摘要
目的分析高原作业电网施工人员急性高原病(AMS)发病率及危险因素。方法回顾性将10956名2019年1月1日—2020年12月31日阿里联网工程高原施工人员纳入研究。由阿里联网工程职工医疗站医疗记录数据库获取对象的基线资料(包括年龄、性别、体质指数、发育及营养状态、相关临床指标等)和AMS发病情况的随访资料,生命早期居住地所在地和工作环境海拔高度由网站(https://zh-cn.topographic-map.com/legal/)获取。计算不同特征对象AMS发病率,采用Cox比例风险回归模型探索AMS发病危险因素。结果研究对象年龄为(36.1±10.5)岁,其中男性占95.27%(10438名),随访时间为(17.46±4.23)个月,生命周期居住地和工作环境海拔分别为(1959±937)和(4533±233)m。随访期AMS发病率为15.58%(1707例),其中急性高原反应和高原肺水肿(HAPE)发病率分别为15.53%(1702例)和0.05%(5例),未发现高原脑水肿(HACE)患者。Cox比例风险回归模型分析显示:工作环境海拔高度每上升100 m,AMS发病风险升高45%[HR(95%CI):1.45(1.41~1.51)];生命早期居住地海拔高度越高,发病风险越低[HR(95%CI):0.84(0.80~0.88)];以基线时氧饱和度90%~94%作为对照组,氧饱和度<75%会增加AMS的发病风险(HR=1.67,95%CI:1.24~2.23)。结论高原作业电网施工人员AMS发病率较低,发病危险因素包括高工作环境海拔、低生命早期居住地海拔和基线时氧饱和度低于75%。
Objective To analyze the incidence and risk factors of acute mountain sickness(AMS)in grid construction personnel working at plateau.Methods A total of 10956 plateau construction personnel of Ali Network Project from January 1,2019 to December 31,2020 were included.Baseline information(including age,sex,body mass index,developmental and nutritional status,relevant clinical indicators,etc.)and follow-up data of AMS were obtained from the medical record of Ali Internet engineering staff medical station.The altitude of the residence place in early life and the working environment were obtained from the website(https://zh-cn.topographic-map.com/legal/).The incidences of overall AMS and its subgroups were calculated,and the Cox proportional hazards model was used to explore the risk factors for AMS.Results The age of the participants was(36.1±10.5)years old at baseline,and 95.27%(10438)of them were males.The follow-up time was(17.46±4.23)months.The altitude of the residence place in early-life and working environment were(1959±937)m and(4533±233)m,respectively.During the follow-up period,the incidence of AMS was 15.58%(1707 cases),and the incidence for acute mountain sickness and high altitude pulmonary edema were 15.53%(1702 cases)and 0.05%(5 cases),respectively.No high altitude cerebral edema patients were found.Cox proportional hazards model showed that the risk of AMS increased by 45%for every 100 m elevation in the altitude of working environment[HR(95%CI):1.45(1.41-1.51)].The higher the altitude for the residence place in early-life,the lower the risk of AMS[HR(95%CI):0.84(0.80-0.88)].Compared with the group with oxygen saturation during 90%-94%,the participants with oxygen saturation<75%[HR(95%CI):1.67(1.24-2.23)]at baseline was also associated with increased risk of AMS.Conclusions The incidence of AMS is relatively low in grid construction workers working on plateau.The risk factors of AMS included higher working altitude,lower altitude of the residence place in early-life and oxygen saturation<75%.
作者
张云静
周虎子威
巩泉泉
王鑫宇
杨昕昱
张骁彧
李志霞
王胜锋
Zhang Yunjing;Zhou Huziwei;Gong Quanquan;Wang Xinyu;Yang Xinyu;Zhang Xiaoyu;Li Zhixia;Wang Shengfeng(Department of Epidemiology and Biostatistics,School of Public Health,Peking University,Beijing 100191,China;State Grid Shandong Electric Power Research Institute,Ji′nan 250003,China;School of Public Health,Peking University,Beijing 100191,China;Department of Education,Peking University Health Science Center,Beijing 100191,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2023年第4期278-286,共9页
National Medical Journal of China
基金
国家电网有限公司科技项目(52060021004Q)
关键词
高原病
发病率
危险因素
队列研究
Altitude sickness
Incidence
Risk factors
Cohort studies
作者简介
通信作者:王胜锋,Email:wangshengfeng@bjmu.edu.cn
