歼(强)击机飞行员心脏瓣膜生理性返流调查分析

Objective To investigate the prevalence of physiological valvular regurgitation and its influence in fighter (attacker) pilots. Methods One hundred pilots were divided into high performance fighter pilot group (56 pilots) and common fighter pilot group (44 pilots). Their cardiac structure and function were examined by echocardiography. Results 55 pilots were diagnosed with physiological valvular regurgitation (55.00%), including 32 high performance fighter pilots (57.14%) and 23 common fighter pilots (52.27%). The prevalence of tricuspid, mitral and combined valvular regurgitation was 33. 00%, 9.00% and 13.00% respectively. There were 11 cases of mitral combined tricuspid valvular regurgitation, 1 case of tricuspid combined pulmonic valvular regurgitation and 1 ease of tricuspid combined aortic valvular regurgitation. In common fighter pilot group, right ventricular internal dimension (RVID) of the pilots with regurgitation was significantly higher than that of the pilots without regurgitation (t= 1.69, P＜0.05). No other significant differences were observed between groups (P＞0. 05). The cardiac structure and function of 100 pilots were in normal range. Conclusions High prevalence of physiological valvular regurgitation is found in fighter pilots, and in which tricuspid valvular regurgitation takes the highest. It is necessary to further investigate if the fighter pilot's specificity makes the different mechanism of physiological regurgitation from other eareer's and its long-term influence on pilot's cardiac structure and function.     

血管回声跟踪技术对男性飞行员颈动脉血管弹性的定量检测

目的 通过血管回声跟踪(echo-tracking,ET)技术对颈动脉血管弹性的定量检测,探讨年龄及飞行时间对男性飞行员颈动脉血管弹性的影响. 方法 根据年龄将72例飞行员分为20～29岁(27人)、30～39岁(30人)和40～49岁(15人)3组.应用ET技术检测各组飞行员的颈动脉血管,并采用t检验分别对各个年龄组颈动脉血管弹性值[僵硬度(stiffness parameter,β)、弹性模量(pressure-strain elastic modulus,Ep)、顺应性(arterial compliance,AC)和脉搏波传导速度(pulse wave velocity calculated from β value,PWVβ)]与国人正常测量值(对照组)进行对比分析,采用方差分析对各组间血管弹性值和飞行时间进行比较,通过直线相关和偏相关分析对各组飞行员年龄与飞行时间对颈动脉血管弹性的影响进行分析. 结果 飞行员各组β、Ep及PWVβ均较国人正常测量值降低,AC增高.飞行员20～29岁及30～39岁组血管弹性值与其对照组比较,有统计学意义(t=2.061～6.712,P＜0.05或P＜0.01),40～49岁组与对照组比较,无统计学意义.通过直线相关分析,30～39岁组的年龄、飞行时间与β、Ep和PWVβ均存在显著正相关;在20～29岁和30～39岁组中,年龄与飞行时间存在显著性正相关(r=0.655、0.723,P=0.001、0.000).通过偏相关分析,在控制飞行时间因素时,30～39岁组中β和Ep值与年龄存在显著正相关(r=0.516、0.452,P=0.007、0.020),即随着年龄的增加,β和Ep值增加. 结论 年龄对男性飞行员颈动脉血管弹性影响较大,而飞行时间影响较小.ET技术对飞行员颈动脉血管弹性值的定量检测有助于进一步了解男性飞行员的血管功能状态. Abstract： Objective To investigate quantitative detection of the carotid elasticity of male pilots in different age groups by using echo-tracking (ET) technique. Methods The carotid arteries were detected by ET technique in 72 male pilots who were divided into 3 groups according to age. The elasticity values, including stiffness parameter (β), pressure-strain elastic modulus (Ep), arterial compliance (AC) and pulse wave velocity calculated from β value (PWVβ) were analyzed by t test.The elasticity values and flying hours were also processed by variance analysis among 3 groups. The influence of age and flying hours to elasticity values was resolved by linear correlation and partial correlation analysis. Results There was no difference on elasticity values of bilateral carotid. The arterial stiffness indices, such as β, Ep and PWVβ in each group, were lower than those by the normal measuring, but AC value was higher. By comparing with control group, the carotid elasticity values had statistical difference in 20-29 yrs and 30-30 yrs groups, but for 40-49 yrs group comparison there was no significant difference (t= 2. 061-6. 712, P＜0.05 or P＜0.01). Linear correlation analysis showed that age and flying hours appeared significant and positive correlation to β, Ep and PWVβ in 30-39 yrs group. In 20-29 and 30-39 yrs groups, age was significantly and positively correlated to flying hours (r=0. 655, 0. 723, P=0. 001, 0. 000). In 30-39 yrs group β and Ep were positively correlated with age based on partial correlation analysis (r= 0. 516, 0. 452, P= 0. 007, 0. 020), which meant that β and Ep significantly increased with age. Conclusions For male pilot age expresses greater influence than flying hours to carotid artery elasticity. Quantitatively detecting male pilot's carotid artery elasticity by ET technique will contribute to the delermination of pilot's artery functional status.     

