切换至 "中华医学电子期刊资源库"

中华肺部疾病杂志(电子版) ›› 2022, Vol. 15 ›› Issue (06) : 879 -881. doi: 10.3877/cma.j.issn.1674-6902.2022.06.031

短篇论著

高原肺水肿患者临床特点分析
郭亮1, 何思毅2, 杨毓斌3, 关尚全3, 吴学玲4,(), 李少莹5,()   
  1. 1. 400037 重庆,陆军(第三)军医大学第二附属医院呼吸与危重症医学科
    2. 610083 成都,西部战区总医院心血管外科
    3. 844900 新疆,陆军第950医院感染科
    4. 200127 上海,上海交通大学仁济医院呼吸与危重症医学科
    5. 650032 昆明,联勤保障部队第九二〇医院呼吸与危重症医学科
  • 收稿日期:2022-04-17 出版日期:2022-12-25
  • 通信作者: 吴学玲, 李少莹
  • 基金资助:
    联勤保障部队第九二〇医院军事医学研究计划成长项目(2019YGA17)

Analysis of the clinical characteristics of patients with plateau pulmonary edema

Liang Guo1, Siyi He2, Yubin Yang3   

  • Received:2022-04-17 Published:2022-12-25
引用本文:

郭亮, 何思毅, 杨毓斌, 关尚全, 吴学玲, 李少莹. 高原肺水肿患者临床特点分析[J]. 中华肺部疾病杂志(电子版), 2022, 15(06): 879-881.

Liang Guo, Siyi He, Yubin Yang. Analysis of the clinical characteristics of patients with plateau pulmonary edema[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2022, 15(06): 879-881.

高海拔肺水肿(high altitude pulmonary edema, HAPE)是指人们在高海拔环境时,由于环境缺氧导致肺血管收缩和毛细血管通透性增加而引起的高原危重症[1,2,3,4,5]。HAPE的发生主要取决于上升速度、运动强度和绝对海拔高度,尤其是静息时的海拔高度[6]。HAPE的常见症状包括呼吸困难、运动不耐受、疲劳、咳嗽和发绀等。如救治不及,HAPE患者的病死率可达50%[7],如果出现合并症,病死率升高。HAPE的并发症包括肺炎、高原脑水肿(high-altitude cerebral edema, HACE)、肺栓塞和脑梗死[8,9,10,11]。尽管HAPE合HACE在急性高原病中并不常见[12],本文收集的资料中,36例HAPE患者,6例合并HACE。本文回顾性分析HAPE患者的临床特征,报道如下。

