a School of Sport, Exercise, & Rehabilitation Sciences , University of Birmingham , Birmingham , UK.
b Department of Vascular Surgery , University Hospitals of Coventry and Warwickshire; Warwick Medical School , Coventry , UK.
Expert Opin Pharmacother. 2018 Dec;19(17):1891-1902. doi: 10.1080/14656566.2018.1528228. Epub 2018 Oct 11.
The physiological responses on exposure to high altitude are relatively well known, but new discoveries are still being made, and novel prevention and treatment strategies may arise. Basic information has changed little since our previous review in this journal 10 years ago, but considerable more detail on standard therapies, and promising new approaches are now available.
Herein, the authors review the role of pharmacological agents in preventing and treating high-altitude illnesses. The authors have drawn on their own experience and that of international experts in this field. The literature search was concluded in March 2018.
Slow ascent remains the primary prevention strategy, with rapid descent for the management of serious altitude illnesses. Pharmacological agents are particularly helpful when rapid ascent cannot be avoided or when rapid descent is not possible. Acetazolamide remains the drug of choice for prophylaxis of acute mountain sickness. However, evidence indicates that reduced dosage schemes compared to the current recommendations are warranted. Calcium channel blockers and phosphodiesterase inhibitors remain the drugs of choice for the management of high-altitude pulmonary edema. Dexamethasone should be reserved for the treatment of more severe cases of altitude illnesses such as cerebral edema.
人们对暴露于高海拔时的生理反应已经有了较为全面的认识，但仍在不断有新的发现，可能会出现新的预防和治疗策略。自我们十年前在本期刊上进行综述以来，基本信息几乎没有变化，但现在有更多关于标准治疗方法的详细信息，以及有前途的新方法。
本文作者回顾了药物在预防和治疗高山病中的作用。作者借鉴了他们自己以及该领域国际专家的经验。文献检索于 2018 年 3 月结束。
缓慢上升仍然是主要的预防策略，对于严重的高原病则采用快速下降的方法。当无法避免快速上升或无法快速下降时，药物治疗特别有帮助。乙酰唑胺仍然是预防急性高原病的首选药物。然而，有证据表明，与目前的建议相比，减少剂量方案是合理的。钙通道阻滞剂和磷酸二酯酶抑制剂仍然是治疗高原肺水肿的首选药物。地塞米松应保留用于治疗更严重的高原病，如脑水肿。
