de Meer K, Heymans H S, Zijlstra W G
Department of Paediatrics, University Children's Hospital Het Wilhelmina Kinderziekenhuis, Utrecht, The Netherlands.
Eur J Pediatr. 1995 Apr;154(4):263-72.
Children permanently exposed to hypoxia at altitudes of > 3000 m above sea level show a phenotypical form of adaptation. Under these environmental conditions, oxygen uptake in the lungs is enhanced by increases in ventilation, lung compliance, and pulmonary diffusion. Lung and thorax volumes in children growing up at high altitude are increased. The haemoglobin concentration in highlanders is elevated. With respect to the decreased arterial oxygen tension at high altitude, this seems a useful adaptation. Blood viscosity also increases as a result of the increase in red blood cell concentrations however, and this has potentially negative effects on the microcirculation in the tissues. The decreased partial pressure of oxygen in the lungs of highland children is associated with a higher pulmonary artery pressure. Pulmonary hypertension, high altitude pulmonary oedema, and chronic mountain sickness form part of the pathophysiology afflicting highland dwellers. Birth weight at high altitude is decreased. Decreased postnatal growth has been widely reported in populations at high altitude, particularly in early studies from the Andes. Recent studies taking into account the effects of socio-economic deprivation, suggest that long-term exposure to altitudes of 2500-3900 m is associated with a moderate reduction in linear growth in children.
长期暴露于海拔3000米以上低氧环境的儿童会表现出一种适应性表型。在这些环境条件下，肺通气量、肺顺应性和肺扩散增加，从而增强了肺对氧气的摄取。在高海拔地区成长的儿童，其肺和胸廓容积会增大。高原居民的血红蛋白浓度会升高。鉴于高海拔地区动脉血氧分压降低，这似乎是一种有益的适应。然而，红细胞浓度增加也会导致血液粘度增加，这对组织中的微循环可能产生负面影响。高原儿童肺部氧分压降低与肺动脉压升高有关。肺动脉高压、高原肺水肿和慢性高原病是困扰高原居民病理生理学的一部分。高海拔地区的出生体重会降低。高海拔人群出生后生长发育减缓的情况已被广泛报道，尤其是在安第斯山脉早期的研究中。最近考虑到社会经济剥夺影响的研究表明，长期暴露于海拔2500 - 3900米的环境与儿童线性生长适度减缓有关。
