Regular Observation of De-Acclimatization and Randomized Controlled Research of Diagnostic Criteria of High Altitude De-Acclimatization Syndrome among Different Plateau Migrants Crowd after Their Return to the Plain

Qiquan Zhou^1,2*, Shengyue Yang³, Zhencai Yuan⁴, Yinhu Wang⁵, Xuefeng Zhang⁶, Wei Gao⁷, Zifu Shi⁸, Youli Yang⁹, Yunhong Wu¹⁰, Yong Fan^1,2, Fuling Wang⁵, Guansong Wang^11*

¹Department of High Altitude Disease, College of High Altitude Military Medicine, Third Military Medical University, Chongqing, China.
²Key Laboratory of High Altitude Medicine of Ministry of Education and Key Laboratory of High Altitude Medicine of PLA, Chongqing, China.
³Department of Respiratory Medicine, Fourth Hospital of Chinese PLA, Xining, China.
⁴Xianyang Hospital of China Railway First Group Co., Ltd., Xianyang, China.
⁵Research Institute of High Altitude Diseases, 18th Hospital of Chinese PLA, Yecheng, China.
⁶Research Center of High Altitude Medicine, People’s Hospital of Golmud City, Golmud, China.
⁷Department of Thoracic Surgery, Lanzhou General Hospital of Lanzhou Command, Lanzhou, China.
⁸The 68303 Troop Hospital of Chinese PLA, Wuwei, China.
⁹Department of Clinical Laboratory, Tenth Hospital of Chinese PLA, Wuwei, China.
¹⁰Department of Endocrinology, Hospital of Chengdu Office of Tibet Autonomous Region, Chengdu, China.
¹¹Research Institute of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University, Chongqing, China.

DOI: 10.4236/odem.2014.24010                

Abstract

Objective: The objective of this study was to investigate the diagnostic methods of high altitude de-acclimatization syndrome and to formulate diagnostic criteria. Methods: This study was conducted using epidemiological surveys and a multi-center randomized controlled clinical trial. A total of 3011 subjects were studied, and the following indices were collected after their return to low altitude areas from the plateau: general health status, blood, urine and stool samples, myo-cardial enzyme levels, liver and kidney function, nerve function, sex hormone levels, microalbuminuria, electrocardiogram (ECG), echocardiography, pulmonary function, and hemorheological markers. These data were compared to those of randomized healthy subjects in the same age range who lived at the same altitude to determine the characteristics of high altitude de-acclimatization syndrome. Based on these characteristics, diagnostic criteria for high altitude de-acclimatization syndrome were formulated. Results: This study demonstrated that the incidence of high altitude de-acclimatization syndrome was 84.36%. Sixty percent of the cases were mild, 30% were medium, and 10% were severe. The incidence was higher among those who returned to a place of lower altitude, resided at a high altitude for a longer period of time, or engaged in heavy labor while at high altitude. Patients with high altitude de-acclimatization syndrome manifested hematological abnormalities and abnormal ventricular function, notably a right ventricular diastolic function, which recovered to baseline function after one to five years. Exposure to long-term hypoxia often caused obvious changes in cardiac morphology, i.e., left and right ventricular hypertrophy, particularly within the right ventricle. In addition, patients with high altitude de-acclimatization syndrome often presented with low blood pressure, low pulse pressure, and microalbuminuria. A few patients presented with occult blood in their feces. The diagnosis of high altitude de-acclimatization syndrome can be made if a patient who recently returns to the plain from the plateau complains of dizziness, weakness, sleepiness, chest tightness, edema, memory loss, and other symptoms and signs that do not alleviate under short-term rehabilitation or symptomatic treatment, and if organic diseases of the heart, lung, kidney, and other organs have been excluded. Conclusion: The diagnosis of high altitude de-acclimatization syndrome should be made after a comprehensive analysis of the patient’s clinical symptoms and signs.

Keywords

Plateau Migrants, Low Altitude, High Altitude De-Acclimatization Syndrome, Diagnostic Criteria, Multi-Center Study

Conflicts of Interest

The authors declare no conflicts of interest.

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