Normo or hypobaric hypoxic tests: propositions for the determination of the individual susceptibility to altitude illnesses
Normo or hypobaric hypoxic tests: propositions for the determination of the individual susceptibility to altitude illnesses
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常压或低压缺氧测试：确定个人对高原病易感性的建议
DOI：
10.1007/s00421-007-0417-8
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发表时间：
2007
影响因子：
3
通讯作者：
C. Bourrilhon
中科院分区：
文献类型：
--
作者：
G. Savourey;J. Launay;Y. Besnard;Angélique Guinet;A. Alonso;F. Sauvet;C. Bourrilhon
通过在常压缺氧(NH)或低压缺氧(HH)中进行试验来评估个体对高原疾病的易感性，尤其是对急性高原反应(AMS)的易感性，目前仍存在争议。18名受试者在远征前接受了HH和NH测试(PIO2=120 hpa，30分钟)。最大和平均急性高原反应评分(AMSmax和平均值)采用路易斯湖自我报告问卷每日评分。分别于试验后5、30min测定心肺功能(f、VT、PetO2、PetCO2、HR和指脉血氧分压SpO2)。测定动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)、pH、血氧饱和度(SaO2)和毛细血管血红蛋白(Hb)。计算低氧呼吸反应(HVR)、心脏反应(HCR)、外周血氧分压(CPO2)。Δ血氧饱和度存在显著的时间效应(P=0.04)。HH组PaCO_2(P=0.005)、SaO_2(P=0.07)、pH值(P=0.02)均低于NH组。AMSmax在3~12之间，AMSean在0.6~3.5之间。在NH组，30min时AMSmax与PaO2(R=0.61，P=0.03)、CPO2(R=−0.53，P=0.02)和HH与CPO2(R=−0.57，P=0.01)呈正相关。在NH组，AMS平均值与Δf(R=0.46，P=0.05)、Hcr(R=0.49，P=0.04)、CPO2(R=0.51，P=0.03)相关；在HH组，30分钟时，AMS平均值与VT(R=0.69，P=0.01)相关，并与CPO2趋势(R=−0.43，P=0.07)相关。我们得出结论，HH和NH测试在生理上是不同的，它们必须持续30分钟。CpO2是预测AMS的重要指标。出于实际考虑，建议使用以下公式来量化AMS个体的易感性：AMSmax=99.47Hpa+0.104PetO2(Hpa)-0.68CpO2(%)，(R=0.77，P=0.001)；AMS平均Δ=93.91Ph+0.135CpO2(R=0.438HCR-0.135CpO2(R=0.71，P=0.017)。
Assessment of individual susceptibility to altitude illnesses and more particularly to acute mountain sickness (AMS) by means of tests performed in normobaric hypoxia (NH) or in hypobaric hypoxia (HH) is still debated. Eighteen subjects were submitted to HH and NH tests (PIO2=120 hPa, 30 min) before an expedition. Maximal and mean acute mountain sickness scores (AMSmax and mean) were determined using the self-report Lake Louise questionnaire scored daily. Cardio-ventilatory (f, VT, PetO2and PetCO2, HR and finger pulse oxymetry SpO2) were measured at times 5 and 30 min of the tests. Arterial (PaO2, PaCO2, pH, SaO2) and capillary haemoglobin (Hb) measurements were performed at times 30 min. Hypoxic ventilatory (HVR) and cardiac (HCR) responses, peripheral O2blood content (CpO2) were calculated. A significant time effect is found for ΔSpO2(P= 0.04). Lower PaCO2(P= 0.005), SaO2(P= 0.07) and higher pH (P= 0.02) are observed in HH compared to NH. AMSmax varied from 3 to12 and AMSmean between 0.6 and 3.5. In NH at 30 min, AMSmax is related to PetO2(R= 0.61,P= 0.03), CpO2(R= −0.53,P= 0.02) and in HH to CpO2(R= −0.57,P= 0.01). In NH, AMSmean is related to Δf(R= 0.46,P= 0.05), HCR (R= 0.49,P= 0.04), CpO2(R= −0.51,P= 0.03) and, in HH at 30 min, to VT(R= 0.69,P= 0.01) and a tendency for CpO2(R= −0.43,P= 0.07). We conclude that HH and NH tests are physiologically different and they must last 30 min. CpO2is an important variable to predict AMS. For practical considerations, NH test is proposed to quantify AMS individual susceptibility using the formulas: AMSmax = 9.47 + 0.104PetO2(hPa)–0.68CpO2(%), (R= 0.77,P= 0.001); and AMSmean = 3.91 + 0.059Δf+ 0.438HCR–0.135CpO2(R= 0.71,P= 0.017).