Eigenberger Paul, Faino Anna, Maltzahn Joanne, Lisk Christina, Frank Eddie, Frank Amy, Loomis Zoe, Schroeder Thies, Strand Matthew, Irwin David
University of Colorado, Denver, Anschutz Medical Campus, Aurora, CO, USA.
Aviat Space Environ Med. 2014 Nov;85(11):1125-9. doi: 10.3357/ASEM.4037.2014.
High altitude illnesses (HAI) are a risk factor for any individual who is exposed to a significant increase in altitude. To learn more about the epidemiology of HAI, we sought to determine if health records from a commercial trekking company could provide novel data on the prevalence of HAI, as well as efficacy data regarding common HAI therapeutics.
Health parameters from 917 tourists ascending Mt. Kilimanjaro over a 10-yr period were analyzed for meaningful data.
Of all subjects, 70% experienced at least one instance of a symptom related to HAI (headache, nausea, vomiting, diarrhea, or loss of appetite) during the trek. Acetazolamide was used at least once by 90% of subjects and, of those who used acetazolamide, 92% began taking it on day 1 of the ascent. Acetazolamide was found to improve oxygen saturation 1.2% above 9842.5 ft (3000 m). Dexamethasone use 12 h prior to ascending above 18,996 ft (5790 m) decreased the probability of a subject exhibiting at least one AMS symptom at that altitude.
The prevalence of AMS symptoms was not reduced by taking 2 extra days to reach the summit of Mt. Kilimanjaro. Prophylactic acetazolamide modestly improved oxygen saturation; however, it did not reduce symptoms. Therapeutic dexamethasone, especially at higher altitudes, was effective at reducing symptoms. We conclude that meaningful high altitude physiological data can be obtained from private trekking companies.
高原病（HAI）是任何暴露于海拔显著升高环境中的个体所面临的风险因素。为了更深入了解高原病的流行病学，我们试图确定一家商业徒步旅行公司的健康记录是否能提供有关高原病患病率的新数据，以及有关常见高原病治疗方法的疗效数据。
分析了10年间攀登乞力马扎罗山的917名游客的健康参数，以获取有意义的数据。
在所有受试者中，70%在徒步旅行期间至少经历过一次与高原病相关的症状（头痛、恶心、呕吐、腹泻或食欲不振）。90%的受试者至少使用过一次乙酰唑胺，在使用乙酰唑胺的受试者中，92%在登山第一天就开始服用。发现乙酰唑胺可使海拔9842.5英尺（3000米）以上的血氧饱和度提高1.2%。在海拔超过18996英尺（5790米）前12小时使用地塞米松可降低受试者在该海拔出现至少一种急性高山病症状的概率。
多花两天时间到达乞力马扎罗山顶峰并没有降低急性高山病症状的患病率。预防性使用乙酰唑胺适度提高了血氧饱和度；然而，它并没有减轻症状。治疗性使用地塞米松，尤其是在更高海拔地区，对减轻症状有效。我们得出结论，可从私人徒步旅行公司获得有意义的高原生理数据。
