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