出入高原全过程生活方式改良对高原脱适应症的影响  

Effect of lifestyle modification during the whole process of entering and existing the plateau on high-altitude de-adaptation

作　　者：王瑞[1] 赵佳[2] 罗其发 罗勇军[1] WANG Rui;ZHAO Jia;LUO Qifa;LUO Yongjun(Department of Military Medical Geography,Army Medical Service Training Base,Army Medical University(Third Military Medical University),Chongqing,400038;Troop 31670,Wuzhong,Ningxia Hui Autonomous Region,751100,China)

机构地区：[1]陆军军医大学(第三军医大学)陆军卫勤训练基地军事医学地理学教研室,重庆400038 [2]中国人民解放军31670部队,宁夏吴忠751100

出　　处：《陆军军医大学学报》2024年第11期1298-1305,共8页Journal of Army Medical University

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

摘　　要：目的采用问卷调查出入高原全过程的生活方式对高原脱适应症(high-altitude de-adaptation,HADA)的影响,为防治HADA提供科学依据。方法采用病例-对照研究设计方案,以2021-2022年某单位集体从高原返回1~2周的1751人为调查对象,获得有效问卷1544份,根据高原脱适应症量表得分是否≥6分,将调查对象分为高原脱适应组(n=192)与对照组(n=1352)。对研究对象的生活习惯与一般情况进行问卷调查,通过秩和检验比较2组调查对象之间的生活方式是否存在差异,采用非条件Logistic回归分析明确HADA的独立危险因素。结果头发脱落(19.95%)、嗜睡(16.58%)和疲倦(12.31%)为最常见的高原脱适应症症状;且进入高原前高盐饮食,在高原时吸烟、出现高原反应(OR=1.893,95%CI:1.142~3.137,P=0.013)、乘飞机离开高原(OR=1.688,95%CI:1.082~2.634,P=0.021),离开高原后多饮茶、运动强度过高和睡眠不足均为HADA的独立危险因素。结论进入高原前清淡饮食、积极预防高原反应,在高原时戒烟、选择较慢的交通工具出入高原,离开高原后少饮茶、适量运动和保持睡眠充足可以有效降低HADA的发病风险。Objective To investigate the effect of lifestyle on high-altitude de-adaptation(HADA)through questionnaire during the whole process of entering and existing the plateau in order to provide scientific basis for prevention and treatment of the disease.Methods A case-control trial was conducted on 1751 participants from a certain unit who entered and existed the plateau together during 2021 and 2022.In 1 to 2 weeks after they returning from the plateau,they were surveyed,and finally,1544 valid questionnaires were obtained.According to the score of the plateau deacclimation scale≥6 or not,the subjects were divided into plateau deacclimation group(n=192)and control group(n=1352).They were further surveyed for their lifestyles and general conditions.Rank sum test was used to analyze the differences of lifestyles between the 2 groups,and unconditional logistic regression analysis was employed to identify the independent risk factors of HADA.Results Hair loss(19.95%),drowsiness(16.58%)and tiredness(12.31%)were the most common symptoms of HADA.High salt diet before entering the plateau,smoking at the plateau,altitude sickness(OR=1.893,95%CI:1.142~3.137,P=0.013),leaving the plateau by plane(OR=1.688,95%CI:1.082~2.634,P=0.021),and drinking much tea,excessive exercise intensity and insufficient sleep after leaving the plateau were independent risk factors for HADA.Conclusion Low salt diet before entering the plateau,active prevention for altitude sickness,smoking cessation at the plateau,taking a slower means of transportation to enter and leave the plateau,drinking less tea,moderate exercise intensity and keeping enough sleep after leaving the plateau can effectively reduce the risk of HADA.

关 键 词：高原脱适应症 生活方式 高海拔 习服 问卷调查 

分 类 号：R195.1[医药卫生—卫生统计学] R594.3[医药卫生—卫生事业管理]