个体慢性高山病症状是认知障碍的早期预警信号。

Individual chronic mountain sickness symptom is an early warning sign of cognitive impairment.

机构信息

State Key Laboratory of Trauma, Burns and Combined Injury, Department of Rocket Force Medicine, College of Military Preventive Medicine, Third Military Medical University, Chongqing, China; Department of High Altitude Operational Medicine, College of High Altitude Military Medicine, Third Military Medical University, Chongqing, China.

Shigatse Hospital, Second Affiliated Hospital of Third Military Medical University, Tibet, China.

出版信息

Physiol Behav. 2020 Feb 1;214:112748. doi: 10.1016/j.physbeh.2019.112748. Epub 2019 Nov 23.

DOI:10.1016/j.physbeh.2019.112748

PMID:31770535

Abstract

OBJECTIVE

To investigate the relationship between various chronic mountain sickness (CMS) symptoms and cognitive performances and identify whether individual CMS symptom can be used as early warning signs of specific cognitive impairment in long-term high altitude migrators.

METHODS

A total of 287 workers living at an altitude of 3850 m for 1-5 years participated in the study. According to the International Qinghai CMS Diagnostic Criteria, a questionnaire survey was conducted to measure the existence and severity of 7 self-perceptible CMS symptoms in addition to hemoglobin (Hb) levels in the blood. Six neurobehavioral tests were then conducted to assess cognitive function, and physiological indices, including Pittsburgh Sleep Quality Index (PSQI) and arterial oxygen saturation were also measured.

RESULTS

Compared with a score of 0 for each CMS symptom, scores of 1-3 universally corresponded to impairment in some aspects of cognition. Moreover, the correlation analysis revealed that subjects with different CMS symptoms exhibited specific aspects of cognitive impairment. Cyanosis was associated with slower auditory and visual reactions, reduced motion agility and poor visual memory ability (R = =0.236, 0.261, 0.155, 0.221, P < 0.01). Sleep disturbance and excessive erythrocytosis were significantly correlated to poor memory ability (R = =0.206~0.251, P < 0.01), and the symptoms of headache were mainly associated with impaired motion agility (R = =0.266, P < 0.01). The results also indicated that Hb ≥ 200 g/L, SpO ≤ 88%, and PSQI scores ≥ 7, which correspond to excessive erythrocytosis, cyanosis and sleep disturbance symptoms respectively, predicted the decline of cognitive function.

CONCLUSIONS

The characteristics of symptoms used in Qinghai CMS Score System were associated with specific cognitive impairments in long-term plateau migrators, which supported the usefulness of monitoring cognitive status using CMS-related symptoms for both CMS patients and non-CMS people at high altitude.

摘要

目的

探讨不同慢性高原病（CMS）症状与认知表现之间的关系，并确定个体 CMS 症状是否可作为长期高海拔移居者特定认知障碍的预警信号。

方法

共 287 名在海拔 3850 米处居住 1-5 年的工人参加了本研究。根据国际青海 CMS 诊断标准，除了血液中的血红蛋白（Hb）水平外，还通过问卷调查来测量 7 种自我感知 CMS 症状的存在和严重程度。然后进行了 6 项神经行为测试来评估认知功能，还测量了生理指标，包括匹兹堡睡眠质量指数（PSQI）和动脉血氧饱和度。

结果

与每个 CMS 症状得分为 0 相比，得分为 1-3 普遍对应于认知的某些方面受损。此外，相关分析显示，具有不同 CMS 症状的受试者表现出特定的认知障碍。发绀与听觉和视觉反应较慢、运动敏捷性降低和视觉记忆能力差有关（R=0.236、0.261、0.155、0.221，P<0.01）。睡眠障碍和红细胞增多与记忆力差显著相关（R=0.206-0.251，P<0.01），头痛症状主要与运动敏捷性降低有关（R=0.266，P<0.01）。结果还表明，Hb≥200g/L、SpO2≤88%和 PSQI 得分≥7 分别对应于红细胞增多、发绀和睡眠障碍症状，预测认知功能下降。