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高海拔体验人群的临床和生化指标与急性高原病相关联。

Clinical and biochemical indices of people with high-altitude experience linked to acute mountain sickness.

机构信息

Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, 400038, China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, 400038, China.

出版信息

Travel Med Infect Dis. 2023 Jan-Feb;51:102506. doi: 10.1016/j.tmaid.2022.102506. Epub 2022 Nov 19.

Abstract

BACKGROUND

Acute mountain sickness (AMS) is a major health issue for people travelling to high altitudes. This study was designed to comprehensively evaluate the changes in clinical characteristics and biochemical indices of high-altitude travelers and determine whether these changes were associated with AMS.

METHODS

A total of 14 clinical indices and 52 biochemical indices were determined in 22 subjects before and during acute high-altitude exposure. Six hours after passive ascent to 3648 m (Lhasa, China), the Lake Louise Scoring (LLS) system 2018 was used to assess AMS, which was defined as headache with a total LLS ≥3.

RESULTS

Before travelling to high altitudes, uric acid (UA), platelet distribution width (PDW), mitral peak E velocity (MVE), and ejection fraction (EF) were significantly higher in AMS-resistant individuals than in AMS-susceptible ones (all p < 0.05). A good predictive value of UA (0.817, 95% CI: 0.607-1.000) and PDW (0.844, 95% CI: 0.646-1.000) for AMS-susceptible subjects was found. With high-altitude experience, 14 subjects were diagnosed as having AMS. Compared with non-AMS, the changes in UA and number of neutrophils in AMS presented a significant difference (all p < 0.05). The high-altitude-induced changes in UA, area under the curve, specificity, and sensitivity for identifying AMS were 0.883 (95% CI: 0.738-1.000), 83.30%, and 90.00%, respectively.

CONCLUSION

Human presents a compensatory physiological and biochemical response to high-altitude travel at early phase. The UA concentration before travel and its trend with high-altitude experience exhibited good performance for identifying AMS.

摘要

背景

急性高原病(AMS)是高原旅行者的一个主要健康问题。本研究旨在全面评估高原旅行人群的临床特征和生化指标变化,并确定这些变化是否与 AMS 有关。

方法

对 22 名受试者在急性高原暴露前和期间共测定了 14 项临床指标和 52 项生化指标。在被动上升到 3648 米(中国拉萨)后 6 小时,使用 2018 年的路易斯湖评分(LLS)系统评估 AMS,定义为头痛且总 LLS≥3。

结果

在前往高原之前,AMS 抵抗者的尿酸(UA)、血小板分布宽度(PDW)、二尖瓣峰值 E 速度(MVE)和射血分数(EF)明显高于 AMS 易感者(均 p<0.05)。UA(0.817,95%CI:0.607-1.000)和 PDW(0.844,95%CI:0.646-1.000)对 AMS 易感者具有良好的预测价值。随着高原经验的增加,有 14 名受试者被诊断为 AMS。与非 AMS 相比,AMS 患者的 UA 和中性粒细胞数量变化有显著差异(均 p<0.05)。UA、曲线下面积、特异性和敏感性对识别 AMS 的高空诱导变化分别为 0.883(95%CI:0.738-1.000)、83.30%和 90.00%。

结论

人类在高原旅行的早期阶段会出现代偿性的生理和生化反应。旅行前的 UA 浓度及其随高原经验的变化对识别 AMS 表现出良好的性能。

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