神经行为评价系统在飞行员脑功能评定中的应用研究

Objective To explore the application of neurobehavioral evaluation system-C3(NES-C3) for pilot's cerebral function (CF) evaluation. Methods The characters of CF under interference of simulated jet engine noise and neurobehavioral ability index (NAI) were investigated in 45 military pilots [(27.6±2.5) yr] (as pilot group) and in 45 college students [(27.5±2.6) yr] (as control group) by NES-C3. The variance of profile of mood statues (POMS) scales, (including tension-anxiety, angry-hostility, exhausted-inertia, gloom-depressed, powerful-restless and stumblepuzzle) and NAI (including memory scanning, digital scanning, visual simple reaction time, visual complex reaction time, pursuit aiming, and consecutive performance) were compared respectively.Results With or without interference of noise, the score of "powerful-restless" in pilot group was higher than that in control group (t=9.74, 12.52, P＜0.05), and the score of tension-anxiety in control group was higher than that in pilot group (t= 10. 46, 14.25, P＜0. 05). When noise was applied, the score of POMS in control group was significantly increased (t=2. 85-6. 33, P＜0. 05) but in pilot group only "tension-anxiety" and "powerful-restless" were significantly increased (t = 4. 12,5.92, P＜0.05). The score of "tension-anxiety" in control group was higher than that in pilot group.Four items of NAI in pilot group were significantly higher than those in control group (t= 2 91-10.55, P＜0. 05). There were no noised induced significant NAI changes in pilot group but in control group. They were not only lower than that in the state without noise interference (t-5.24-29.24,P＜0. 05) but also lower than that in pilot group (t=4. 07-28. 41, P＜0. 05). Conclusions NES-C3 is a useful tool for the identification of pilot's CF.     

高性能战斗机飞行员血清铁浓度和红细胞指标变化分析

目的 探讨高性能战斗机飞行员血清铁浓度和红细胞指标变化的机制. 方法 将来我院疗养的39名高性能战斗机飞行员作为观察组,72名歼-7、歼-8和强-5飞行员作为对照组,并比较两组飞行员血清铁浓度、红细胞指标的变化. 结果 高性能战斗机飞行员较对照组飞行员血清铁浓度、血红蛋白量、红细胞平均血红蛋白含量、平均红细胞血红蛋白浓度均降低,且有统计学意义(t=3.50～7.95,P<0.01);而红细胞计数升高,且有统计学意义(t=3.01,P<0.01). 结论 高性能战斗机飞行员因承受较大的加速度、缺氧、热负荷及应激,可能会引起血清铁浓度降低,红细胞计数代偿性升高,从而导致血红蛋白、红细胞平均血红蛋白含量、平均红细胞血红蛋白浓度下降,缺氧耐受力降低.因此.及早采取干预措施,及时减轻飞行疲劳和提高飞行耐力,对于保障飞行安全有重要意义. Abstract： Objective To explore the mechanism of serum iron and red blood cell changes in high performance fighter pilots. Methods Thirty-nine high performance fighter aircraft pilots were selected as test group while other 72 fighter and attacker pilots were in control group.The serum iron and red blood cell index were compared between groups. Results Pilots in test group showed significantly lower serum iron,hemoglobin,mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration than those of other pilots' in control group (t=3.50-7.95,P<0.01) but red blood cell was counted significantly higher (t=3.0 1,P<0.01). Conclusions Changes happened on high performance fighter aircraft pilots indicate that they are undertaking higher working loads such as acceleration,hypoxia.heat and stress.And these would be the reasons of resulting in lower serum iron,higher compensatory red blood cell indices,and lower hemoglobin,mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration,subsequently the poor hypoxia tolerance.Therefore,intervention measures are suggested with timely erythrocyte indices monitoring in order to release fatigue and ensure safety.     

