急性高原反应发生相关的生理学指标研究

doi:10.24920/003518

Abstract

Objective To identify the physiological variables associated with the development of acute mountain sickness (AMS).Methods Eighty four young Chinese men residing at low altitude were taken to an altitude of 4000 m within 40 hours. At sea level and at high altitude, we measured the heart rate, blood pressure, and peripheral oxygen saturation (SpO₂) respectively. We also collect blood samples from each participants before and after the altitude elevation. The blood routine and biochemical examinations were performed for all blood samples. The revised Lake Louise Criteria was adopted to diagnose AMS after the subjects arrived at the target high altitude. The association between the presence of AMS and subjects’ physiological variables were analysed statistically.Results Of 84 participants, 34 (40.5%) developed AMS. Compared with non AMS group, in the AMS group, the percentage of neutrophils was significantly higher (64.5%±11.2% vs. 58.1%±8.8%, P =0.014), while the level of SpO₂ was significantly lower (79.4%±5.4% vs. 82.7%±5.6, P=0.008). Binary logistic regression analyses emphasized the association of neutrophils (OR: 1.06, 95% CI: 1.01-1.12, P=0.034) and SpO₂ level (OR: 0.87, 95% CI : 0.79-0.95, P=0.004) with the development of AMS.Conclusion The ability to sustain SpO₂after altitude elevation and the increase of neutrophils were associated with the development of AMS in young males.

Key words: altitude sickness, hypoxia, physiology

Funding: Fund supported by the National Science and Technology Major Projects for Major New Drugs Innovation and Development No(2014ZX09J1402-02A)

Liu Chunwei, Li Zongbin, Guo Jun, Shi Yajun, Wang Jinli, Chen Yundai. Physiological Variables Associated with the Development of Acute Mountain Sickness[J].Chinese Medical Sciences Journal, 2019, 34(4): 263-269.

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References 29.

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Variables	AMS(+) n=34	AMS(-) n=50	t/Z	P
Age(y)	25.0±1.9	25.6±2.4	-2.096	0.036^*
Weight(kg)	71.6±9.0	71.4±8.4	0.093	0.501†
Height(cm)	175.3±4.7	174.6±4.7	0.676	0.926†
BMI(kg/m²)	23.3±2.6	23.4±2.6	-0.561	0.575^*

Variables	AMS (+) n=34		AMS (-) n=50		t/Z^(a)	P†^(a)	t/Z^(b)	P†^(b)
Variables	Sea level	Altitude	Sea level	Altitude	t/Z^(a)	P†^(a)	t/Z^(b)	P†^(b)
RBC(10¹²/L)	5.3±0.4	5.3±0.3	5.2±0.4	5.2±0.4	1.349	0.181	1.987	0.050
Hb(g/L)	158.0±8.4	164.2±7.5	155.3±8.9	161.0±8.6	1.351	0.180	1.804	0.075
MCH(pg)	30.0±1.1	30.7±1.3	30.2±0.9	31.0±1.0	-0.616	0.539	-1.111	0.270
MCHC(g/L)	335.8±7.4	339.4±10.2	335.0±9.0	338.1±7.0	0.410	0.683	-1.537	0.124^*
MCV(fl)	89.5±3.2	90.4±2.9	90.1±2.6	91.6±3.0	-0.974	0.333	-1.275	0.202^*
WBC(10⁹/L)	7.2±1.8	8.7±2.5	6.5±1.7	8.1±1.7	1.653	0.102	1.169	0.248
Neutrophil (%)	54.5±8.4	64.5±11.2	52.8±6.9	58.1±8.8	0.969	0.335	-2.461	0.014^*
Monocyte (%)	5.5±1.2	3.9±1.0	6.0±1.3	4.9±1.3	-1.223	0.221^*	-3.521	<0.001^*
Basophil (%)	0.6±0.3	0.6±0.3	0.6±0.3	0.6±0.3	-0.010	0.992^*	-0.089	0.929^*
Lymphocyte (%)	36.5±7.5	29.3±10.5	38.3±6.6	34.9±8.1	-1.177	0.243	-2.699	0.008
Eosinophil (%)	2.9±3.6	1.6±1.4	2.8±4.3	1.5±1.2	-0.343	0.731^*	-0.247	0.805^*
Platelet(10⁹/L)	233.6±38.6	220.6±52.8	225.6±47.7	232.4±45.4	0.790	0.432	-1.081	0.283

