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目的通过对急性轻型高原病(急性高原反应,AMS)及高原肺水肿(HAPE)的临床症状、心率(HR)、动脉氧饱和度(Sa O2)及白细胞(WBC)计数的分析,探讨上述指标对HAPE早期预警的意义。方法以628名初入昆仑山的驻训人员为研究对象,按照急性高原病路易斯湖评分系统(LLSS)和临床出现的呼吸系统症状评分的总分归入:A组(健康组,评分<3分),B组(AMS组,至少1次评分>3分,排除HAPE)、C组(HAPE组),比较各组临床症状发生情况及HR、Sa O2,并对部分对象进行WBC计数分析。结果 C组呼吸系统症状发生率及WBC计数较B组明显升高(P<0.05);初入高原3 d内,A、B两组平均HR呈逐渐下降趋势,而C组平均HR却逐渐上升,且在第3天较A、B两组明显升高(F=6.37,P<0.05);C组Sa O2在第1、2、3天明显低于A、B两组(F=8.21,F=8.77,F=9.58,P<0.01)。结论初入高原人群中,出现呼吸系统症状、WBC计数升高、HR无适应性下降及Sa O2显著减低(>30%)者发生HAPE的风险明显增加,这些变化对早期识别预警HAPE具有重要意义。
Objective To investigate the clinical characteristics, acute heart disease (acute altitude sickness, AMS) and high altitude pulmonary edema (HAPE) clinical symptoms, heart rate (HR), arterial oxygen saturation (Sa O2) and white blood cell (WBC) Implications for early warning of HAPE. Methods A total of 628 ambulances who entered the Kunlun Mountains were included in the study. The total score of the LLSS and clinical respiratory symptom scores of acute mountain sickness were included in group A (healthy group, score <3 Group B (AMS group, at least one score> 3 points, excluding HAPE), C group (HAPE group), clinical symptoms and HR, SaO2 in each group were compared, and WBC count analysis was performed on some subjects. Results The incidence of respiratory symptoms and the number of WBC in group C were significantly higher than those in group B (P <0.05). Within 3 days after entering the plateau, the average HR of group A and B decreased gradually, while the average HR of group C gradually increased (F = 6.37, P <0.05). The Sa O2 in group C was significantly lower than that in groups A and B on day 1, 2, and 3 (F = 8.21, F = 8.77, F = 9.58, P <0.01). Conclusions The risk of developing HAPE in early stage high altitude patients with respiratory symptoms, increased WBC count, no adaptive decline in HR, and a significant decrease in Sa O2 (> 30%) is significantly increased, and these changes have important implications for the early identification of HAPE .