高原病。

IF 76.9 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Hannes Gatterer, Francisco C Villafuerte, Silvia Ulrich, Sanjeeb S Bhandari, Linda E Keyes, Martin Burtscher
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引用次数: 0

摘要

每年有数百万人前往高海拔地区,8000 多万人长期生活在海拔 2500 米以上的地区。急性高海拔暴露可引发高海拔疾病(HAIs),包括急性高山病(AMS)、高海拔脑水肿(HACE)和高海拔肺水肿(HAPE)。慢性高山病(CMS)可影响世界各地的高海拔常住人口。急性高山症的发病率因适应状况、上升速度和个人易感性而异。以头痛、恶心、头晕和疲劳为特征的高山反应通常是良性和自限性的,与缺氧引起的脑血容量增加、炎症和相关的三叉神经血管系统激活有关。血脑屏障破坏会导致 HACE,表现为精神状态改变和共济失调,以及肺毛细血管压力升高;相关的应激衰竭会诱发 HAPE,表现为呼吸困难、咳嗽和运动不耐受。这两种情况都会逐渐恶化并危及生命,需要立即进行医疗干预。治疗方法包括补充氧气和采用适当的药物治疗进行下降。预防措施包括缓慢上升、预先适应和在某些情况下使用药物。红细胞增多症的特点是红细胞增多和相关临床症状。对于严重的 CMS,建议暂时或永久迁移到低海拔地区。未来的研究应侧重于更客观的诊断工具,以便及时治疗、更好地识别个人易感性以及有效的适应和预防方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Altitude illnesses.

Altitude illnesses.

Millions of people visit high-altitude regions annually and more than 80 million live permanently above 2,500 m. Acute high-altitude exposure can trigger high-altitude illnesses (HAIs), including acute mountain sickness (AMS), high-altitude cerebral oedema (HACE) and high-altitude pulmonary oedema (HAPE). Chronic mountain sickness (CMS) can affect high-altitude resident populations worldwide. The prevalence of acute HAIs varies according to acclimatization status, rate of ascent and individual susceptibility. AMS, characterized by headache, nausea, dizziness and fatigue, is usually benign and self-limiting, and has been linked to hypoxia-induced cerebral blood volume increases, inflammation and related trigeminovascular system activation. Disruption of the blood-brain barrier leads to HACE, characterized by altered mental status and ataxia, and increased pulmonary capillary pressure, and related stress failure induces HAPE, characterized by dyspnoea, cough and exercise intolerance. Both conditions are progressive and life-threatening, requiring immediate medical intervention. Treatment includes supplemental oxygen and descent with appropriate pharmacological therapy. Preventive measures include slow ascent, pre-acclimatization and, in some instances, medications. CMS is characterized by excessive erythrocytosis and related clinical symptoms. In severe CMS, temporary or permanent relocation to low altitude is recommended. Future research should focus on more objective diagnostic tools to enable prompt treatment, improved identification of individual susceptibilities and effective acclimatization and prevention options.

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来源期刊
Nature Reviews Disease Primers
Nature Reviews Disease Primers Medicine-General Medicine
CiteScore
76.70
自引率
0.20%
发文量
75
期刊介绍: Nature Reviews Disease Primers, a part of the Nature Reviews journal portfolio, features sections on epidemiology, mechanisms, diagnosis, management, and patient quality of life. The editorial team commissions top researchers — comprising basic scientists and clinical researchers — to write the Primers, which are designed for use by early career researchers, medical students and principal investigators. Each Primer concludes with an Outlook section, highlighting future research directions. Covered medical specialties include Cardiology, Dermatology, Ear, Nose and Throat, Emergency Medicine, Endocrinology, Gastroenterology, Genetic Conditions, Gynaecology and Obstetrics, Hepatology, Haematology, Infectious Diseases, Maxillofacial and Oral Medicine, Nephrology, Neurology, Nutrition, Oncology, Ophthalmology, Orthopaedics, Psychiatry, Respiratory Medicine, Rheumatology, Sleep Medicine, and Urology.
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