Background  Acute mountain sickness (AMS) is the most important non-combat attrition factor after troops enter the plateau rapidly. There are many factors affect the incidence of AMS, while researches on influencing factors and symptom changes of AMS with the increase in altitude are still insufficient.

  Objective  To analyze the occurrence of various discomfort symptoms of AMS in different altitude areas, explore the influencing factors of AMS after rushing to the plateau, and predict the occurrence of AMS.

  Methods  A follow-up survey of conscious symptoms from 184 officers and soldiers was made in September 2020 by self-compiled questionnaires during their advancing to the plateau at altitudes of 2 780 meters and 4 200 meters. A logistic regression model was established to explore the changes and influencing factors of AMS symptoms in officers and soldiers who were rapidly advancing to different altitudes.

  Results  The average age of the 171 subjects (47 females and 124 males) included in the study was 31.95±6.85 years. The incidences of AMS symptoms at an altitude of 2 780 m and 4 200 m were 63.74% and 90.64%, respectively. The risk of AMS significantly increased after rapid entry into the plateau (OR=5.838, 95% CI: 3.162-10.778, P=0.000). Gender was an independent influencing factor for AMS, and the incidence of AMS symptoms in women was significantly higher than that in men (OR=0.335, 95% CI: 0.151-0.743, P=0.007), while age, ethnicity, BMI, smoking history, and history of exposure to high altitude were not correlated with AMS (P＞0.05). Analysis on the symptoms of AMS found that the incidence of symptoms similar to "cold" decreased (OR=0.638, 95% CI: 0.463-0.878, P=0.006) with the increase of age, while the incidence and severity of symptoms such as dyspnea and palpitation showed a trend of getting more serious with the increase of age (P＜0.05), and the risk of diarrhea increased with the increase of BMI (OR=1.639, 95% CI: 1.083-2.480, P=0.019). In addition, symptoms including palpitation, feeble or fatigue, insomnia, memory loss, and thinking problems in smokers were significantly milder than that of non-smokers (P＜0.05).

  Conclusion  The incidence of AMS reaches 90.64% at an altitude of 4 200 meters. Gender and altitude have a significant impact on the occurrence of AMS, and age, BMI and smoking history affect some symptoms of AMS, which provide scientific evidences for reducing the occurrence of AMS in officers and soldiers.