图1 高原肺水肿的胸部CT表现;注:A、B:为双侧肺水肿;C、D:为单侧肺水肿
表1 HAPE合并HACE患者和HAPE患者血常规、生化指标及凝血功能差异性分析
1
Das BB, Wolfe RR, Chan KC, et al. High-altitude pulmonary edema in children with underlying cardiopulmonary disorders and pulmonary hypertension living at altitude[J]. Arch Pediatr Adolesc Med, 2004158: 1170-1176.
2
Swenson ER, Bartsch P. High-altitude pulmonary edema[J]. Compr Physiol, 2012, 2: 2753-2773.
3
Woods P, Alcock J. High-altitude pulmonary edema[J]. Evol Med Public Health, 2021, 9(1): 118-119.
4
Walker C, Miner B, Bolotin T. High-Altitude Pulmonary Edema in Ohio at an Elevation of 339 Meters[J]. Open Access Emerg Med, 2021, 13: 151-153.
5
Mulchrone A, Moulton H, Eldridge MW, et al. Susceptibility to high-altitude pulmonary edema is associated with increased pulmonary arterial stiffness during exercise[J]. J Appl Physiol (1985), 2020, 128(3): 514-522.
6
Bartsch P, Mairbaurl H, Swenson ER, et al. High altitude pulmonary oedema[J]. Swiss Med Wkly, 2003, 133(27-28): 377-384.
7
Woods P, Alcock J. High-altitude pulmonary edema[J]. Evol Med Public Health, 2021, 9(1): 118-119.
8
Li Y, Zhang Y, Zhang Y. Research advances in pathogenesis and prophylactic measures of acute high altitude illness[J]. Respir Med, 2018145: 145-152.
9
Lopez JI, Holdridge A, Mendizabal JE. Altitude headache[J]. Curr Pain Headache Rep, 2013, 17(12): 383.
10
Hultgren HN. High altitude pulmonary edema: hemodynamic aspects[J]. Int J Sports Med, 1997, 18(1): 20-25.
11
Clarke C. Acute mountain sickness: medical problems associated with acute and subacute exposure to hypobaric hypoxia[J]. Postgrad Med J, 2006, 82(973): 748-753.
12
Hackett PH, Oelz O. The Lake Louise consensus on definition and quantification of altitude illness. In: Sutton JR, Coates G, Houston CS, eds. Hypoxia: Mountain Medicine. Burlington VT: Queen City Press; 1992: 327-330.
13
Luks AM, Swenson ER, Bartsch P. Acute high-altitude sickness[J]. Eur Respir Rev, 2017, 26(143): 160096.
14
Bärtsch P, Swenson ER. Clinical practice: acute high-altitude illnesses [J]. N Engl J Med, 2013, 368: 2294-2302.
15
Gudbjartsson T, Sigurdsson E, Gottfredsson M, et al. High altitude illness and related diseases-a review[J]. Laeknabladid, 2019, 105(11): 499-507.
16
Zubieta-Calleja GR, Zubieta-DeUrioste N. High altitude pulmonary edema, high altitude cerebral edema, and acute mountain sickness: an enhanced opinion from the high andes-la paz, bolivia 3,500 m[J]. Rev Environ Health, 2022.doi: 10.1515/reveh-2021-0172.
17
Eduardo P, Samia El A, Patricia S, et al. Oxidative stress and diseases associated with high-altitude exposure[J]. Antioxidants (Basel), 2022, 11(2): 267.
18
Joyce KE, Lucas SJE, Imray CHE, et al. Advances in the available non-biological pharmacotherapy prevention and treatment of acute mountain sickness and high altitude cerebral and pulmonary oedema[J]. Expert Opin Pharmacother, 19(17): 1891-1902.
19
Wu J, Han X, Ke H, et al. Pulmonary embolism at extreme high altitude: A study of seven cases[J]. High Alt Med Biol, 2022, 23(3): 209-214.
20
Simko LC, Culleiton AL. Uncommon causes of noncardiogenic pulmonary edema[J]. Nurse Pract, 2020, 45(4): 26-32.
21
Luks AM, Swenson ER. COVID-19 Lung Injury and High-Altitude Pulmonary Edema. A False Equation with Dangerous Implications[J]. Ann Am Thorac Soc, 2020, 17(8): 918-921.
22
Ferguson SK, Pak DI, Hopkins JL, et al. Pre-clinical assessment of a water-in-fluorocarbon emulsion for the treatment of pulmonary vascular diseases[J]. Drug Deliv2019, 26(1): 147-157.
23
Pennardt A. High-altitude pulmonary edema: diagnosis, prevention, and treatment[J]. Curr Sports Med Rep, 2013, 12(2): 115-119.
24
Luks AM, McIntosh SE, Grissom CK, et al. Wilderness Medical Society practice guidelines for the prevention and treatment of acute altitude illness: 2014 update[J]. Wilderness Environ Med, 2014, 25(4Suppl): S4-S14.
25
Pollard AJ, Niermeyer S, Barry P, et al. Children at high altitude: an international consensus statement by an adhoc committee of the international society for mountain medicine[J]. High Alt Med Biol, 2001, 2: 389-403.
[1] 段燕, 郭欣, 吕慧芳, 王国利, 黄明光, 董英俊. 乳腺癌患者辅助化疗后感染肺孢子菌一例[J]. 中华乳腺病杂志(电子版), 2023, 17(05): 318-321.
[2] 张巧梅, 孙小平, 李冠胜, 邓扬嘉. 针灸对大鼠呼吸机相关性肺炎中性粒细胞归巢及胞外诱捕网的影响[J]. 中华危重症医学杂志(电子版), 2023, 16(04): 265-271.
[3] 罗晨, 宗开灿, 李世颖, 傅应亚. 微小RNA-199a-3p调控CD4T细胞表达参与肺炎支原体肺炎患儿免疫反应研究[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 569-574.
[4] 沈娟, 陈宇, 沈玉凤, 张佩. 肺炎支原体肺炎儿童的诊治研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(03): 273-277.
[5] 杨梅, 周春, 赵艾红, 王琴. 儿童难治性肺炎支原体肺炎所致塑型性支气管炎风险列线图模型的构建[J]. 中华实验和临床感染病杂志(电子版), 2023, 17(04): 274-281.
[6] 胡皓翀, 刘一霆, 郭嘉瑜, 邹寄林, 陈忠宝, 周江桥, 邱涛. 肾移植术后耐碳青霉烯类肺炎克雷伯菌感染的诊疗分析[J]. 中华移植杂志(电子版), 2023, 17(04): 246-249.
[7] 安钱, 徐彬, 陈志祥, 徐晶晶, 黄丹丹. PCT、CRP及SAA对呼吸机相关性肺炎病情严重程度和预后分析[J]. 中华肺部疾病杂志(电子版), 2023, 16(04): 544-546.
[8] 张帅, 袁媛, 邢振川, 王焕勇, 张虹霞. 71例急性肺血栓栓塞症并发肺梗死临床特征[J]. 中华肺部疾病杂志(电子版), 2023, 16(04): 566-568.
[9] 肖慧, 徐维国, 范小兵, 李厚衡. 血清IL-34、SP-D、CXCL17在甲型流感病毒性肺炎患者中表达及临床意义[J]. 中华肺部疾病杂志(电子版), 2023, 16(03): 349-351.
[10] 盛名, 王敬文, 郭爽, 万文蕾. 重症肺炎NT-proBNP动态演变与患者预后风险的相关性分析[J]. 中华肺部疾病杂志(电子版), 2023, 16(03): 379-381.
[11] 李静静, 翟蕾, 赵海平, 郑波. 多囊肾合并囊肿的多重耐药菌感染一例并文献复习[J]. 中华临床医师杂志(电子版), 2023, 17(08): 920-923.
[12] 余林阳, 王美英, 李建斌, 楼骁斌, 谢思远, 马志忠, 齐海英, 李稼. 高原地区肺炎合并右心功能衰竭体征患儿的肺动脉压力和心脏形态与功能的特征[J]. 中华临床医师杂志(电子版), 2023, 17(05): 535-544.
[13] 于洋, 刘孝洁, 王丽娟, 高宇晨, 丁瑶, 敖虎山. 新冠肺炎常态化条件下心肺复苏培训模式初探[J]. 中华临床医师杂志(电子版), 2023, 17(04): 483-486.
[14] 邱学荣, 张秀琴, 张欢, 刘婷, 高翠琴. 动态监测SAA给予抗生素在电子支气管镜联合普米克令舒治疗重症肺炎中的价值研究[J]. 中华临床医师杂志(电子版), 2023, 17(03): 308-313.
[15] 王燕, 郭蕊, 王淑杰. 老年烧伤气管切开患者死亡风险诊断模型构建及对策分析[J]. 中华诊断学电子杂志, 2023, 11(04): 249-253.
阅读次数
全文


摘要