Institute of Respiratory and Critical Care Medicine, The First Hospital of China Medical University, Shenyang, China; Institute of Respiratory Medicine, Zhejiang Hospital, Hangzhou, China.
Institute of Respiratory Medicine, People's Hospital of Naqu, Naqu, China.
Am J Med Sci. 2021 Aug;362(2):154-160. doi: 10.1016/j.amjms.2020.12.015. Epub 2020 Dec 24.
We aimed to review records from 429 patients with high altitude pulmonary edema (HAPE) to identify some of the salient characteristics associated with this condition.
General information and clinical symptoms, along with laboratory test results from HAPE patients were collected and analyzed. Blood assay results and imaging at admission were compared with those at discharge. Results from routine blood assays were compared among three subgroups of these patients that were generated based upon the duration of their hypoxia exposure.
Of these 429 HAPE patients, 9.32% also showed high altitude cerebral edema (HACE). White blood cell and neutrophil counts, as well as levels of alanine aminotransferase and aspartate aminotransferase, uric acid, lactic dehydrogenase and creatine kinase were all increased in HAPE patients, with further increases observed in those with HAPE combined with HACE. Levels of white blood cells, neutrophils, lymphocytes, and hemoglobin concentrations in HAPE patients at admission were significantly higher than that obtained at discharge. White blood cell and neutrophil counts were lower in patients who developed HAPE after a duration of 7 days of high altitude exposure as compared with those who developed the condition within 1 or 3 days.
A combination of HAPE and HACE was present in 9.32% of the patients with HAPE. HAPE was more prevalent in males. Hepatocytes and the myocardium were likely sites of damage in patients with HAPE, with more severe damage observed in the patients with HAPE/HACE. White blood cell and neutrophil counts were significantly higher than normal ranges and these levels were negatively correlated with the duration of hypoxia exposure.
本研究旨在分析 429 例高原肺水肿(HAPE)患者的病历资料,以探讨与高原肺水肿相关的特征。
收集并分析高原肺水肿患者的一般资料、临床症状、实验室检查结果,比较患者入院和出院时的血液检查和影像学结果。根据患者的缺氧暴露时间,将患者分为三组,比较三组间常规血液检查结果的差异。
429 例高原肺水肿患者中,9.32%合并高原脑水肿(HACE)。高原肺水肿患者的白细胞计数、中性粒细胞计数、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、尿酸、乳酸脱氢酶、肌酸激酶均升高,HACE 合并高原肺水肿患者上述指标进一步升高。高原肺水肿患者入院时白细胞计数、中性粒细胞计数、淋巴细胞计数、血红蛋白浓度均显著高于出院时,发病时间在 7 天以上的患者白细胞计数和中性粒细胞计数显著低于发病时间在 1~3 天的患者。
9.32%的高原肺水肿患者合并 HACE。高原肺水肿在男性中更为常见。高原肺水肿患者可能存在肝、心肌损伤,合并 HACE 者损伤更为严重。白细胞计数和中性粒细胞计数显著高于正常值,且与缺氧暴露时间呈负相关。