Background: So far, there have been no measurements confirmed useful in diagnosing acute mountain sickness(AMS). The aim of this study was to determine the role of heart rate(HR) difference(ΔHR) and oxygen saturation...Background: So far, there have been no measurements confirmed useful in diagnosing acute mountain sickness(AMS). The aim of this study was to determine the role of heart rate(HR) difference(ΔHR) and oxygen saturation(Sa O2) as objective risk factors in aiding the diagnosis of AMS.Methods: A total of 1,019 participants were assigned to either the acute exposure group(AEG): from 500 m to 3,700 m by flight within 2.5 hours(n=752); or the pre-acclimatization group(PAG): ascended to 4,400 m from 3,650 m within three hours by car after adapting 33 days at 3,650m(n=267). The questionnaires or measurements of resting Sa O2 and HR were completed between 18 and 24 hours before departure and after arrival.Results: Incidence of AMS was 61.3%(461) in AEG, with 46.1%(347) mild cases and 15.2%(114) severe cases. In PAG, the incidence was 38.9%(104), with 30.7%(82) mild cases and 8.2%(22) severe cases. The AMS subjects showed a significant increase in HR and a decrease in Sa O2 levels compared with the non-AMS subjects in both groups. ΔHR and post-exposure Sa O2 were significantly correlated with the Lake Louise Score(LLS) in both groups. Stepwise logistic regression analysis revealed the ΔHR >25 and Sa O2 <88% in AEG as well as ΔHR >15 and Sa O2 <86% in PAG to be independent risk factors of AMS. Combining these two measurements could specifically indicate participants with AMS, which showed a positive predictive value of 89% and specificity of 97% in AEG as well as 85% and 98% in PAG.Conclusion:ΔHR or Sa O2, as objective measurements, correlate with AMS. Combination of these two measurements may be useful as an additional specific and objective factor to further confirm the diagnosis of AMS.展开更多
Background: Excessive elevation of arterial blood pressure(BP) at high altitude can be detrimental to our health due to acute mountain sickness(AMS) or some AMS symptoms. This prospective and observational study aimed...Background: Excessive elevation of arterial blood pressure(BP) at high altitude can be detrimental to our health due to acute mountain sickness(AMS) or some AMS symptoms. This prospective and observational study aimed to elucidate blood pressure changes induced by exposure to high-altitude hypoxia and the relationships of these changes with AMS prevalence, AMS severity, sleep quality and exercise condition in healthy young men.Methods: A prospective observational study was performed in 931 male young adults exposed to high altitude at 3,700 m(Lhasa) from low altitude(LA, 500 m). Blood pressure measurement and AMS symptom questionnaires were performed at LA and on day 1, 3, 5, and 7 of exposure to high altitude. Lake Louise criteria were used to diagnose AMS. Likewise, the Athens Insomnia Scale(AIS) and the Epworth Sleepiness Scale(ESS) were filled out at LA and on day 1, 3, and 7 of exposure to high altitude.Results: After acute exposure to 3,700 m, diastolic blood pressure(DBP) and mean arterial blood pressure(MABP) rose gradually and continually(P【0.05). Analysis showed a relationship with AMS for only MABP(P【0.05) but not for SBP and DBP(P】0.05). Poor sleeping quality was generally associated with higher SBP or DBP at high altitude, although inconsistent results were obtained at different time(P【0.05). SBP and Pulse BP increased noticeably after high-altitude exercise(P【0.05).Conclusions: Our data demonstrate notable blood pressure changes under exposure to different high-altitude conditions: 1) BP increased over time. 2) Higher BP generally accompanied poor sleeping quality and higher incidence of AMS. 3) SBP and Pulse BP were higher after high-altitude exercise. Therefore, we should put more effort into monitoring BP after exposure to high altitude in order to guard against excessive increases in BP.展开更多
Background: More people ascend to high altitude(HA) for various activities, and some individuals are susceptible to HA illness after rapidly ascending from plains. Acute mountain sickness(AMS) is a general complaint t...Background: More people ascend to high altitude(HA) for various activities, and some individuals are susceptible to HA illness after rapidly ascending from plains. Acute mountain sickness(AMS) is a general complaint that affects activities of daily living at HA. Although genomic association analyses suggest that single nucleotide polymorphisms(SNPs) are involved in the genesis of AMS, no major gene variants associated with AMS-related symptoms have been identified.Methods: In this cross-sectional study, 604 young, healthy Chinese Han men were recruited in June and July of 2012 in Chengdu, and rapidly taken to above 3700 m by plane. Basic demographic parameters were collected at sea level, and heart rate, pulse oxygen saturation(Sp O2), systolic and diastolic blood pressure and AMS-related symptoms were determined within 18–24 h after arriving in Lhasa. AMS patients were identified according to the latest Lake Louise scoring system(LLSS). Potential associations between variant genotypes and AMS/AMS-related symptoms were identified by logistic regression after adjusting for potential confounders(age, body mass index and smoking status).Results: In total, 320 subjects(53.0%) were diagnosed with AMS, with no cases of high-altitude pulmonary edema or high-altitude cerebral edema. Sp O2 was significantly lower in the AMS group than that in the non-AMS group(P=0.003). Four SNPs in hypoxia-inducible factor-related genes were found to be associated with AMS before multiple hypothesis testing correction. The rs6756667(EPAS1) was associated with mild gastrointestinal symptoms(P=0.013), while rs3025039(VEGFA) was related to mild headache(P=0.0007). The combination of rs6756667 GG and rs3025039 CT/TT further increased the risk of developing AMS(OR=2.70, P<0.001).Conclusions: Under the latest LLSS, we find that EPAS1 and VEGFA gene variants are related to AMS susceptibility through different AMS-related symptoms in the Chinese Han population;this tool might be useful for screening susceptible populations and predicting clini展开更多
