Nafstad Per, Stigum Hein, Wu Tianyi, Haldorsen Øyvind Drejer, Ommundsen Kristoffer, Bjertness Espen
Institute of Health and Society, University of Oslo, P.O. Box 1130 Blindern, Oslo, 0318 Norway ; Tibet University Medical College, No. 1 South Luobulinka Road, Lhasa, 850002 Tibet China.
Tibet University Medical College, No. 1 South Luobulinka Road, Lhasa, 850002 Tibet China.
Arch Public Health. 2016 Jun 1;74:23. doi: 10.1186/s13690-016-0134-z. eCollection 2016.
Traveling to Tibet implies a risk for developing acute mountain sickness (AMS), and the size of this problem is likely increasing due to the rising number of tourists. No previous study on AMS has been conducted among the general tourist population in Tibet. Thus, the aim of this study was to estimate the prevalence and determinants of AMS in a large tourist population visiting Lhasa.
A sample of 2385 tourists was recruited from seven randomly selected hotels in Lhasa between June and October 2010. Within three days of their first arrival, the participants filled in a questionnaire based on the Lake Louise Scoring System (LLSS) about AMS-related symptoms and potential contributing factors. AMS was defined as the presence of headache and a cumulative Lake Louise Score ≥4. After estimating the prevalence of AMS, a Log-Binomial Model was applied to analyse the relationship between AMS and selected risk factors.
The prevalence of AMS was 36.7 % (95 % CI: 34.6-38.7 %) and was not dependent on tourists' country of origin. Among the participants who developed AMS, 47.6 % reported that they experienced symptoms within the first 12 h after arriving in Lhasa, and 79.0 % reported that they had to reduce their activity level. A poor or average health condition (adjusted PR 1.63, 95 % CI 1.38-1.93), an age below 55 years (adjusted PR 1.29, 95 % CI 1.04-1.60), a rapid ascent to Lhasa (adjusted PR 1.17, 95 % CI 1.02-1.34) were independent AMS risk factors, while smoking (adjusted PR 0.75, 95 % CI 0.59-0.96) and pre-exposure to high altitude (adjusted PR 0.71, 95 % CI 0.60-0.84) reduced the risk of AMS.
AMS is commonly experienced by tourists visiting Lhasa Tibet, and often affects their activities. The tourists' country of origin did not seem to affect their risk of AMS, and their age was inversely related to AMS. Subjects planning to visit a high-altitude area should be prepared for experiencing AMS-related problems, and consider preventive measures such as pre-exposure or a gradual ascent to high altitudes.
前往西藏旅行存在患急性高原病（AMS）的风险，且由于游客数量不断增加，这一问题可能愈发严重。此前尚未针对西藏普通游客群体开展过AMS相关研究。因此，本研究旨在估算前往拉萨的大量游客中AMS的患病率及相关影响因素。
2010年6月至10月期间，从拉萨随机选取的7家酒店招募了2385名游客作为样本。在他们首次抵达的三天内，参与者根据路易斯湖评分系统（LLSS）填写了一份关于AMS相关症状及潜在影响因素的问卷。AMS定义为出现头痛且路易斯湖累计评分≥4分。在估算AMS患病率后，应用对数二项式模型分析AMS与选定风险因素之间的关系。
AMS患病率为36.7%（95%置信区间：34.6 - 38.7%），且与游客的国籍无关。在出现AMS的参与者中，47.6%报告称他们在抵达拉萨后的前12小时内出现了症状，79.0%报告称他们不得不降低活动水平。健康状况较差或一般（调整后风险比1.63，95%置信区间1.38 - 1.93）、年龄低于55岁（调整后风险比1.29，95%置信区间1.04 - 1.60）、快速抵达拉萨（调整后风险比1.17，95%置信区间1.02 - 1.34）是AMS的独立风险因素，而吸烟（调整后风险比0.75，95%置信区间0.59 - 0.96）和预先暴露于高海拔环境（调整后风险比0.71，95%置信区间0.60 - 0.84）可降低AMS风险。
前往西藏拉萨的游客普遍会经历AMS，且常常影响他们的活动。游客的国籍似乎并不影响其患AMS的风险，而年龄与AMS呈负相关。计划前往高海拔地区的人群应做好应对AMS相关问题的准备，并考虑采取如预先暴露或逐渐攀升至高海拔等预防措施。
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