高原施工人群急性重型高原病患病率调查

目的：了解高原施工人群急性重型高原病患病率及群体影响因素。方法：用流行病学调查对3年期间8个施工单位27606人次，累积229例发病者进行统计，并将群体基础预防优良者8176人（A组）和预防不良者19430人（B组），海拔～3600m、～4600m、～5072m进行比较。结果：患病率（％）：总人群0．83，其中高原肺水肿0．50，高原脑水肿0．28，两者并存者0．05，且在B组高于A组和随海拔梯度上升总患病率上升。A组0．32，B组1．04（χ^2=36．95．P〈0．001）；三个海拔人群依次为0．00，0．68及1．34（χ^2=21．90，P〈0．001）；个群最高4．82（首年）和2．26（次年），且均发生在最高海拔区。结论：急性重型高原病患病率仍不容乐观，主要影响因素为海拔高度和群体基础预防水平；加强劳动保护、卫勤保障、习服性登高及社会-心理适应促进可大幅度降低群体患病率．且是当前高原医学和社会支持需要解决的首要实践问题。

An Investigation on the Prevalence Rate of Severe Acute Altitude Disease in the Crowds Working at High Altitude

Objective:To know the prevalence rate of the severe acute altitude disease (PRSAAD) of the crowds who are working at high altitude and the influential factors upon the people. Methods:27 606 persons, who are working in the plateau at various altitudes (3 600m, 4 600m, 5 072m) during 3 years, were studied on the base of epidemiology. 8 175 persons were designed in the group A, in which the subjects had a good adaptation; 19 430 were designed in the group B, in which the persons had no an available adaptation. Results: The PRSAAD in all persons was 0.83%, 0.50%, 0.28% and 0.05% of this prevalence rate showed the high altitude pulmonary edema, cerebral edema and pulmonary edema + cerebral edema respectively, and it was lower in the group A (1.04%) than that in the group B (0.32%)(x~2=36.95,P<0.01). The PRSAAD at 3 600m, 4 600m and 5 072m altitudes was 0.00%, 0.68% and 1.34% respectively. Conclusion:The PSAAD is important problem on site. The main risk factors are a higher altitude and adaptive capacity, such as the level of basic prevention for the crowds, the working protection, medical safeguard and social psychological adaptation.