高原驻训人员高原脱适应症发病特征与影响因素调查分析  

Investigation and analysis on epidemiological features and influencing factors of HADAS among encamping training personnel at high altitude

作　　者：谢佳新 吴玉[1] 董华平 钟志凤 周思敏[1] 李鹏[1] 张钢[1] Xie Jiaxin;Wu Yu;Dong Huaping;Zhong Zhifeng;Zhou Simin;Li Peng;Zhang Gang(Department of High Altitude Operational Medicine,College of High Altitude Military Medicine,Army Medical University/Key Laboratory of Extreme Environmental Medicine of Army Medical University/Key Laboratory of High Altitude Medicine,Army Medical University,Chongqing,400038,China)

机构地区：[1]陆军军医大学高原军事医学系高原作业医学教研室、极端环境医学教育部重点实验室、全军高原医学重点实验室,重庆400038

出　　处：《西南国防医药》2021年第6期556-560,共5页Medical Journal of National Defending Forces in Southwest China

基　　金：国家自然科学基金(81571842)。

摘　　要：目的调查高原驻训人员返回低海拔地区后高原脱适应证(high altitude de-acclimatization syndrome,HADAS)的发病特征并探索其相关因素,为HADAS的科学防治提供线索。方法对在西藏阿里地区(4300 m)驻训1年并返回平原1月的456名官兵进行体格检查,同时对其中356名官兵进行HADAS问卷调查。结果HADAS总发病率为53.93%(192/356),最常见的HADAS症状依次为嗜睡(58.02%)、精力不集中(53.35%)、疲倦(51.31%),均以轻度症状为主。进驻高原中急性高原反应史显著增加HADAS发病风险(OR=2.20,95%CI:1.33~3.63,P=0.002)。相关性分析发现,高原驻训期间的慢性高原病症状评分与HADAS症状得分呈显著正相关(rs=0.765,P<0.01)。急性高原反应史结合5~7个慢性高原病症状对预测HADAS具有较好的灵敏度(88.10%)与特异度(92.31%)。结论对高原缺氧环境的反应显著影响返回平原后的HADAS的发生,结合个体急性高原反应史与慢性高原症状对HADAS具有较好的预测价值。Objective To investigate the epidemiological features and related factors of high altitude de-acclimatization(HADAS) among the encamping personnel after return to low altitude areas, thus providing guidance for scientific prevention and treatment of HADAS. Methods Physical examination was carried out for 456 officers and soldiers who had stationed in Ali area of Tibet(4300 m) for one year and returned one month ago, among which 356 received HADAS questionnaire. Results The total incidence of HADAS was 53.93%(192/356). The most common symptoms were drowsiness(58.02%), inattention(53.35%), and fatigue(51.31%), all of which were typically mild. History of acute mountain sickness(AMS) in the process of ascending to the plateau significantly increased the risk of HADAS(OR=2.20, 95%CI: 1.33-3.63, P=0.002). Correlation analysis revealed that there was a significantly positive correlation between chronic mountain sickness(CMS) symptoms score during the encamping at high altitude and the HADAS symptoms score(rs=0.765, P=0.002). The history of AMS combined with five to seven CMS symptoms showed good sensitivity(88.10%) and specificity(92.31%) in predicting HADAS. Conclusion The response to high altitude anoxic environment significantly affects the occurrence of HADAS after returning to the plain. The combination of AMS and CMS is effective in predicting HADAS.

关 键 词：高原脱适应症 急性高原反应 慢性高原病 影响因素 

分 类 号：R594.3[医药卫生—内科学]