短期进驻高原健康人群急性高原反应与高原环境特征、睡眠障碍的关系研究  

Relationship between high altitude environmental characteristics and acute mountain sickness and sleep disorder in healthy people entering high altitude for short time

作　　者：马燕[1,2] 李华 杜红霞[2] 李伟[2] 牛冰冰[3] 吴悠悠 MA Yan;LI Hua;DU Hongxia;LI Wei;NIU Bingbing;WU Youyou(College of Nursing and Rehabilitation of Shandong University,Jinan,Shandong 250213,China;不详)

机构地区：[1]山东大学护理与康复学院,山东济南250213 [2]济南市中心医院 [3]联勤保障部队第九四〇医院野战医疗所

出　　处：《中国国境卫生检疫杂志》2024年第6期570-573,共4页Chinese Journal of Frontier Health and Quarantine

基　　金：济南市卫健委科技计划项目(2023-2-19)。

摘　　要：目的自制高原环境特征量表探讨高原环境特征与急性高原反应、呼吸困难和睡眠障碍的关系。方法2022年7-9月,采取便利抽样法选取短期进驻青海格尔木地区的汉族健康人群,且在进驻高原(海拔高度≥3000 m)3 d内明确诊断为急性高原反应者120名作为研究对象。采用一般资料问卷、高原环境特征量表、急性高原反应量表、改良呼吸困难量表、失眠严重程度指数量表进行调查,探讨变量间的相关关系及作用路径。结果相关性分析显示,呼吸困难与高原环境特征(r=0.21,P<0.05)、急性高原反应(r=0.55,P<0.01)、睡眠障碍(r=0.56,P<0.01)呈正相关;睡眠障碍与急性高原反应(r=0.51,P<0.01)呈正相关。回归分析显示,呼吸困难、睡眠障碍对急性高原反应解释率明显增加(R~2=0.509,P<0.01),产生显著的正向作用;平行中介效应分析显示,呼吸困难在急性高原反应与睡眠障碍之间起部分中介作用[效应值=0.130,95%CI(0.104,0.345)],在高原环境特征与睡眠障碍之间起完全中介作用[效应值=0.054,95%CI(0.013,0.232)]。链式中介效应分析结果显示,高原环境特征→呼吸困难→急性高原反应→睡眠障碍的效应值=0.020,95%CI(0.002,0.047),链式中介效应显著。结论高原环境特征影响呼吸,进而影响急性高原反应的发生及严重程度,最后导致不同程度的睡眠障碍。Objective To develop High Altitude Environmental Characteristics Scale(PES)and explore the relationship between high altitude environmental characteristics and acute mountain sickness(AMS),respiratory difficulty and sleep disorder.Methods From July to September 2022,a total of 120 Han healthy individuals who were temporarily stationed in Golmud,Qinghai,and had been diagnosed with AMS within 3 days of entering the plateau(altitude≥3000 m)were selected as the research subjects by using convenience sampling method.High Altitude Environmental Charac-teristics Scale,Acute High Altitude Response Scale,Modified Respiratory Difficulty Scale(MMRS)and Insomnia Severity Index Scale(ISI)were used for investigation to explore the correlation between variables and their pathways of action.Results The correlation analysis showed that respiratory difficulty was positively correlated with high alti-tude environmental characteristics(r=0.21,P<0.05),AMS(r=0.55,P<0.01)and sleep disorder(r=0.56,P<0.01).Sleep disorder were positively correlated with AMS(r=0.51,P<0.01).The regression analysis showed that respiratory difficulty and sleep disorder significantly increased the explanatory power of AMS(R2=0.509,P<0.01),producing a significant positive effect.The parallel mediation analysis showed that respiratory difficulty partially mediated the relation-ship between AMS and sleep disorder[β=0.130,95%CI(0.104,0.345)],fully mediated the relationship between high altitude environmental characteristics and sleep disorder[β=0.054,95%CI(0.013,0.232)].The chain mediation analysis showed that high altitude environmental characteristics→respiratory difficulty→AMS→sleep disorder[β=0.020,95%CI(0.002,0.047)],which was significant.Conclusion High altitude environmental characteristics affected respiratory difficulty,which in turn affected the occurrence and severity of AMS,ultimately leading to sleep disorder.

关 键 词：急性高原反应 睡眠障碍 呼吸困难 高原环境特征 

分 类 号：R339.54[医药卫生—人体生理学]