Clinical, Laboratory and Imaging Features of High Altitude Pulmonary Edema in Tibetan Plateau

Li Zongbin; Chen Hongyan; Li Jiayue; Li Gaoyuan; Liu Chunwei; Chen Yundai

doi:10.24920/11813

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Clinical, Laboratory and Imaging Features of High Altitude Pulmonary Edema in Tibetan Plateau

Chinese Medical Sciences Journal Vol. 33, Issue 3, Pages: 160-173(2018)

ORIGINAL ARTICLE | Updated：2024-04-10

- Clinical, Laboratory and Imaging Features of High Altitude Pulmonary Edema in Tibetan Plateau
- Affiliations：
  
  1 Department of Cardiology, Chinese PLA General Hospital, Beijing 100853, China
  2 Department of Pulmonary and Cardiology, Chinese PLA 22 Hospital, Geermu, Qinghai 816000, China
- Author bio：
- Funds：
- DOI：10.24920/11813
  CLC：
- Published Online：20 September 2018，
  
  Published：20 September 2018
- Accepted：
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Li Zongbin, Chen Hongyan, Li Jiayue, et al. Clinical, Laboratory and Imaging Features of High Altitude Pulmonary Edema in Tibetan Plateau[J]. Chinese medical sciences journal, 2018, 33(3): 160-173.
DOI：

Li Zongbin, Chen Hongyan, Li Jiayue, et al. Clinical, Laboratory and Imaging Features of High Altitude Pulmonary Edema in Tibetan Plateau[J]. Chinese medical sciences journal, 2018, 33(3): 160-173. DOI： 10.24920/11813.

摘要

目的

分析中国人高原肺水肿的临床特征及实验室与影像学特点。

方法

本研究对98例高原肺水肿患者进行了回顾性分析

通过阅读病历、统计分析

总结了高原肺水肿患者住院时及出院前的临床特征、实验室及影像学特点。

结果

48例患者(49.0%)在海拔2800米至3000米发生高原肺水肿

95例患者 (96.9%)是男性。湿罗音分布在两肺

14例患者右肺的湿罗音强度强于左肺。入院时

患者的白细胞计数[（12.83±5.55)×109/L比(8.95±3.23)×109/L

P=0.001）]及中性粒细胞计数[（11.34±3.81)×109/L比(7.49±2.83)×109/L

P=0.001）]

显著高于出院时

而白细胞的其他类型计数显著低于出院时。入院时的血清碱性磷酸酶（115.8±37.6 mmol/L比85.7±32.4 mmol/L

P=0.020）

胆碱酯酶（7226.2± 1631.8 mmol/L比6285.3±1693.3 mmol/L

P=0.041）

肌酐（401.9±114.2 mmol/L比75.1±12.8 mmol/L

P=0.021）

尿酸（85.2±17.1 mmol/L比326.0±154.3

P=0.041）

以及尿糖浓度（7.20±1.10 mmol/L比5.51±1.11 mmol/L

P=0.001）显著高于出院时。入院时的二氧化碳结合力（26.7±4.42 mmol/L比28.9±4.50 mmol/L

P=0.042）及血清钙（2.32±0.13比2.41±0.10 mmol/L

P=0.006）显著低于出院时。入院时血气分析表现为低氧血症合并呼吸性碱中毒。

结论

男性更容易发生高原肺水肿

发生高原肺水肿时右肺损伤较左肺为重。高原肺水肿发生时部分血常规、血生化、血气分析结果发生变化。

Abstract

Objective

To analyze characteristics of high altitude pulmonary edema (HAPE) in Chinese patients.

Methods

We performed a retrospective study of 98 patients with HAPE. We reviewed the medical records and summarized the clinical

laboratory and imaging characteristics of these cases

and compared the results on admission with those determined before discharge.

Results

Forty-eight (49.0%) patients developed HAPE at the altitude of 2800 m to 3000 m. Ninty-five (96.9%) patients were man. Moist rales were audible from the both lungs

and moist rales over the right lung were clearer than those over the left lung in fourteen patients. The white blood cells [(12.83±5.55)

versus

(8.95±3.23) ×10

=0.001)] as well as neutrophil counts [(11.34±3.81)

versus

(7.49±2.83)×10

=0.001)] were higher

whereas the counts of other subsets of white blood cells were lower on admission than those after recovery (all

0.05). Serum levels of alkaline phosphatase (115.8±37.6

versus

85.7±32.4 mmol/L

=0.020)

cholinesterase (7226.2±1631.8

versus

6285.3±1693.3 mmol/L

=0.040)

creatinine (85.2±17.1

versus

75.1±12.8 mmol/L

=0.021)

uric acid (401.9±114.2

versus

326.0±154.3 mmol/L

=0.041)

and uric glucose (7.20±1.10

versus

5.51±1.11 mmol/L

=0.001) were higher

but carbondioxide combining power (CO

26.7±4.4

versus

28.9±4.5 mmol/L

=0.042) and serous calcium (2.32±0.13

versus

2.41±0.10 mmol/L

=0.006) were lower on admission. Arterial blood gas results showed hypoxemia and respiratory alkalosis on admission.

Conclusions

In the present research

men were more susceptible to HAPE than women

and in the process of HAPE

the lesions of the right lung were more serious than those of the left lung. Some indicators of routine blood test and blood biochemistry of HAPE patients changed.

关键词

Keywords

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