解放军医学杂志2012，Vol.37Issue(2)：146-155,10.
高原移居人群返回平原后高原脱适应症的诊断标准:多中心、随机对照研究
A research in diagnostic criteria of high altitude de-adaptation for plateau migrants returning to the plains: a multicenter, randomized controlled trial
摘要
Abstract
Objective To investigate the diagnostic method of high altitude de-adaptation and to constitute the diagnostic criteria of high altitude plains de-adaptation for people returning to low altitude plains from the plateau. Methods Epidemiological survey and clinical multi-center randomized controlled studies were used. In the current study, blood routine, urine routine, stool routine, myocardial enzymes, liver and kidney functions, nerve function, sex hormone, microalbuminuria, ECG, echocardiography, pulmonary function tests, and so on, were performed and determined among 3011 subjects after they returned to low altitude from the plateau. The diagnostic criteria of high altitude de-adaptation were formulated by a comparative analysis of the obtained data with that of subjects living in the same area, altitude, and age. The regularity and characteristics of high altitude de-adaptation syndrome were found and the diagnostic criteria of high altitude de-adaptation was established based on the results. Results The investigative results showed that the incidence of high altitude de-adaptation syndrome was found in 84.36% of population returning to low altitude from the plateau. About 60% of them were considered to have mild reactions, 30% medium, and 10% of them were severe. The lower the altitude they returned, the longer the duration of stay in highland, the heavier the labor they engaged in high altitude, the incidence rate of high altitude de-adaptation syndrome is likewise higher. Patients with high altitude de-adaptation syndrome exhibited hematological abnormality and abnormal ventricular function, especially the right ventricular diastolic function after returning for 1 year to 5 years. Long-term hypoxia exposure often caused obvious change in cardiac morphology with left and right ventricular hypertrophy, particularly the right ventricle. In addition, low blood pressure and low pulse pressure were found at times. Microalbuminuria was found in some high altitude de-adaptation patients. Some patients often had occult blood in feces. The diagnostic criteria of de-adaptation syndrome should include: the subject had recently returned from high altitude area, complaining dizziness, fatigability, lethargy, chest distress, edema, amnesia, and other physical signs, and these symptoms and signs did not ameliorate under short-term rehabilitation and symptomatic treatment, and organic diseases of the heart, lung, kidney and other organs were ruled out. Conclusion The diagnosis of high altitude de-adaptation syndrome should be made after a comprehensive analysis of clinical symptoms and signs, and organic diseases of the vital organs are ruled out.关键词
高原移居人群/低海拔/高原脱适应症/诊断标准/多中心研究Key words
plateau migrants/ low altitude/ high altitude de-adaptation/ diagnostic criteria/ multicenter studies分类
医药卫生引用本文复制引用
周其全,范勇,王关嵩,高钰琪,杨生岳,袁振才,王引虎,张雪峰,高炜,石自福,杨有利,邬云红..高原移居人群返回平原后高原脱适应症的诊断标准:多中心、随机对照研究[J].解放军医学杂志,2012,37(2):146-155,10.基金项目
国家科技支撑计划课题(2009BAI8SB03) （2009BAI8SB03）
