Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
BMJ Open. 2013 Jul 17;3(7). doi: 10.1136/bmjopen-2013-003064. Print 2013.
Exposure to altitudes >2500 m can result in acute mountain sickness (AMS), a mild and usually self-limiting condition. Research has attempted to identify factors associated with developing AMS without controlling important factors related to the ascent or collecting a comprehensive set of variables.
The Antarctic Study of Altitude Physiology (ASAP) investigated variables associated with the development of AMS in adults experiencing rapid passive transport to altitude by airplane.
Our prospective observational trial collected data, including personal history, anthropometrics, vital signs, blood samples and pulmonary function, at sea level and at altitude. Statistical analysis utilised independent sample t tests to investigate between-group differences (p<0.05) and a forward, step-wise binary logisitic regression analysis was performed.
Of 248 eligible ASAP participants, those who did not use acetazolamide (N=98) were included in the present analysis.
The diagnosis of AMS using the Lake Louise Symptom Score.
Analysis of participants not using acetazolamide (n=90) found 30 participants developed AMS and 60 participants did not. Estimated plasma volume decreased significantly at altitude (p=0.025) in the AMS group as compared with the No AMS group while body weight did not change (p=0.125). Serum sodium (p=0.045) and low-density lipoprotein (LDL) (p=0.049) levels were higher in the No AMS group. A logistic regression analysis emphasised the contributions of LDL and eosinophil levels in the development of AMS.
These results suggest that the body water regulation and inflammation are key factors in AMS development when all other factors such as the level of physical exertion during ascent, the rate and magnitude of ascent and the use of acetazolamide are controlled.
暴露于 2500 米以上的海拔高度可导致急性高原病（AMS），这是一种轻度且通常是自限性的疾病。研究试图确定与 AMS 发展相关的因素，但未控制与攀登相关的重要因素或收集全面的变量集。
南极高原生理学研究（ASAP）调查了通过飞机快速被动运输到高原的成年人中与 AMS 发展相关的变量。
我们的前瞻性观察性试验在海平面和海拔高度收集了数据，包括个人史、人体测量学、生命体征、血液样本和肺功能。统计分析采用独立样本 t 检验来研究组间差异（p<0.05），并进行了向前、逐步二元逻辑回归分析。
在 248 名符合 ASAP 条件的参与者中，未使用乙酰唑胺的参与者（N=98）被纳入本分析。
使用路易斯湖症状评分诊断 AMS。
在未使用乙酰唑胺的参与者（n=90）中，30 名参与者出现 AMS，60 名参与者未出现 AMS。与无 AMS 组相比，AMS 组的估计血浆体积在海拔高度显著下降（p=0.025），而体重没有变化（p=0.125）。无 AMS 组的血清钠（p=0.045）和低密度脂蛋白（LDL）（p=0.049）水平较高。逻辑回归分析强调了 LDL 和嗜酸性粒细胞水平在 AMS 发展中的作用。
这些结果表明，当控制其他因素（如攀登期间的体力活动水平、攀登的速度和幅度以及乙酰唑胺的使用）时，体液调节和炎症是 AMS 发展的关键因素。
