A specific objective supplemental factor in evaluating acute mountain sickness: ΔHR in combination with SaO_2

作     者：Ming Li Ji-Hang Zhang Guo-Xi Zhao Shi-Zhu Bian Xu-Bin Gao Xi Liu Jie Yu Jun-Qing Dong Guo-Zhu Chen Hong Wang Lan Huang 

作者机构：Institute of Cardiovascular Diseases of PLAXinqiao Hospital Third Military Medical University Department of Cardiology 533 Hospital of PLA Department of Cadre Wards Kunming General Hospital of Chengdu Command 

出 版 物：《Military Medical Research》 (军事医学研究（英文版）)

年 卷 期：2015年第3卷第3期

页      面：139-144页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：funded by grants from the Special Health Research Project the Ministry of Health of China (01002012) 

主　　题：Acute mountain sickness Oxygen saturation Heart rate difference 

摘      要：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 ***: 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 ***: 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 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 ***: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.