University College London Centre for Altitude Space and Extreme Environment Medicine, UCLH NIHR Biomedical Research Centre, Institute of Sport and Exercise Health, London, UK.
Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Physiol Rep. 2021 Apr;9(7):e14809. doi: 10.14814/phy2.14809.
Acute mountain sickness (AMS) occurs when there is failure of acclimatisation to high altitude. The aim of this study was to describe the relationship between physiological variables and the incidence of AMS during ascent to 5300 m. A total of 332 lowland-dwelling volunteers followed an identical ascent profile on staggered treks. Self-reported symptoms of AMS were recorded daily using the Lake Louise score (mild 3-4; moderate-severe ≥5), alongside measurements of physiological variables (heart rate, respiratory rate (RR), peripheral oxygen saturation (SpO ) and blood pressure) before and after a standardised Xtreme Everest Step-Test (XEST). The overall occurrence of AMS among participants was 73.5% (23.2% mild, 50.3% moderate-severe). There was no difference in gender, age, previous AMS, weight or body mass index between participants who developed AMS and those who did not. Participants who had not previously ascended >5000 m were more likely to get moderate-to-severe AMS. Participants who suffered moderate-to-severe AMS had a lower resting SpO at 3500 m (88.5 vs. 89.6%, p = 0.02), while participants who suffered mild or moderate-to-severe AMS had a lower end-exercise SpO at 3500 m (82.2 vs. 83.8%, p = 0.027; 81.5 vs. 83.8%, p < 0.001 respectively). Participants who experienced mild AMS had lower end-exercise RR at 3500 m (19.2 vs. 21.3, p = 0.017). In a multi-variable regression model, only lower end-exercise SpO (OR 0.870, p < 0.001) and no previous exposure to altitude >5000 m (OR 2.740, p-value 0.003) predicted the development of moderate-to-severe AMS. The Xtreme Everest Step-Test offers a simple, reproducible field test to help predict AMS, albeit with relatively limited predictive precision.
急性高原病（AMS）发生于未能适应高原环境时。本研究旨在描述在海拔 5300 米上升过程中，生理变量与 AMS 发生率之间的关系。332 名低地居民志愿者分批次遵循相同的上升路线。采用路易丝湖评分（轻度 3-4 分；中重度≥5 分）每日记录 AMS 症状，同时在标准珠穆朗玛峰极限攀登测试（XEST）前后测量生理变量（心率、呼吸频率（RR）、外周血氧饱和度（SpO ）和血压）。参与者 AMS 总发生率为 73.5%（轻度 23.2%，中重度 50.3%）。患有 AMS 与未患有 AMS 的参与者在性别、年龄、既往 AMS、体重或体重指数方面无差异。既往未攀登过>5000 米的参与者更易发生中重度 AMS。患有中重度 AMS 的参与者在 3500 米静息 SpO 较低（88.5 比 89.6%，p=0.02），而患有轻度或中重度 AMS 的参与者在 3500 米运动后 SpO 较低（82.2 比 83.8%，p=0.027；81.5 比 83.8%，p<0.001）。患有轻度 AMS 的参与者在 3500 米时运动后 RR 较低（19.2 比 21.3，p=0.017）。在多变量回归模型中，仅运动后 SpO 较低（OR 0.870，p<0.001）和既往无>5000 米海拔暴露（OR 2.740，p 值 0.003）预测中重度 AMS 的发生。珠穆朗玛峰极限攀登测试提供了一种简单、可重复的现场测试方法，有助于预测 AMS，但预测精度相对有限。
