CAJ | 학술논문

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（ SaO2）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、SaO2，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SaO2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SaO2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。
목적：통과대급성경형고원병（급성고원반응，AMS）급고원폐수종（ HAPE）적림상증상、심솔（ HR）、동맥양포화도（ SaO2）급백세포（ WBC）계수적분석，탐토상술지표대HAPE조기예경적의의。방법이628명초입곤륜산적주훈인원위연구대상，안조급성고원병로역사호평분계통（ LLSS）화림상출현적호흡계통증상평분적총분귀입：A조（건강조，평분＜3분），B조（ AMS조，지소1차평분＞3분，배제HAPE）、C조（ HAPE조），비교각조림상증상발생정황급HR、SaO2，병대부분대상진행WBC계수분석。결과 C조호흡계통증상발생솔급WBC계수교B조명현승고（P＜0．05）；초입고원3 d내，A、B량조평균HR정축점하강추세，이C조평균HR각축점상승，차재제3천교A、B량조명현승고（F＝6．37，P＜0．05）；C조SaO2재제1、2、3천명현저우A、B량조（F＝8．21，F＝8．77，F＝9．58，P＜0．01）。결론초입고원인군중，출현호흡계통증상、WBC계수승고、HR무괄응성하강급SaO2현저감저（＞30％）자발생HAPE적풍험명현증가，저사변화대조기식별예경HAPE구유중요의의。
Objective By analyzing the clinical symptoms, heart rate ( HR) , arterial oxygen saturation ( SaO2 ) and the number of white blood cells (WBC), we aimed to explore the implication of the above-mentioned indexes for early warning of high altitude pulmonary edema ( HAPE) .Methods Based on the Lake Louise Self-assessmeat Scoring System ( LLSS) and the scoring of respiratory symptoms, 628 subjects were divided into three groups: group A ( the healthy;score<3),group B(acute mountain sickness, AMS; score>3 and excluding HAPE),and group C (HAPE).Moreover, we analyzed the incidence of some clinical symptoms, HR and SaO2 , as well as the WBC number of some subjects in the three groups.Results The incidence of respiratory symptoms and WBC number were significantly increased in group C compared with group B(P<0.05).In addition,unlike group A and B, the mean HR in group C rose gradually in the first 3 days and was markedly increased at the third day(F=6.37,P<0.05).The mean SaO2in group C was remarkably lower than in group A and B in the first 3 days(F=8.21,F=8.77,F=9.58,P<0.01).Conclusion Those who enter high altitude for the first time with notable respiratory symptoms, WBC increase, HR maladaptation and decrease in SaO2 (>30%) have high risk of HAPE.It is of special importance to detect HAPE earlier at high altitude.