高海拔疾病預防用藥之探討

DRUGS FOR PREVENTING HIGH ALTITUDE ILLNESS

林怡儂(Yi-Nong Lin)

《秀傳醫學雜誌》 20卷1期 (2021/06) Pp. 45-50

https://doi.org/10.3966/156104972021062001007

摘要

高海拔疾病包括3種形式：急性高山症、高海拔腦水腫及高海拔肺水腫。高海拔腦水腫與急性高山症可同時處理。比起用於治療高海拔疾病，藥物在預防上較有重要角色；只有處於發生高海拔疾病的中高度風險，才需使用預防藥物。常見預防用藥Acetazolamide 125 mg一日兩次即可有效預防急性高山症，不需使用劑量高至250 mg一日兩次。另外，發生高海拔肺水腫的登高者不一定會發生急性高山症，致病機轉與因應的預防用藥有所不同；而第五型磷酸二酯酶抑制劑如Sildenafil（威爾鋼）只能有效預防高海拔肺水腫，無法有效預防急性高山症，故應破除只帶威而鋼上山就可避免所有高海拔疾病的常見民眾迷思。

關鍵字

高海拔疾病 ； 急性高山症 ； 高海拔腦水腫 ； 高海拔肺水腫

並列摘要

There are three forms of high-altitude illness (HAI): acute mountain sickness (AMS), high altitude cerebral edema (HACE) and high altitude pulmonary edema (HAPE). HACE and AMS can be addressed simultaneously. Prophylactic medicines should only be used for individuals with a moderate-to-high risk of HAI. The effective preventive dose of acetazolamide with minimal side effects is 125 mg BID, not 250 mg BID. Subject with HAPE do not all develop AMS. The pathogenesis and preventive medication are different to those for AMS. Prophylaxis with phosphodiesterase-5 inhibitors such as sildenafil decreases the incidence of HAPE but is not effective against AMS. It is not possible to prevent all HAI by taking Viagra®.

並列關鍵字

High altitude illness ； Acute mountain sickness ； High altitude cerebral edema ； High altitude pulmonary edema