西藏珠穆朗玛峰地区攀登高海拔和极高海拔的哮喘患者
2010/09/14
摘要
目的：本文旨在研究高海拔和极高海拔哮喘患者的哮喘行为。
方法：24名荷兰轻度哮喘患者，徒步旅行至高海拔和极高海拔（6410 m = 21030 ft）的西藏珠穆朗玛峰地区。于1300 m（基线状态）、3875 m、4310 m、5175 m和6410 m处，记录患者的哮喘症状、哮喘药物使用、急性高原病症状、肺活量检测结果、外周血氧饱和度、心率。哮喘症状通过修订版的哮喘控制测试(Asthma Control Test)进行评价。急性高原病症状采用Lake Louise自陈式问卷调查。旅行队包括7名健康人员作为对照。
结果：在哮喘组和对照组中，用力肺活量(FVC)和第1秒用力呼气容量(FEV1)随着海拔的增加而下降，而FEV1与FVC的比值却未显著变化。两组中，呼气峰值流量(PEF)随着海拔增加而增加。健康对照和哮喘患者的肺活量检测结果无显著差异。哮喘症状也未随海拔的增加而变化。在海拔上升阶段，不到一半的哮喘患者其药物使用量增加。根据Lake Louise 评分，除了某些哮喘组患者在海拔6410 m处出现轻症急性高原病外，其他患者未见急性高原病。正如预期，哮喘患者和健康对照，外周血氧饱和度随着海拔增加而下降，两者之间的差异未见统计学意义。总体来说，除哮喘患者在6410 m出现心率增加外，心率（静息状态下）未见随海拔而变化。
结论：我们的研究结果显示对于轻度哮喘患者，至高海拔和极高海拔地区旅行是安全的。
（刘国梁 审校）
J Asthma. 2010 Jul 16. [Epub ahead of print]
Asthma in Patients Climbing to High and Extreme Altitudes in the Tibetan Everest Region
Huismans HK, Douma WR, Kerstjens HA, Renkema TE.
1Department of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Abstract
Objectives: The aim of this study was to investigate the behavior of asthma in patients traveling to high and extreme altitudes.
Methods: Twenty-four Dutch patients with mild asthma did a trekking at high and extreme altitudes (up to 6410 m = 21030 ft) in the Tibetan Everest region. Asthma symptoms, use of asthma medication, symptoms of acute mountain sickness, spirometry, peripheral oxygen saturation, and heart rate were measured at 1300 m (baseline), and at 3875, 4310, 5175, and 6410 m. Asthma symptoms were assessed by means of a modified version of the Asthma Control Test. Symptoms of acute mountain sickness were scored by the Lake Louise self-report questionnaire. The expedition staff, consisting of seven healthy persons, acted as a control group.
Results: In both asthmatics and controls, forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) decreased with increasing altitude, whereas FEV1 as percent of FVC (FEV1%FVC) did not change. In both groups, peak expiratory flow (PEF) increased with increasing altitude. In general, differences in spirometric values between asthmatics and controls were not significant. Asthma symptoms did not change with increasing altitude. During ascent, less than half of the asthma patients increased their medication use. According to the Lake Louise score, no acute mountain sickness occurred, except for in the asthma group at 6410 m, which showed mild acute mountain sickness at that altitude. As expected, peripheral oxygen saturation decreased with increasing altitude in asthmatics and controls, differences between the two groups not being significant. In general, heart rate (at rest) did not change with altitude, except for an increase in asthmatics at 6410 m.
Conclusions: These results suggest that traveling to high and extreme altitudes is safe for patients with mild asthma.
J Asthma. 2010 Jul 16. [Epub ahead of print]
目的：本文旨在研究高海拔和极高海拔哮喘患者的哮喘行为。
方法：24名荷兰轻度哮喘患者，徒步旅行至高海拔和极高海拔（6410 m = 21030 ft）的西藏珠穆朗玛峰地区。于1300 m（基线状态）、3875 m、4310 m、5175 m和6410 m处，记录患者的哮喘症状、哮喘药物使用、急性高原病症状、肺活量检测结果、外周血氧饱和度、心率。哮喘症状通过修订版的哮喘控制测试(Asthma Control Test)进行评价。急性高原病症状采用Lake Louise自陈式问卷调查。旅行队包括7名健康人员作为对照。
结果：在哮喘组和对照组中，用力肺活量(FVC)和第1秒用力呼气容量(FEV1)随着海拔的增加而下降，而FEV1与FVC的比值却未显著变化。两组中，呼气峰值流量(PEF)随着海拔增加而增加。健康对照和哮喘患者的肺活量检测结果无显著差异。哮喘症状也未随海拔的增加而变化。在海拔上升阶段，不到一半的哮喘患者其药物使用量增加。根据Lake Louise 评分，除了某些哮喘组患者在海拔6410 m处出现轻症急性高原病外，其他患者未见急性高原病。正如预期，哮喘患者和健康对照，外周血氧饱和度随着海拔增加而下降，两者之间的差异未见统计学意义。总体来说，除哮喘患者在6410 m出现心率增加外，心率（静息状态下）未见随海拔而变化。
结论：我们的研究结果显示对于轻度哮喘患者，至高海拔和极高海拔地区旅行是安全的。
（刘国梁 审校）
J Asthma. 2010 Jul 16. [Epub ahead of print]
Asthma in Patients Climbing to High and Extreme Altitudes in the Tibetan Everest Region
Huismans HK, Douma WR, Kerstjens HA, Renkema TE.
1Department of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Abstract
Objectives: The aim of this study was to investigate the behavior of asthma in patients traveling to high and extreme altitudes.
Methods: Twenty-four Dutch patients with mild asthma did a trekking at high and extreme altitudes (up to 6410 m = 21030 ft) in the Tibetan Everest region. Asthma symptoms, use of asthma medication, symptoms of acute mountain sickness, spirometry, peripheral oxygen saturation, and heart rate were measured at 1300 m (baseline), and at 3875, 4310, 5175, and 6410 m. Asthma symptoms were assessed by means of a modified version of the Asthma Control Test. Symptoms of acute mountain sickness were scored by the Lake Louise self-report questionnaire. The expedition staff, consisting of seven healthy persons, acted as a control group.
Results: In both asthmatics and controls, forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) decreased with increasing altitude, whereas FEV1 as percent of FVC (FEV1%FVC) did not change. In both groups, peak expiratory flow (PEF) increased with increasing altitude. In general, differences in spirometric values between asthmatics and controls were not significant. Asthma symptoms did not change with increasing altitude. During ascent, less than half of the asthma patients increased their medication use. According to the Lake Louise score, no acute mountain sickness occurred, except for in the asthma group at 6410 m, which showed mild acute mountain sickness at that altitude. As expected, peripheral oxygen saturation decreased with increasing altitude in asthmatics and controls, differences between the two groups not being significant. In general, heart rate (at rest) did not change with altitude, except for an increase in asthmatics at 6410 m.
Conclusions: These results suggest that traveling to high and extreme altitudes is safe for patients with mild asthma.
J Asthma. 2010 Jul 16. [Epub ahead of print]
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