Variables	AMS (+) n=34		AMS (-) n=50		t/Z^(a)	P†^(a)	t/Z^(b)	P†^(b)
Variables	Sea level	Altitude	Sea level	Altitude	t/Z^(a)	P†^(a)	t/Z^(b)	P†^(b)
ALT(U/L)	22.5±12.7	22.6±17.6	22.6±17.6	21.4±13.6	-1.678	0.093^*	-0.274	0.784^*
ALP(U/L)	69.4±12.8	73.6±19.0	68.0±20.4	77.3±20.6	-0.702	0.483^*	-0.980	0.327^*
TP(g/L)	75.6±3.3	78.3±3.9	75.4±3.2	77.5±4.2	0.345	0.731	0.839	0.404
ALB(g/L)	48.4±2.1	51.6±2.2	48.7±2.2	52.1±2.5	-0.635	0.527	-0.961	0.339
BUN( mmol/L)	4.6±1.2	5.0±0.8	4.7±1.0	5.0±1.0	-1.058	0.290^*	-0.584	0.559^*
Scr(μmol/L)	77.3±8.8	84.3±12.8	77.8±9.7	79.4±11.5	-0.244	0.808	1.833	0.071
Tc( mmol/L)	4.2±0.6	4.3±0.7	4.2±0.7	4.5±0.6	-0.002	0.999	0.598	0.119
HDL(mmol/L)	1.4±0.3	1.3±0.3	1.5±0.3	1.4±0.3	-1.421	0.159	-0.628	0.531
LDL(mmol/L)	2.6±0.6	2.5±0.7	2.6±0.7	2.7±0.6	-0.020	0.984	-0.912	0.364
TBil(μmol/L)	14.1±5.5	7.9±4.3	14.5±5.9	8.4±3.7	-0.105	0.917^*	-0.916	0.360^*
DBil(μmol/L)	4.8±2.0	3.1±1.8	4.9±1.6	3.2±1.0	-0.146	0.884	-1.615	0.106^*
cTnT(μg/L)	0.005±0.002	0.005±0.001	0.005±0.001	0.005±0.001	-1.445	0.148^*	-0.221	0.825^*
Na⁺(mmol/L)	141.6±1.5	143.3±2.0	142.0±2.0	143.6±1.9	-0.959	0.338^*	-1.482	0.138^*
Cl^-(mmol/L)	99.1±2.5	102.3±2.0	99.4±3.0	102.7±1.7	-0.531	0.597	-1.345	0.179^*

Variables	AMS (+) n=34		AMS (-) n=50		t/Z^(a)	P†^(a)	t/Z^(b)	P†^(b)
Variables	Sea level	Altitude	Sea level	Altitude	t/Z^(a)	P†^(a)	t/Z^(b)	P†^(b)
SpO₂(mmHg)	98.3±1.2	79.4±5.4	98.3±1.3	82.7±5.6	-0.074	0.941^*	-2.698	0.008
HR_max(/min)	130±10	134±12	132±14	133±16	-0.921	0.360	0.154	0.878
HR_min(/min)	48±5	53±7	48±5	52±7	0.166	0.869	0.894	0.374
HR_mean(/min)	72±6	82±8	73±8	81±10	-0.480	0.632	0.542	0.590
HRVTI	53.5±13.2	35.3±10.7	51.8±15.5	39.4±10.6	-0.869	0.385^*	-1.554	0.125
SBP_mean(mmHg)	113.5±6.4	119.6±8.3	114.7±6.7	119.5±8.1	-0.792	0.431	0.021	0.983
DBP_mean(mmHg)	69.1±5.9	75.4±7.1	69.9±5.6	74.4±6.8	-0.592	0.555	0.637	0.526
SCV(%)	15.7±5.9	15.6±5.3	15.4±6.7	16.6±6.0	-0.637	0.524^*	-0.803	0.424
DCV(%)	25.0±10.3	25.7±10.6	24.4±9.2	25.1±8.8	-0.195	0.845^*	-0.080	0.936^*

Variables	OR	95% CI	P
Age(y)	0.82	0.63-1.08	0.157
BMI(kg /m²)	0.91	0.74-1.12	0.376
Neutrophil (%)	1.06	1.01-1.12	0.034
SpO₂(mmHg)	0.87	0.79-0.95	0.004
Hb(g/L)	1.05	0.98-1.12	0.200
Scr(μmol/L)	1.02	0.97-1.06	0.459

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