Zhao Caitong, Zhao Xinyu, Ma Yan, Liu Yupeng, Chen Renzheng, Sha Lide
Department of Quality Control, General Hospital of Northern Theater Command, Shenyang, China.
Department of Critical Care Medicine, The 967th Hospital of Joint Logistics Support Force of Chinese PLA, Dalian, China.
Front Public Health. 2024 Nov 21;12:1472935. doi: 10.3389/fpubh.2024.1472935. eCollection 2024.
Leisure, work, and sports activities that involve ascending to high altitudes (HA) are growing in popularity, yet they also pose the risk of developing acute mountain sickness (AMS). Despite the dynamic nature of AMS, its prevalence, clinical manifestations, and associated risks have still not to be comprehensively characterized.
A total of 770 healthy males, ranging in age from 18 to 45 years, were included in this study. The subjects were divided into two cohorts: a fast ascent cohort ( = 424) who ascended to 3,650 m by airplane, and a slow ascent cohort ( = 346) who ascended to the same altitude by bus. Subsequently, they all further ascended to 4,400 m. AMS was diagnosed using the Lake Louise Scoring system (LLS), with either the old or new version were employed.
As diagnosed by the old LLS and new LLS, the incidence of AMS was 37.9 and 32.4% at 3650 m, respectively, which decreased to 35.7 and 32.4% after further ascending to 4,400 m in the fast ascent cohort; the incidence of AMS was 26.5 and 23.2% at 3650 m, which increased to 44.5 and 42.3% after further ascending to 4,400 m in the slow ascent cohort. Furthermore, there were noticeable disparities in the occurrence and progression of AMS-related symptoms among cohorts adhering to different ascent protocols. Specifically, fast ascent protocol posed a risk during the initial phase of the ascent, but transformed into a protective effect upon further ascent to a higher altitude.
Ascent protocol emerged as the pivotal influence on the prevalence of AMS and associated manifestations, demonstrating a transition from a risk factor during initial ascent to a protective factor following further ascent to higher altitudes. These findings suggest an innovative strategy for high-altitude expeditions and work endeavors, emphasizing the importance of a strategic plan for ascending to higher altitudes.
涉及攀登到高海拔地区（HA）的休闲、工作和体育活动越来越受欢迎，但它们也带来了患急性高山病（AMS）的风险。尽管AMS具有动态性，但其患病率、临床表现和相关风险仍未得到全面描述。
本研究共纳入770名年龄在18至45岁之间的健康男性。受试者分为两个队列：乘坐飞机上升到3650米的快速上升队列（n = 424）和乘坐巴士上升到相同海拔的缓慢上升队列（n = 346）。随后，他们都进一步上升到4400米。使用路易斯湖评分系统（LLS）诊断AMS，采用旧版或新版均可。
根据旧版LLS和新版LLS诊断，快速上升队列在3650米时AMS的发病率分别为37.9%和32.4%，进一步上升到4400米后降至35.7%和32.4%；缓慢上升队列在3650米时AMS的发病率为26.5%和23.2%，进一步上升到4400米后升至44.5%和42.3%。此外，遵循不同上升方案的队列在AMS相关症状的发生和进展方面存在明显差异。具体而言，快速上升方案在上升初期构成风险，但在进一步上升到更高海拔时转变为保护作用。
上升方案成为影响AMS患病率及相关表现的关键因素，显示出从上升初期的风险因素转变为进一步上升到更高海拔后的保护因素。这些发现为高海拔探险和工作努力提出了一种创新策略，强调了上升到更高海拔的战略计划的重要性。
