- 期刊
急性高山症之生理反應及藥物治療
Physiological Responses and Medical Treatments of Acute Mountain Sickness
摘要
每年皆有數千人因工作、休閒、運動訓練等因素，登高至高海拔地方而處於急性高海拔症風險。此風險依登高速率、海拔高度、適應環境能力、年齡、高海拔症候群病史與個人敏感性有關，造成個體間之生理反應差異，因此有不同的治療方式。當登高超過2,500公尺海拔高度，並歷時6 ~12小時後出現包含頭痛、疲倦、頭昏眼花、腸胃不適（厭食、噁心、嘔吐）、失眠頻醒等低壓低氧血症之五大症狀即患有急性高山症。依症狀嚴重程度評量，若無法適應又不加以治療將進展為致命的高海拔腦水腫或高海拔肺水腫。本文目的乃針對包含運動訓練需求須登高之族群，探討急性暴露於低氧環境下，由器官至分子層次描述生理狀況改變，並給予藥物及非藥物之預防與治療之建議。研究方法係透過文獻回顧整理分析。研究結果發現治療急性高山症第一線治療藥物為利尿劑及類固醇，然而該藥物為運動禁藥。本文建議運動選手切勿因此誤服禁藥，以免違反運動禁藥管制規範，受禁賽之處罰。也希望本文提供之生理反應變化及藥物治療，對低氧運動訓練計劃擬定與因應策略有所幫助。
並列摘要
With increasing numbers of individuals working, traveling, or exercising at high altitude, people are occasionally exposed to the risk of acute altitude illness. Acute altitude sickness can occur in anyone going to a high altitude. The risk depends on the rate of ascent, prior acclimatization, age, history of prior altitude illness, and inborn susceptibility. Acute mountain sickness (AMS) is a group of symptoms associated with hypobaric hypoxemia above 2,500 m. It usually manifests with headache, which is often associated with fatigue, lightheadedness, lack of appetite, nausea and vomiting, and insomnia. These symptoms typically occur after 6 ~ 12 hours of ascent. Without treatment, AMS can progress to life-threatening high altitude cerebral edema or high altitude pulmonary edema. The purposes of this article were to provide information regarding physiological responses from the organ systems to the molecular level, and medical treatments of hypoxemic condition during ascent. A literature review was conducted in this study. Diuretics and steroids were the first-line treatment of AMS; hence we have to remind athletes not to violate doping rules while training at high altitude. Once coaches understand these physiological changes, better training strategy is expected.