High-altitude gastrointestinal bleeding:An observation in Qinghai-Tibetan railroad construction workers on Mountain Tanggula  

作　　者：Tian-Yi Wu Shou-Quan Ding Jin-Liang Liu Jian-Hou Jia Rui-Chen Dai Dong-Chun Zhu Bao-Zhu Liang De-Tang Qi Yong-Fu Sun 

机构地区：[1]Physiological Research Group of Ministry of Railway, PRC, High Altitude Medical Research Institute, Xining 810012, Qinghai Province, China [2]12^th Hospital of Qinghai-Tibetan Railroad Construction Company, Golmud 816000, Qinghai Province, China [3]20^th Hospital of Qinghi-Tibetan Railroad Construction Company, Golmud 816000, Qinghai Province, China [4]Public Health Bureau of Qinghai-Tibetan Railroad Construction Company, Golmud 816000, Qinghai Province, China [5]China Railroad Construction Company, Beijing 100844, China [6]Ministry of Railway, Beijing 100844, China

出　　处：《World Journal of Gastroenterology》2007年第5期774-780,共7页世界胃肠病学杂志（英文版）

基　　金：Supported by the grant LS-CNNSF-30393130, and 973 Program 2006 CB 504100, CB708514, China

摘　　要：AIM: To investigate the gastrointestinal bleeding (GIB) in people from lowland to high altitude and in workers on Mountain Tanggula and its causes as well as treatment and prophylaxis.METHODS: From 2001 to October 2003, we studied GIB in 13 502 workers constructing the railroad on Mountain Tanggula which is 4905 m above the sea level. The incidence of GIB in workers at different altitudes was recorded. Endoscopy was performed when the workers evacuated to Golmud (2808 m) and Xining (2261 m). The available data on altitude GIB were analyzed.RESULTS: The overall incidence of GIB was 0.49% in 13 502 workers. The incidence increased with increasing altitude. The onset of symptoms in most patients was within three weeks after arrival at high altitude. Bleeding manifested as hematemesis, melaena or hematochezia, and might be occult. Endoscopic examination showed that the causes of altitude GIB included hemorrhage gastritis, gastric ulcer, duodenal ulcer, and gastric erosion. Experimental studies suggested that acute gastric mucosal lesion (AGML) could be induced by hypoxic and cold stress, which might be the pathogenesis of altitude GIB. Those who consumed large amount of alcohol, aspirin or dexamethasone were at a higher risk of developing GIB. Persons who previously suffered from peptic ulcer or high-altitude polycythemia were also at risk of developing GIB. Early diagnosis, evacuation, and treatment led to early recovery. CONCLUSION: GIB is a potentially life threatening disease, if it is not treated promptly and effectively. Early diagnosis, treatment and evacuation lead to an early recovery. Death due to altitude GIB can be avoided if early symptoms and signs are recognized.AIM： To investigate the gastrointestinal bleeding （GIB） in people from lowland to high altitude and in workers on Mountain Tanggula and its causes as well as treatment and prophylaxis. METHODS： From 2001 to October 2003, we studied GIB in 13 502 workers constructing the railroad on Mountain Tanggula which is 4905 m above the sea level. The incidence of GIB in workers at different altitudes was recorded. Endoscopy was performed when the workers evacuated to Golmud （2808 m） and Xining （2261 m）. The available data on altitude GIB were analyzed. RESULTS： The overall incidence of GIB was 0.49% in 13502 workers. The incidence increased with increasing altitude. The onset of symptoms in most patients was within three weeks after arrival at high altitude. Bleeding manifested as hematemesis, melaena or hematochezia, and might be occult. Endoscopic examination showed that the causes of altitude GIB included hemorrhage gastritis, gastric ulcer, duodenal ulcer, and gastric erosion. Experimental studies suggested that acute gastric mucosal lesion （AGML） could be induced by hypoxic and cold stress, which might be the pathogenesis of altitude GIB. Those who consumed large amount of alcohol, aspirin or dexamethasone were at a higher risk of developing GIB. Persons who previously suffered from peptic ulcer or high-altitude polycythemia were also at risk of developing GIB. Early diagnosis, evacuation, and treatment led to early recovery. CONCLUSION： GIB is a potentially life threatening disease, if it is not treated promptly and effectively. Early diagnosis, treatment and evacuation lead to an early recovery. Death due to altitude GIB can be avoided if early symptoms and signs are recognized.

关 键 词：High altitude Gastrointestinal bleeding Hypoxic stress Acute gastric mucosal lesion Risk factors 

分 类 号：R594.3[医药卫生—内科学] R573[医药卫生—临床医学]