每年有数百万人访问高海拔地区,超过8000万人永久生活在2500米以上。急性高海拔暴露会引发高海拔疾病(HAIs),包括急性高山病(AMS),高原脑水肿(HACE)和高原肺水肿(HAPE)。慢性高山病(CMS)可影响全球高海拔常住人口。急性HAIs的患病率根据适应状态而变化,上升率和个体易感性。AMS,以头痛为特征,恶心,头晕和疲劳,通常是良性的和自我限制的,并与缺氧诱导的脑血容量增加有关,炎症和相关的三叉神经血管系统激活。血脑屏障的破坏导致HACE,以精神状态改变和共济失调为特征,肺毛细血管压升高,相关的应力破坏会导致HAPE,以呼吸困难为特征,咳嗽和运动不耐受。这两种情况都是渐进的,危及生命,需要立即医疗干预。治疗包括补充氧气和通过适当的药物治疗下降。预防措施包括缓慢上升,适应前,在某些情况下,medications.CMS的特征是红细胞增多和相关的临床症状。在严重CMS中,建议临时或永久迁移到低空。未来的研究应该集中在更客观的诊断工具上,以便及时治疗。改善对个体易感性的识别以及有效的适应和预防选择。
Millions of people visit high-altitude regions annually and more than 80 million live permanently above 2,500 m. Acute high-altitude exposure can trigger high-altitude illnesses (HAIs), including acute mountain sickness (AMS), high-altitude cerebral oedema (HACE) and high-altitude pulmonary oedema (HAPE). Chronic mountain sickness (CMS) can affect high-altitude resident populations worldwide. The prevalence of acute HAIs varies according to acclimatization status, rate of ascent and individual susceptibility. AMS, characterized by headache, nausea, dizziness and fatigue, is usually benign and self-limiting, and has been linked to hypoxia-induced cerebral blood volume increases, inflammation and related trigeminovascular system activation. Disruption of the blood-brain barrier leads to HACE, characterized by altered mental status and ataxia, and increased pulmonary capillary pressure, and related stress failure induces HAPE, characterized by dyspnoea, cough and exercise intolerance. Both conditions are progressive and life-threatening, requiring immediate medical intervention. Treatment includes supplemental oxygen and descent with appropriate pharmacological therapy. Preventive measures include slow ascent, pre-acclimatization and, in some instances, medications. CMS is characterized by excessive erythrocytosis and related clinical symptoms. In severe CMS, temporary or permanent relocation to low altitude is recommended. Future research should focus on more objective diagnostic tools to enable prompt treatment, improved identification of individual susceptibilities and effective acclimatization and prevention options.