Li Zong-Bin, Chen Hong-Yan, Li Jia-Yue, Li Gao-Yuan, Liu Chun-Wei, Chen Yun-Dai
Department of Cardiology, Chinese PLA General Hospital, Beijing 100853, China.
Department of Pulmonary and Cardiology, Chinese PLA 22 Hospital, Geermu, Qinghai 816000, China.
Chin Med Sci J. 2018 Sep 20;33(3):160-173. doi: 10.24920/11813.
Objective To analyze characteristics of high altitude pulmonary edema (HAPE) in Chinese patients.Methods We performed a retrospective study of 98 patients with HAPE. We reviewed the medical records and summarized the clinical, laboratory and imaging characteristics of these cases, and compared the results on admission with those determined before discharge.Results Forty-eight (49.0%) patients developed HAPE at the altitude of 2800 m to 3000 m. Ninty-five (96.9%) patients were man. Moist rales were audible from the both lungs, and moist rales over the right lung were clearer than those over the left lung in fourteen patients. The white blood cells [(12.83±5.55) versus (8.95±3.23) ×10 /L, P=0.001)] as well as neutrophil counts [(11.34±3.81) versus (7.49±2.83)×10 /L, P=0.001)] were higher, whereas the counts of other subsets of white blood cells were lower on admission than those after recovery (all P<0.05). Serum levels of alkaline phosphatase (115.8±37.6 versus 85.7±32.4 mmol/L, P=0.020), cholinesterase (7226.2±1631.8 versus 6285.3±1693.3 mmol/L, P=0.040), creatinine (85.2±17.1 versus75.1±12.8 mmol/L, P=0.021), uric acid (401.9±114.2 versus 326.0±154.3 mmol/L, P=0.041), and uric glucose (7.20±1.10 versus 5.51±1.11 mmol/L, P=0.001) were higher, but carbondioxide combining power (COCP, 26.7±4.4 versus 28.9±4.5 mmol/L, P=0.042) and serous calcium (2.32±0.13 versus 2.41±0.10 mmol/L, P=0.006) were lower on admission. Arterial blood gas results showed hypoxemia and respiratory alkalosis on admission. Conclusions In the present research, men were more susceptible to HAPE than women, and in the process of HAPE, the lesions of the right lung were more serious than those of the left lung. Some indicators of routine blood test and blood biochemistry of HAPE patients changed.
目的 分析中国患者高原肺水肿（HAPE）的特征。方法 对98例HAPE患者进行回顾性研究。查阅病历，总结这些病例的临床、实验室及影像学特征，并比较入院时与出院前的检查结果。结果 48例（49.0%）患者在海拔2800 m至3000 m处发生HAPE。95例（96.9%）为男性。双肺可闻及湿啰音，14例患者右肺湿啰音比左肺更清晰。入院时白细胞计数[（12.83±5.55）对（8.95±3.23）×10⁹/L，P = 0.001]及中性粒细胞计数[（11.34±3.81）对（7.49±2.83）×10⁹/L，P = 0.001]较高，而其他白细胞亚群计数低于恢复后（均P < 0.05）。入院时血清碱性磷酸酶（115.8±37.6对85.7±32.4 mmol/L，P = 0.020）、胆碱酯酶（7226.2±1631.8对6285.3±1693.3 mmol/L，P = 0.040）、肌酐（85.2±17.1对75.1±12.8 mmol/L，P = 0.021）、尿酸（401.9±114.2对326.0±154.3 mmol/L，P = 0.041）及血糖（7.20±1.10对5.51±1.11 mmol/L，P = 0.001）较高，但二氧化碳结合力（COCP，26.7±4.4对28.9±4.5 mmol/L，P = 0.042）及血清钙（2.32±0.13对2.41±0.10 mmol/L，P = 0.006）较低。动脉血气结果显示入院时存在低氧血症及呼吸性碱中毒。结论 在本研究中，男性比女性更易患HAPE，且在HAPE过程中，右肺病变比左肺更严重。HAPE患者的一些血常规及血液生化指标发生了变化。
