PDF(Pubmed)
Abstract：
Background: Hypoxia and old age impair postural control and may therefore enhance the risk of accidents. We investigated whether acetazolamide, the recommended drug for prevention of acute mountain sickness, may prevent altitude-induced deterioration of postural control in older persons. Methods: In this parallel-design trial, 95 healthy volunteers, 40 years of age or older, living <1,000 m, were randomized to preventive therapy with acetazolamide (375 mg/d) or placebo starting 24 h before and during a 2-day sojourn at 3,100 m. Instability of postural control was quantified by a balance platform with the center of pressure path length (COPL) as primary outcome while pulse oximetry (SpO2) was monitored. Effects of altitude and treatment on COPL were evaluated by ordered logistic regression. www.ClinicalTrials.gov NCT03536429. Results: In participants taking placebo, ascent from 760 m to 3,100 m increased median COPL from 25.8 cm to 27.6 cm (odds ratio 3.80, 95%CI 2.53-5.70) and decreased SpO2 from 96% to 91% (odds ratio 0.0003, 95%CI 0.0002-0.0007); in participants taking acetazolamide, altitude ascent increased COPL from 24.6 cm to 27.3 cm (odds ratio 2.22, 95%CI 1.57-3.13), while SpO2 decreased from 96% to 93% (odds ratio 0.007, 95%CI 0.004-0.012). Altitude-induced increases in COPL were smaller with acetazolamide vs. placebo (odds ratio 0.58, 95%CI 0.34-0.99) while drops in SpO2 were mitigated (odds ratio 19.2, 95%CI 9.9-37.6). Conclusion: In healthy individuals, 40 years of age or older, postural control was impaired after spending a night at 3,100 m. The altitude-induced deterioration of postural control was mitigated by acetazolamide, most likely due to the associated improvement in oxygenation.
摘要：
背景：缺氧和老年会损害姿势控制，因此可能会增加事故的风险。我们调查了乙酰唑胺，预防急性高山病的推荐药物，可以防止海拔引起的老年人姿势控制恶化。方法：在这项平行设计试验中，95名健康志愿者40岁或以上，生活<1,000米，在3,100m的2天逗留前24小时开始随机接受乙酰唑胺（375mg/d）或安慰剂的预防性治疗。通过平衡平台量化姿势控制的不稳定性，以压力路径长度中心（COPL）为主要结果，同时监测脉搏血氧饱和度（SpO2）。通过有序逻辑回归评估海拔高度和治疗对COPL的影响。www.ClinicalTrials.govNCT03536429.结果：在服用安慰剂的参与者中，从760m上升到3,100m，COPL中位数从25.8cm上升到27.6cm（比值比3.80，95CI2.53-5.70），SpO2从96%下降到91%（比值比0.0003，95CI0.0002-0.0007）；在服用乙酰唑胺的参与者中，海拔上升将COPL从24.6厘米增加到27.3厘米（赔率比2.22，95CI1.57-3.13），而SpO2从96%降至93%（比值比0.007，95CI0.004-0.012）。与乙酰唑胺相比，海拔引起的COPL增加较小安慰剂(比值比0.58,95CI0.34-0.99),同时SpO2下降得到缓解(比值比19.2,95CI9.9-37.6).结论：在健康个体中，40岁或以上，在3,100m处过夜后，姿势控制受损。乙酰唑胺减轻了海拔引起的姿势控制恶化，最有可能是由于氧合的相关改善。
