基于血液学参数的急性高原反应潜在预测指标的筛查分析  

Screening analysis of potential predictors of acute mountain sickness based on hematological parameters

作　　者：叶梓 刘鑫源 陈郁 罗勇军 YE Zi;LIU Xinyuan;CHEN Yu;LUO Yongjun(Department of Military Medical Geography,Army Medical Service Training Base,Army Medical University,Chongqing 400038,China;The Fourth Student Brigade,Basic Medicine College of Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学陆军卫勤训练基地军事医学地理学教研室,重庆400038 [2]陆军军医大学基础医学院学员四大队,重庆400038

出　　处：《重庆医学》2023年第23期3560-3566,共7页Chongqing medicine

基　　金：国家自然科学基金面上项目(42377466);科技部第二次青藏高原综合科学考察研究专题(2019QZKK0607)。

摘　　要：目的急性高原反应(AMS)的发病机制目前仍不清楚,本研究拟通过持续记录平原汉族人群在高原暴露后生理参数的变化,筛选出AMS和高原习服良好人员之间的差异性预测指标。方法招募健康平原汉族人员46例建立研究队列,于平原(海拔500 m,CQ)、到达高原(海拔3650 m)第2天(LS_(1))、第23天(LS_(2))、第44天(LS_(3))、第65天(LS_(4))分别检测其基本生理和血液学参数,并根据到达高原第2天的2018版路易斯湖急性高山病评分系统(LLS)量表评分分为AMS组和非AMS组,分析组间参数差异和持续变化。结果AMS组和非AMS组在任何时间点上,血氧饱和度(SpO_(2))、心率(HR)、血压(BP)、红细胞数(RBC)、血红蛋白(Hb)、红细胞比容(HCT)等基本生理参数组间差异均无统计学意义(P>0.05),血生化参数中仅清蛋白在到达高原第2天和第44天组间差异有统计学意义(P<0.05),且ALB升高与AMS发病率下降明显相关(OR=0.676,95%CI:0.511~0.894,P=0.006)。结论SpO_(2)、RBC、Hb、HCT可能对AMS并无预测价值,而ALB可能是AMS发生的一个良好预测指标,其升高可能在避免AMS发生,促进高原习服中扮演重要角色。Objective The pathogenesis of acute mountain sickness(AMS)is still unclear.This study intends to continuously record the changes of physiological parameters of the Han population in the plain after high altitude exposure,and screen out the difference between AMS and high altitude acclimatization.Methods A total of 46 healthy Han people in the plain were recruited to establish a study cohort.The basic physiological and hematological parameters were measured at the time of in the plain(500 m above sea level,CQ),on the second day(LS_(1)),the 23rd day(LS_(2)),the 44th day(LS_(3))and the 65th day(LS_(4))after reaching the plateau.According to the 2018 version of the Louise Lake Acute Mountain Sickness Scoring System(LLS)scale score at LS_(2),they were divided into the AMS group and the non-AMS group,and the differences and continuous changes of parameters between groups were analyzed.Results At any time point,there was no significant difference in basic physiological and hematological parameters such as oxygen saturation,heart rate(HR),blood pressure(BP),red blood cell count(BRC),hemoglobin(Hb),and hematocrit(HCT)between the two groups(P>0.05).Among the blood biochemical parameters,only albumin(ALB)was statistically significant at the time of LS 2 and LS 3 between the AMS group and the non-AMS group(P<0.05),and the increase of ALB was significantly co rrelated with the decrease of AMS incidence(OR=0.676,95%CI:0.511-0.894,P=0.006).Conclusion Blood oxy gen saturation,BRC,hemoglobin level Hb,Hb may have no predictive value for AMS,while ALB may be a good predictor for AMS,and its changes may play an important role in avoiding AMS and promoting high altitude acclimatization.

关 键 词：急性高原反应 血液指标 清蛋白 高原习服 

分 类 号：R594.3[医药卫生—内科学]