Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Sports Health. 2010 Jul;2(4):291-300. doi: 10.1177/1941738110373065.
Sports and other activities at high altitude are popular, yet they pose the unique risk for high-altitude illness (HAI). Once those who have suffered from a HAI recover, they commonly desire or need to perform the same activity at altitude in the immediate or distant future.
As based on key text references and peer-reviewed journal articles from a Medline search, this article reviews the pathophysiology and general treatment principles of HAI.
In addition to the type of HAI experienced and the current level of recovery, factors needing consideration in the return-to-play plan include physical activity requirements, flexibility of the activity schedule, and available medical equipment and facilities. Most important, adherence to prudent acclimatization protocols and gradual ascent recommendations (when above 3000 m, no more than 600-m net elevation gain per day, and 1 rest day every 1 to 2 ascent days) is powerful in its preventive value and thus strongly recommended. When these are not practical, prophylactic medications (acetazolamide, dexamethasone, salmeterol, nifedipine, or phosphodiesterase inhibitors, depending on the type of prior HAI) may be prescribed and can reduce the risk of illness. Athletes with HAI should be counseled that physical and mental performance may be adversely affected if activity at altitude continues before recovery is complete and that there is a risk of progression to a more serious HAI.
With a thoughtful plan, most recurrent HAI in athletes can be prevented.
在高海拔地区进行运动和其他活动很受欢迎，但它们会带来高海拔病（HAI）的独特风险。一旦患有 HAI 的人康复，他们通常会渴望或需要在不久的将来或遥远的将来在高海拔地区进行相同的活动。
基于关键文本参考文献和 Medline 搜索的同行评议期刊文章，本文综述了 HAI 的病理生理学和一般治疗原则。
除了所经历的 HAI 类型和当前的恢复水平外，返回运动计划中需要考虑的因素包括身体活动要求、活动计划的灵活性以及可用的医疗设备和设施。最重要的是，遵守谨慎的适应方案和逐渐上升的建议（在 3000 米以上时，每天的净海拔升高不超过 600 米，每 1 到 2 个上升日休息 1 天）具有强大的预防价值，因此强烈推荐。当这些不可行时，可以开具预防性药物（乙酰唑胺、地塞米松、沙美特罗、硝苯地平或磷酸二酯酶抑制剂，具体取决于先前 HAI 的类型），可以降低患病风险。患有 HAI 的运动员应该得到劝告，如果在完全康复之前继续在高海拔地区活动，身体和精神表现可能会受到不利影响，并且存在向更严重 HAI 发展的风险。
如果制定了深思熟虑的计划，大多数运动员的复发性 HAI 是可以预防的。
