高原世居藏族居民罹患重症急性高原病的临床特点

目的对高原世居藏族居民重症急性高原病的发病情况及其临床特点进行探讨。方法对西藏军区总医院1956年6月至2005年6月的全部高原肺水肿、高原脑水肿病历进行回顾性分析，并对其中的高原世居藏族病例的发病情况及其临床特点进行分析。结果共检出24例高原世居藏族重症急性高原病病例，其中高原肺水肿21例、高原脑水肿3例，世居藏族居民重症急性高原病发病率为0．75％（24／3184）。24例患者均存在明显的诱发因素，诱因主要有从高原到更高海拔地区、劳累、受凉和饮酒。9例患者并发多器官或多系统功能障碍。结论高原世居藏族居民在往返于高原与平原或进入更高海拔地区时，机体器官、系统明显存在低氧损伤，在一定因素作用下亦可罹患重症急性高原病和并发多器官、多系统功能障碍。

The clinical characteristics of acute severe high-altitude diseases in indigenous Tibetans

Objective To describe the incidence and clinical characteristics of acute severe high-altitude diseases in indigenous Tibetans.Methods The medical records of indigenous Tibetan patients with high-altitude pulmonary edema(HAPE)and high-altitude cerebral edema(HACE),who were treated in this hospital from June of 1956 to June of 2005,were retrospectively reviewed.Results A total of 3 184 cases of high-altitude disease were recorded in this period.Twenty four patients(0.75%,24/3 184),21 with HAPE and 3 with HACE,were indigenous Tibetans.Risk factors or precipitating factors were found in all the 24 cases,including getting into even higher altitude,exertion,cold,and alcohol drinking.From clinical symptoms,physical signs and laboratory examinations,it was found that 9 cases were complicated with multi-organ dysfunction.Conclusion Indigenous Tibetans who travel between the plateau and the plain or to even higher altitude can suffer from hypoxic injury,even acute severe high-altitude disease,which may be complicated by multi-organ dysfunction.