Physiological Research Group of the Ministry of Railway, High Altitude Medical Research Institute, Xining, Qinghai 810012, China.
Chin Med J (Engl). 2012 Apr;125(8):1393-400.
It is important to determine the incidence of acute mountain sickness (AMS) among workers at altitudes between 3500 m and 5000 m on Mt. Tanggula during the construction of the Qinghai-Tibet railroad. This study explored the risk factors predisposing workers to developing AMS and attempted to develop more effective ways of preventing and treating AMS.
A total of 11,182 workers were surveyed by completing twice daily a Lake Louise questionnaire, and a score ≥ 3 indicated AMS. The contributing risk factors were assessed for at least 2 months for the duration of the study in the years from 2001 to 2003. A risk model was developed by multiple Logistic regression. Standard statistical methods were used to analyze data.
AMS occurred in 56% of workers working at high altitudes on Mt. Tanggula. The incidence of AMS increased with increasing altitude. Rapid ascent to an altitude above 3500 m, sea-level or lowland newcomers, young people under 25 years of age, heavy physical exertion, obese person, and arterial oxygen saturation (SaO2) below 80% were independent AMS risk factors. No significant association was found between AMS and sex or taking Rhodiola. Medical education contributed to an early diagnosis of AMS.
This study used the Lake Louise scoring system suggesting that it is a well-validated standard for field evaluation of AMS and for making an early diagnosis. These studies have described many variables regarding risk factors for the development of AMS. Risk factors which can be modified should be attended to, and the physicians should carry out check-ups and tests to identify subjects who are more at risk. Prevention consists in continuous gradual ascent, medical education, and prompt descent to avoid progression in patients with serious AMS. It is most important to effectively control the risk factors of AMS.
在青藏铁路建设期间，确定海拔 3500 米至 5000 米的唐古拉山作业工人中急性高原病（AMS）的发病率非常重要。本研究探讨了使工人易患 AMS 的危险因素，并试图开发更有效的预防和治疗 AMS 的方法。
在 2001 年至 2003 年的研究期间，通过每天两次填写路易湖问卷对 11182 名工人进行了调查，得分≥3 表示患有 AMS。至少在研究期间的 2 个月内评估了促成危险因素。通过多元 Logistic 回归建立风险模型。使用标准统计方法分析数据。
在唐古拉山海拔较高的地区工作的工人中，有 56%的人患有 AMS。AMS 的发病率随海拔的升高而增加。快速上升到海拔 3500 米以上、海平面或低地新来者、25 岁以下的年轻人、剧烈体力活动、肥胖者和动脉血氧饱和度（SaO2）低于 80%是独立的 AMS 危险因素。AMS 与性别或服用红景天之间无明显关联。医学教育有助于及早诊断 AMS。
本研究使用了路易湖评分系统，表明该系统是 AMS 现场评估和早期诊断的有效标准。这些研究描述了许多与 AMS 发展相关的危险因素。应关注可修改的危险因素，医生应进行检查和测试，以识别风险较高的患者。预防措施包括持续缓慢上升、医学教育和及时下降，以避免严重 AMS 患者的病情恶化。有效控制 AMS 的危险因素非常重要。
