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目的 通过对特定时间拉萨大学生的疾病健康状况及相关因素进行观察与分析，揭示目标群体急性高原病（AMS）分布特征及中医体质等变量间的关联性。方法 2023年8月17日至9月2日招募西藏大学大学生，采用横断面观察性研究设计，对人口学及社会学指标、生理学指标、危险因素及中医体质、睡眠质量、心理状态的组间差异进行单变量分析，并进一步进行二元Logistic回归分析以探讨AMS与各因素的相关性。结果 共回收有效问卷415份，AMS患病率在入藏后24 h达到峰值（43.55%），整体呈现先上升再下降的趋势。紧张恐惧状态下的大学生AMS患病率是心情无变化状态大学生的4.84倍（OR=4.84,95%CI:1.07～21.95,P=0.041），焦虑状态的大学生AMS患病率是无焦虑大学生的2.21倍（OR=2.21,95%CI:1.23～3.99,P=0.008）。兼夹体质是AMS发生的危险因素（OR=2.44,95%CI:1.16～5.16,P=0.019）。在八种偏颇体质中，气虚质AMS患病率是非气虚质的2.06倍（OR=2.06,95%CI:1.05～4.06,P=0.036）。在时间适应方面，到达拉萨后72～96 h(OR=0.38,95%CI:0.15～0.99,P<0.05)和96～120 h(OR=0.30,95%CI:0.13～0.66,P<0.01)，发生AMS的可能性显著减少。结论 拉萨大学生AMS危险因素主要为入藏前心情、焦虑和体质，72 h的适应时间是AMS的保护因素。
Abstract：Objective To observe and analyze the disease,health status,and related factors of college students in Lhasa at a specific time point,so as to reveal the distribution characteristics of acute mountain sickness(AMS) and the correlation between TCM constitution and other variables in the target population.Methods A cross-sectional observational study design was adopted.Univariate analysis was conducted on the differences between groups in demographic and sociological indicators,physiological indicators,risk factors,TCM constitution,sleep quality,and psychological state,with the presence or absence of AMS as the grouping variable.Binary Logistic regression analysis was performed with variables with P<0.05 in univariate analysis as independent variables and the presence or absence of AMS as the dependent variable to explore the correlation between AMS and various influencing factors.Results A total of 415 valid questionnaires were recovered.The prevalence of AMS peaked at 43.55% within 24 hours after entering Tibet,showing an overall trend of first increasing and then decreasing.AMS was significantly correlated with pre-entry mood,time adaptation,anxiety state,and constitution.College students in a state of tension and fear were 4.84 times more likely to develop AMS than those with no change in mood(OR=4.84,95% CI:1.07～21.95,P=0.041).College students with anxiety were 2.21 times more likely to develop AMS than those without anxiety(OR=2.21,95% CI:1.23～3.99,P=0.008).In terms of constitution,when the Pinghe Constitution was used as the reference group,the combined constitution was significantly associated with the occurrence of AMS(OR=2.44,95% CI:1.16～5.16,P=0.019).Among the eight biased constitutions,the prevalence of AMS in qi-deficiency constitution was 2.06 times that in non-qi-deficiency constitution(95% CI:1.05～4.06,P=0.036).In terms of time adaptation,the stages of 72～96 hours and 96～120 hours after arriving in Lhasa had P<0.05,with OR values of 0.38(95% CI:0.15～0.99) and 0.30(95% CI:0.13～0.66),respectively.Conclusion The main risk factors for AMS in college students in Lhasa are related to anxiety,pre-entry mood,and constitution,and the adaptation time of 72 hours is a protective factor for AMS.
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基本信息:
DOI：10.16289/j.cnki.1002-0837.2025.05003
中图分类号:R259
引用信息:
[1]王馨,辛陈,田煜坤,等.拉萨大学生急性高原病危险因素及中医体质特征的观察性研究[J].航天医学与医学工程,2025,36(05):403-409.DOI:10.16289/j.cnki.1002-0837.2025.05003.
基金信息:
国家重点研发计划（2019YFC1712205）; 中国中医科学院定向委托专项（Z0795-3）; 北京市科协科研基金/中国中医科学院针灸所立项课题（2022031-213116、211069）