Bhalwar Rajvir, Singh Randhir, Ahuja R C, Misra R P
Reader, Dept of PSM, AFMC, Pune 411 040.
Medical Specialist, Military Hospital, Alwar.
Med J Armed Forces India. 1995 Jul;51(3):189-193. doi: 10.1016/S0377-1237(17)30964-4. Epub 2017 Jun 26.
A nested case-control study was undertaken on a cohort of soldiers inducted into high altitude area (11000 to 16000 feet) of Western Himalayas, with the objectives of studying the incidence of high altitude pulmonary oedema (HAPO) and its association with physical exertion and certain other predetermined risk factors. The study indicated that the cumulative incidence of HAPO was 1.42 per 1000 inductions. The association with moderate/strenuous physical exertion within 24 hours of entry into high altitude was significant (Odds ratio (OR) = 3.19; 95% confidence limits (CL) = 1.23 to 8.15); however, this association was not significant for the period 24 to 48 hours or > 48 hours. Physical exertion during first 24 hours was also significantly associated with severity of disease (OR = 14.67, 95% CL = 3.61 to 64.04), but not after 24 hours. Previous history of "high altitude sickness" was also significantly associated with HAPO (OR = 2.74, 95% CL = 1.12 to 6.77). Physical exertion during first 24 hours was found to carry an attributable risk of 2.56 per 1000 inductions and an etiologic fraction of 17.8%. No significant association of HAPO was observed with age, type of inductee (fresh/reinductee), native place, alcohol consumption and smoking.
对一批进驻喜马拉雅山西部高海拔地区（11000至16000英尺）的士兵进行了一项巢式病例对照研究，目的是研究高原肺水肿（HAPO）的发病率及其与体力活动和其他一些预先确定的风险因素之间的关联。研究表明，HAPO的累积发病率为每1000人中有1.42例。进驻高海拔地区后24小时内进行中度/剧烈体力活动与之有显著关联（优势比（OR）=3.19；95%置信区间（CL）=1.23至8.15）；然而，在24至48小时或>48小时期间，这种关联并不显著。最初24小时内的体力活动也与疾病严重程度显著相关（OR = 14.67，95% CL = 3.61至64.04），但在24小时后则不然。“高原病”既往史也与HAPO显著相关（OR = 2.74，95% CL = 1.12至6.77）。发现最初24小时内的体力活动每1000人中有2.56例归因风险，病因分数为17.8%。未观察到HAPO与年龄、入伍类型（新兵/再次入伍者）、籍贯、饮酒和吸烟之间有显著关联。
