Bian Shi-Zhu, Jin Jun, Zhang Ji-Hang, Li Qian-Ning, Yu Jie, Yu Shi-Yong, Chen Jian-Fei, Yu Xue-Jun, Qin Jun, Huang Lan
Institute of Cardiovascular Diseases of PLA; Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Department of Cardiology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
PLoS One. 2015 Nov 10;10(11):e0142375. doi: 10.1371/journal.pone.0142375. eCollection 2015.
We aimed to describe the heterogeneity in the clinical presentation of acute mountain sickness (AMS) and to identify its primary risk factors.
The participants (n = 163) received case report form questionnaires, and their heart rate (HR), oxygen saturation (SpO2), echocardiographic and transcranial Doppler variables, ability to perform mental and physical work, mood and psychological factors were assessed within 18 to 22 hours after arriving at 3700 m from sea level (500 m) by plane. First, we examined the differences in all variables between the AMS-positive and the AMS-negative groups. Second, an adjusted regression analysis was performed after correlation and principal component analyses.
The AMS patients had a higher diastolic vertebral artery velocity (Vd; p = 0.018), a higher HR (p = 0.006) and a lower SpO2. The AMS subjects also experienced poorer sleep quality, as quantified using the Athens Insomnia Scale (AIS). Moreover, the AMS population exhibited more negative mood states, including anxiety, depression, hostility, fatigue and confusion. Five principal components focused on diverse aspects were also found to be significant. Additionally, more advanced age (p = 0.007), a higher HR (p = 0.034), a higher Vd (p = 0.014), a higher AIS score (p = 0.030), a decreased pursuit aiming capacity (p = 0.035) and decreased vigor (p = 0.015) were risk factors for AMS.
Mood states play critical roles in the development of AMS. Furthermore, an elevated HR and Vd, advanced age, elevated AIS sores, insufficient vigor and decreased mental work capacity are independent risk factors for AMS.
我们旨在描述急性高原病（AMS）临床表现的异质性，并确定其主要危险因素。
参与者（n = 163）填写病例报告表问卷，并在从海平面（500米）乘飞机抵达3700米后18至22小时内，对其心率（HR）、血氧饱和度（SpO2）、超声心动图和经颅多普勒变量、进行脑力和体力工作的能力、情绪和心理因素进行评估。首先，我们检查了AMS阳性组和AMS阴性组之间所有变量的差异。其次，在进行相关性和主成分分析后进行了校正回归分析。
AMS患者的椎动脉舒张期速度（Vd；p = 0.018）较高，心率（HR；p = 0.006）较高，SpO2较低。使用雅典失眠量表（AIS）量化发现，AMS受试者的睡眠质量也较差。此外，AMS人群表现出更多负面情绪状态，包括焦虑、抑郁、敌意、疲劳和困惑。还发现聚焦于不同方面的五个主成分具有显著性。此外，年龄较大（p = 0.007）、心率较高（p = 0.034）、Vd较高（p = 0.014）、AIS评分较高（p = 0.030）、追踪瞄准能力下降（p = 0.035）和活力下降（p = 0.015）是AMS的危险因素。
情绪状态在AMS的发生发展中起关键作用。此外，心率和Vd升高、年龄较大、AIS评分升高、活力不足和脑力工作能力下降是AMS的独立危险因素。
