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目的:青藏铁路是世界上海拔最高、路段最长的高原铁路,此项研究为调查青藏铁路列车上乘客中发生急性高原病(AMS)的发病率及其危险因素。方法:分三组观察对象,160名低海拔汉族、62名生活在(2200～2500)m的汉族以及25名生活在(3700～4200)m的世居藏族,在乘火车从西宁到拉萨的过程进行调查。按国际统一的Lake Louise AMS scoring system判定急性高原,并分析危险因素。结果:从海拔2 808m急剧升高到4 768m的1.5小时中,78%的乘客出现了不同程度的缺氧症状,其中24%达到了路易斯湖AMS诊断计分标准。低海拔汉族的AMS发病率为31%,高海拔移居汉族发病率为16%,藏族乘客中则无一人发病。女性及老年人对发生高原病更为易感,多数表现为轻或中度的AMS。结论:列车在青藏铁路线上运行过程中,AMS有较高的发病率,且发病率与年龄、性别及是否高原习服有关。因此对乘客宣讲高原病知识、加强列车医疗保健措施和乘客进行阶梯适应旅游均很重要。
Purpose: The Qinghai-Tibet Railway is the highest altitude plateau railway in the world with the longest section. This study was conducted to investigate the incidence and risk factors of acute mountain sickness (AMS) among passengers on the Qinghai-Tibet Railway. Methods: The subjects were divided into three groups: 160 Han nationality at low altitude, 62 Han (2200-2500) m living and 25 resident Tibetan living at (3700-4200) m. From Xining to Lhasa Process investigation. According to the international unified Lake Louise AMS scoring system to determine the acute plateau, and analyze the risk factors. RESULTS: Seventy-eight percent of passengers experienced various degrees of hypoxemia during the 1.5 hour period from 2 808 m above sea level to 4 768 m, with 24% reaching Lake Louise’s AMS diagnostic score. The prevalence of AMS in low-altitude Han is 31%, the incidence of Han migrating to high altitude is 16%, and none of Tibetan passengers. Women and the elderly are more susceptible to altitude sickness, most of them showing mild or moderate AMS. Conclusion: During the operation of train on the Qinghai-Tibet Railway, AMS has a higher morbidity rate, and its incidence is related to age, sex and plateau habit. Therefore, it is very important to educate passengers on knowledge of altitude sickness, strengthen train health care measures and step up the stairs for tourist travel.