity were observed as possible risk factors. We suggest organizing educational programs to make children and their parents aware of altitude-related problems and advise gradual ascent to such high-altitude pilgrimage sites.
确定尼泊尔当地儿童前往尼泊尔朗塘国家公园地区戈萨昆达湖（海拔4380米）朝圣期间急性高原病（AMS）的发病率及危险因素。
对一组前往戈萨昆达朝圣的儿童进行了一项描述性、非干预性横断面研究。使用路易斯湖评分系统就AMS症状对参与者进行了访谈。
36名3至15岁儿童在从1950米快速上升（1至3天）至4380米后接受了访谈。36名儿童中有17名（47.2%）被诊断为急性高原病。在20名花了2天或更长时间上升的儿童中，只有5名（25%）患病，而在16名仅用1晚（第二天到达戈萨昆达的研究地点）完成相同上升过程的儿童中，有12名（75%）患病（P≤0.01，优势比[OR]=9.0，1.61<OR<57.36）。未发现急性高原病发病率与性别、既往高海拔暴露史或并发疾病之间存在显著相关性。
我们的结果表明，这组尼泊尔儿童急性高原病的发病率很高，且与上升速度有关。快速上升到高睡眠海拔和增加体力活动被视为可能的危险因素。我们建议组织教育项目，让儿童及其父母了解与海拔相关的问题，并建议逐步前往此类高海拔朝圣地点。
