McDevitt Marion, McIntosh Scott E, Rodway George, Peelay Jitsupa, Adams Doug L, Kayser Bengt
Division of Emergency Medicine, University of Utah, Salt Lake City, UT.
Division of Emergency Medicine, University of Utah, Salt Lake City, UT.
Wilderness Environ Med. 2014 Jun;25(2):152-9. doi: 10.1016/j.wem.2013.12.027.
Exposure to altitude may lead to acute mountain sickness (AMS) in nonacclimatized individuals. We surveyed AMS prevalence and potential risk factors in trekkers crossing a 5400-m pass in Nepal and compared the results with those of 2 similar studies conducted 12 and 24 years earlier.
In April 2010, 500 surveys were distributed to English-speaking trekkers at 3500 m on their way to 5400 m, of which 332 (66%) surveys were returned complete. Acute mountain sickness was quantified with the Lake Louise Scoring System (LLSS, cutoff ≥3 and ≥5) and the Environmental Statistical Questionnaire III AMS-C score (ESQ-III, cutoff ≥0.7). We surveyed demographics, body mass index (BMI), smoking habit, rate of ascent, awareness of AMS, and acetazolamide use.
Prevalence of AMS was 22%, 23%, and 48% (ESQ-III ≥0.7, LLSS ≥5, and LLSS ≥3, respectively) lower when compared with earlier studies. Risk factors for AMS were younger age, female sex, higher BMI, and smoking habit. Forty-two percent had elementary knowledge about the risk and prevention of AMS. Forty-four percent used acetazolamide. Trekkers took longer to climb from 3500 to 5400 m than in earlier studies.
Prevalence of AMS continued to decline over a period of 24 years, likely as a result of slower ascent and increased use of acetazolamide. The AMS risk factors of younger age, female sex, and high BMI are consistent with prior studies. Awareness of risk and prevention of AMS remains low, indicating an opportunity to better educate trekkers and potentially further reduce AMS prevalence.
对于未适应环境的个体而言，暴露于高原环境可能会导致急性高原病（AMS）。我们对穿越尼泊尔一座5400米山口的徒步旅行者的AMS患病率及潜在风险因素进行了调查，并将结果与12年和24年前开展的两项类似研究的结果进行了比较。
2010年4月，在前往5400米途中海拔3500米处，向讲英语的徒步旅行者发放了500份调查问卷，其中332份（66%）完整返回。采用路易斯湖评分系统（LLSS，临界值≥3和≥5）和环境统计问卷III AMS-C评分（ESQ-III，临界值≥0.7）对急性高原病进行量化。我们调查了人口统计学特征、体重指数（BMI）、吸烟习惯、上升速率、对AMS的认知以及乙酰唑胺的使用情况。
与早期研究相比，AMS的患病率分别降低了22%、23%和48%（分别为ESQ-III≥0.7、LLSS≥5和LLSS≥3）。AMS的风险因素包括年龄较小、女性、较高的BMI和吸烟习惯。42%的人对AMS的风险和预防有基本了解。44%的人使用了乙酰唑胺。与早期研究相比，徒步旅行者从3500米爬到5400米花费的时间更长。
在24年的时间里，AMS的患病率持续下降，这可能是上升速度较慢和乙酰唑胺使用增加的结果。年龄较小、女性和高BMI这些AMS风险因素与先前的研究一致。对AMS风险和预防的认知仍然较低，这表明有机会更好地对徒步旅行者进行教育，并有可能进一步降低AMS的患病率。
