Department of Emergency Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
Am J Emerg Med. 2013 Jul;31(7):1113-7. doi: 10.1016/j.ajem.2013.03.028. Epub 2013 May 18.
The objective of this study is to determine the association between the duration of high-altitude (>3000 m) pre-exposure and acute mountain sickness (AMS) incidence.
A prospective observational study was conducted on 2 random days each month from April 2007 to March 2008 at Paiyun Lodge (3402 m), Jade Mountain, Taiwan. Demographic data, prior AMS history, symptoms, and scores and the days and times of high-altitude pre-exposure within the preceding 2 months were obtained from lowland (<1500 m) trekkers.
Totally, 1010 questionnaires were analyzed; 106, 76, and 828 trekkers had pre-exposure lasting at least 3 days (group 1), less than 3 days (group 2), and 0 days (group 3), respectively. Acute mountain sickness incidence was significantly higher in groups 2 and 3 than in group 1 (21.70%, 35.53%, 37.08%, respectively; P = .008). Logistic regression analysis indicated a significantly lower AMS risk in group 1 (group 1, P = .004; odds ratio [OR], 0.479; 95% confidence interval [CI], 0.290-0.791; group 2, P = .226; OR, 0.725; 95% CI, 0.430-1.221). In group 1, 28 and 78 trekkers had single and intermittent multiple pre-exposure, respectively. There was no difference in the incidence or severity of AMS symptoms between single and intermittent multiple pre-exposure (AMS, P = .838; headache, P = .891; dizziness or lightheadedness, P = .414; fatigue and/or weakness, P = .957; gastrointestinal symptoms, P = .257; difficulty sleeping, P = .804; AMS score, P = .796).
High-altitude pre-exposure lasting at least 3 days within the preceding 2 months was associated with a significant lower AMS incidence during a subsequent ascent among Jade Mountain trekkers.
本研究旨在确定高原（>3000 米）暴露前持续时间与急性高原病（AMS）发病率之间的关系。
2007 年 4 月至 2008 年 3 月，在台湾玉山白云山庄（海拔 3402 米），每月随机选择 2 天进行前瞻性观察研究。从低海拔（<1500 米）徒步旅行者处获得人口统计学数据、既往 AMS 病史、症状以及在过去 2 个月内的高海拔暴露天数和时间。
共分析了 1010 份问卷，106、76 和 828 名徒步旅行者的高原暴露时间分别至少为 3 天（第 1 组）、<3 天（第 2 组）和 0 天（第 3 组）。第 2 组和第 3 组的 AMS 发病率显著高于第 1 组（分别为 21.70%、35.53%和 37.08%；P =.008）。Logistic 回归分析表明，第 1 组的 AMS 风险显著降低（第 1 组，P =.004；比值比 [OR]，0.479；95%置信区间 [CI]，0.290-0.791；第 2 组，P =.226；OR，0.725；95% CI，0.430-1.221）。第 1 组中，28 名和 78 名徒步旅行者分别有单次和间歇性多次高原暴露。单次和间歇性多次高原暴露之间的 AMS 症状发生率和严重程度无差异（AMS，P =.838；头痛，P =.891；头晕或头晕，P =.414；疲劳和/或无力，P =.957；胃肠道症状，P =.257；睡眠困难，P =.804；AMS 评分，P =.796）。
在过去 2 个月内，海拔 3000 米以上的高原暴露至少 3 天，与玉山徒步旅行者随后攀登时 AMS 发病率显著降低相关。