基金funded by grants from the Special Health Research Project,the Ministry of Health of China (01002012)
文摘Background: So far, there have been no measurements confirmed useful in diagnosing acute mountain sickness(AMS). The aim of this study was to determine the role of heart rate(HR) difference(ΔHR) and oxygen saturation(Sa O2) as objective risk factors in aiding the diagnosis of AMS.Methods: A total of 1,019 participants were assigned to either the acute exposure group(AEG): from 500 m to 3,700 m by flight within 2.5 hours(n=752); or the pre-acclimatization group(PAG): ascended to 4,400 m from 3,650 m within three hours by car after adapting 33 days at 3,650m(n=267). The questionnaires or measurements of resting Sa O2 and HR were completed between 18 and 24 hours before departure and after arrival.Results: Incidence of AMS was 61.3%(461) in AEG, with 46.1%(347) mild cases and 15.2%(114) severe cases. In PAG, the incidence was 38.9%(104), with 30.7%(82) mild cases and 8.2%(22) severe cases. The AMS subjects showed a significant increase in HR and a decrease in Sa O2 levels compared with the non-AMS subjects in both groups. ΔHR and post-exposure Sa O2 were significantly correlated with the Lake Louise Score(LLS) in both groups. Stepwise logistic regression analysis revealed the ΔHR >25 and Sa O2 <88% in AEG as well as ΔHR >15 and Sa O2 <86% in PAG to be independent risk factors of AMS. Combining these two measurements could specifically indicate participants with AMS, which showed a positive predictive value of 89% and specificity of 97% in AEG as well as 85% and 98% in PAG.Conclusion:ΔHR or Sa O2, as objective measurements, correlate with AMS. Combination of these two measurements may be useful as an additional specific and objective factor to further confirm the diagnosis of AMS.
基金supported by grants from the Special Health Research Project, Ministry of Health of China (201002012)
文摘Background: Excessive elevation of arterial blood pressure(BP) at high altitude can be detrimental to our health due to acute mountain sickness(AMS) or some AMS symptoms. This prospective and observational study aimed to elucidate blood pressure changes induced by exposure to high-altitude hypoxia and the relationships of these changes with AMS prevalence, AMS severity, sleep quality and exercise condition in healthy young men.Methods: A prospective observational study was performed in 931 male young adults exposed to high altitude at 3,700 m(Lhasa) from low altitude(LA, 500 m). Blood pressure measurement and AMS symptom questionnaires were performed at LA and on day 1, 3, 5, and 7 of exposure to high altitude. Lake Louise criteria were used to diagnose AMS. Likewise, the Athens Insomnia Scale(AIS) and the Epworth Sleepiness Scale(ESS) were filled out at LA and on day 1, 3, and 7 of exposure to high altitude.Results: After acute exposure to 3,700 m, diastolic blood pressure(DBP) and mean arterial blood pressure(MABP) rose gradually and continually(P【0.05). Analysis showed a relationship with AMS for only MABP(P【0.05) but not for SBP and DBP(P】0.05). Poor sleeping quality was generally associated with higher SBP or DBP at high altitude, although inconsistent results were obtained at different time(P【0.05). SBP and Pulse BP increased noticeably after high-altitude exercise(P【0.05).Conclusions: Our data demonstrate notable blood pressure changes under exposure to different high-altitude conditions: 1) BP increased over time. 2) Higher BP generally accompanied poor sleeping quality and higher incidence of AMS. 3) SBP and Pulse BP were higher after high-altitude exercise. Therefore, we should put more effort into monitoring BP after exposure to high altitude in order to guard against excessive increases in BP.
基金support by the National Natural Science Foundation of China (81730054, 81873519)the Ministry of Health of China (201002012)Research Project of PLA (BLJ18J007)。
文摘Background: More people ascend to high altitude(HA) for various activities, and some individuals are susceptible to HA illness after rapidly ascending from plains. Acute mountain sickness(AMS) is a general complaint that affects activities of daily living at HA. Although genomic association analyses suggest that single nucleotide polymorphisms(SNPs) are involved in the genesis of AMS, no major gene variants associated with AMS-related symptoms have been identified.Methods: In this cross-sectional study, 604 young, healthy Chinese Han men were recruited in June and July of 2012 in Chengdu, and rapidly taken to above 3700 m by plane. Basic demographic parameters were collected at sea level, and heart rate, pulse oxygen saturation(Sp O2), systolic and diastolic blood pressure and AMS-related symptoms were determined within 18–24 h after arriving in Lhasa. AMS patients were identified according to the latest Lake Louise scoring system(LLSS). Potential associations between variant genotypes and AMS/AMS-related symptoms were identified by logistic regression after adjusting for potential confounders(age, body mass index and smoking status).Results: In total, 320 subjects(53.0%) were diagnosed with AMS, with no cases of high-altitude pulmonary edema or high-altitude cerebral edema. Sp O2 was significantly lower in the AMS group than that in the non-AMS group(P=0.003). Four SNPs in hypoxia-inducible factor-related genes were found to be associated with AMS before multiple hypothesis testing correction. The rs6756667(EPAS1) was associated with mild gastrointestinal symptoms(P=0.013), while rs3025039(VEGFA) was related to mild headache(P=0.0007). The combination of rs6756667 GG and rs3025039 CT/TT further increased the risk of developing AMS(OR=2.70, P<0.001).Conclusions: Under the latest LLSS, we find that EPAS1 and VEGFA gene variants are related to AMS susceptibility through different AMS-related symptoms in the Chinese Han population;this tool might be useful for screening susceptible populations and predicting clini
