高原环境下慢性高原病预后与其相互转型关系的临床流行病学研究

目的 :了解高原环境下慢性高原病 (CAD)患者的预后与其相互转型的关系。方法 :对地处海拔 36 5 8m医院 40年间 (195 5 - 12～ 1995 - 12 )收治的并符合筛选标准的 180 90例住院病历为样本 ,随访 1年～ 15年不等 ,样本中以CAD首次者为观察组 ,而以非高原病首次住院者为对照组。对二组在观察期间CAD的发病 (观察组为转型率 )情况进行临床流行病学分析。结果 :(1)观察组CAD转型率随观察年限延长而下降。第 1～ 7观察年度CAD转型率与总转型率 ,观察组显著高于对照组 ,P <0 0 1,OR =5 46 ,RR =4 6 5 ,AR =78 49% ,PAR =12 2 6 %。 (2 )除高原心脏病(HAHD)组的高原红细胞增多症 (HAPC)转型率外 ,各型CAD转型率与总转型率在观察组显著高于对照组 ,P <0 0 1。 (3)各型CAD转型率以Monge s病组和HAPC组最高 ,前者以转型为高原高血压 (HAH)和HAPC为显著 ,P <0 0 1;后者以转型为Monge s病为显著 ,P <0 0 5～ 0 0 1。结论 :各型CAD之间可以相互转型 ,尤以患病前 3年为显著 ,HAH和HAPC是CHD与Monge s病的重要病因。

Clinlc epidemiological study on the relation of chronic altitude disease prognosis and its mutual transformation at high altitude

Objective:To investigate the prognosis and relation of chronic altitude disease(CAD)and the mutual transformation at high alitude.Methods:Between December 1955 and December 1995,we studied 2 patient groups in the hospital at 3658-meter's altitude:1082 patients first hospitalized because of CAD as observation group and 17020 patients first hospitalized not because of CAD as control group.The follow-up of all the patients varied in time from l to 15 years.Clinic epidemiological analysis was usec do to analyze the pathogenic factors of CAD in control group and the transformation rate in observation group.Results:(1)As observation time went on,the CAD transformation rate decreased in observation group.From the 1 st to 7 th observation year,both the CAD and total transformation rate in observation group were higher than that in control group(P<0.01).(2)Escept the high altitude polycythemia (HAPC)transformation rate in high altitude heart disease(HAHD)group,various types CAD and total transformation ratein observation group were much higher than that in control group (P<0.01).(3)The highest transformation rate of various types CAD existed in Monge's disease group and HAPC group.Monge's disease was significantly transformed into high altitude hyperhension(HAH)and HAPC(P<0.05).Conclusion:Various types CAD may be mutually transformed,especially in the first 3 years since the patients suffered from CAD.HAH and HAPC are the main causes of HAHD and Monge's disease.