急性高原病发生相关因素及生理参数变化特征

doi:10.6040/j.issn.1671-7554.0.2026.0665

摘要/Abstract

摘要： 目的探讨急进高原人群急性高原病(acute mountain sickness, AMS)发生相关因素及高原暴露前后生理参数变化特征。方法纳入2024年在西藏地区招募并完成高原暴露前后资料采集的男性受试者101例,根据高原暴露后路易斯湖评分分为非AMS组(n=59)和AMS组(n=42)。收集两组人口学资料、危险因素及高原暴露前后外周血氧饱和度(peripheral oxygen saturation, SpO₂)、心率、血压、平均动脉压(mean arterial pressure, MAP)和心率血压乘积(rate pressure product, RPP)等指标,比较两组差异,并采用logistic回归分析AMS发生相关因素。结果高原暴露后,两组SpO₂显著下降,心率、收缩压、MAP和RPP升高(P<0.05)。高原暴露前,AMS组与非AMS组静息生理指标差异均无统计学意义(P>0.05),但AMS组首次进入高原、吸烟史和饮酒史比例高于非AMS组(P<0.05)。高原暴露后,AMS组SpO₂低于非AMS组,收缩压、舒张压和RPP高于非AMS组(P<0.05)。变化值比较显示,AMS组SpO₂下降幅度大于非AMS组(P=0.01)。多因素logistic回归分析显示,首次进入高原与AMS发生呈相关性(OR=5.42,95%CI:1.80~16.29,P=0.003)。结论急进高原后人群出现明显氧合下降和心血管代偿增强。高原暴露前常规静息生理指标难以区分AMS和非AMS,首次进入高原是AMS发生的重要相关因素;SpO₂下降幅度和RPP升高可作为高原暴露后AMS现场识别与分层管理的参考指标。

关键词: 急性高原病, 外周血氧饱和度, 心率血压乘积, 危险因素

Abstract: Objective To investigate the factors associated with acute mountain sickness(AMS)and characterize changes in physiological parameters before and after high-altitude exposure in individuals undergoing rapid ascent. Methods A total of 101 male participants recruited in Xizang in 2024 with complete data before and after high-altitude exposure were included. According to the Lake Louise score after altitude exposure, participants were assigned to the non-AMS(nAMS)group,(n=59)or AMS group(n=42). Demographic characteristics, potential risk factors, peripheral oxygen saturation(SpO₂), heart rate, blood pressure, mean arterial pressure(MAP), and rate pressure product(RPP)were collected and compared between groups. Logistic regression was used to analyze factors associated with AMS. Results After high-altitude exposure, SpO₂ decreased significantly, whereas heart rate, systolic blood pressure, MAP, and RPP increased significantly in the whole cohort(P<0.05). Before high-altitude exposure, resting physiological parameters did not differ significantly between the AMS and nAMS groups(P>0.05), whereas the proportions of participants with first-time high-altitude exposure, smoking history, and drinking history were higher in the AMS group(P<0.05). After high-altitude exposure, the AMS group had lower SpO₂ and higher systolic blood pressure, diastolic blood pressure, and RPP than the nAMS group(P<0.05). The decrease in SpO₂ was greater in the AMS group(P=0.01). Multivariate logistic regression showed that first-time high-altitude exposure was independently associated with AMS(OR=5.42, 95%CI: 1.80-16.29, P=0.003). Conclusion Rapid ascent to high altitude is accompanied by marked oxygen desaturation and enhanced cardiovascular compensation. Routine resting physiological parameters before high-altitude exposure can not distinguish AMS from nAMS, whereas first-time high-altitude exposure may be associated with an increased risk of AMS. Dynamic changes in SpO₂ and cardiovascular parameters after high-altitude exposure may provide objective references for AMS risk assessment.

Key words: Acute mountain sickness, Peripheral oxygen saturation, Rate pressure product, Risk factor

中图分类号:

R594.3

丁文静,杨一帆,胡忻雨,爱丽菲拉·艾力,张昊芃,薛新颖,潘磊. 急性高原病发生相关因素及生理参数变化特征[J]. 山东大学学报 (医学版), 2026, 64(8): 64-70.

DING Wenjing, YANG Yifan, HU Xinyu, AILI Ailifeila, ZHANG Haopeng, XUE Xinying, PAN Lei. Factors associated with acute mountain sickness and characteristics of physiological parameters[J]. Journal of Shandong University (Health Sciences), 2026, 64(8): 64-70.

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