彩色多普勒超声心动图诊断飞行员左室假腱索及其临床意义

目的 探讨飞行员左室假腱索的彩色多普勒超声心动图诊断及其临床意义.方法 对我院近8年来进行彩色多普勒超声心动图检查的934例男性飞行员资料进行分析,按是否存在左室假腱索对飞行员进行分组,比较两组室性早搏、T波或ST-T改变的检出率及年龄.结果 934例飞行员发现有左室假腱索98例,检出率10.49%,无假腱索者836例(占89.51%).左室假腱索组与无假腱索组飞行员所出现的室性早搏阳性率和T波或ST-T改变阳性率组间比较,差异有统计学意义(x2=97.71、70.16,P＜0.01),两组年龄比较无显著差异(t=1.479,P＞0.05).结论 除外器质性心脏病,飞行员左室假腱索与临床出现的室性早搏和T波或ST-T改变有一定的关联性,左室假腱索的检出对飞行员的医学健康鉴定有一定的诊断价值和临床意义. Abstract： Objective To study the clinical significance of diagnosing pilot's left ventricular false tendons (LVFT) by color Doppler echocardiography.Methods The case history of 934 pilots who were examined by color Doppler echocardiography in recent 8 years was reviewed.Pilots were grouped by judging if the LVFT was diagnosed.The detection rate of premature ventricular contraction and the change of T wave or S-T, as well as age were compared between LVFT group and healthy group.Results There were 98 cases of LVFT picked out of 934 pilots; the detection rate was 10.49%.Masculine of premature ventricular contraction and the change of T wave or S-T in LVFT group showed significant difference (x2=97.71 and 70.16, P＜0.01) but for age (t=1.479, P＞0.05).Conclusions LVFT shows certain relationship with premature ventricular contraction and the change of T wave or S-T except the reason of organic heart disease.Even LEFT taken as a kind of normal anatomical variation but it has the possibility of evoking premature ventricular contraction after all.Caring LVFT is suggested in medical identification of pilot.     

健康飞行员与高血压飞行员血浆内皮素和降钙素基因相关肽含量的比较

目的 比较民航健康飞行员与高血压飞行员血浆内皮素和降钙索基因相关肽含量的差异. 方法 采用放射免疫分析法测定87例民航健康飞行员及92例民航高血压飞行员的血浆内皮素和降钙素基因相关肽浓度. 结果 健康飞行员组血浆内皮素浓度为(49.3±8.64)pg/ml,降钙素基因相关肽浓度为(51.2±19.23)pg/ml;高血压飞行员组血浆内皮素浓度为(65.8±9.32)pg/ml,降钙素基因相关肽浓度为(31.6±15.46)pg/ml.高血压飞行员与健康飞行员相比,血浆内皮素浓度明显升高(t=12.26,P<0.01),而血浆降钙素基因相关肽浓度明显下降(t=7.54,P<0.01),两者差异均具有统计学意义. 结论 民航飞行员血浆内皮素和降钙素基因相关肽的分泌失调可能是其高血压发生的重要原因之一,应加强对民航飞行员血浆内皮素和降钙素基因相关肽的监测. Abstract： Objective To compare the difference of plasma endothelin (ET) and calcitonin generelated peptide (CGRP) concentration between healthy and hypertensive civil pilots. Methods Plasma ET and CGRP concentration were measured by radioimmunoassay in 87 healthy (as control group) and 92 hypertensive civil pilots. Results The plasma concentration of ET and CGRP was respectively (49.3±8.64) pg/ml,(51.2±19.23) pg/ml in healthy pilots,and (65.8±9.32) pg/ml,(31.6±15.46) pg/ml in hypertensive pilots.Comparing to the healthy the hypertensive pilots showed significantly higher plasma ET (t=12.26,P<0.01)) but lower CGRP concentrations (t=7.54,P<0.01). Conclusions The secretion maladjustment of plasma ET and CGRP would be the important reasons for inducing civil pilot's hypertension and the attentive monitoring is suggested.     

健康飞行员与高血压飞行员血浆内皮素和降钙素基因相关肽含量的比较

Objective To compare the difference of plasma endothelin (ET) and calcitonin generelated peptide (CGRP) concentration between healthy and hypertensive civil pilots. Methods Plasma ET and CGRP concentration were measured by radioimmunoassay in 87 healthy (as control group) and 92 hypertensive civil pilots. Results The plasma concentration of ET and CGRP was respectively (49.3±8.64) pg/ml,(51.2±19.23) pg/ml in healthy pilots,and (65.8±9.32) pg/ml,(31.6±15.46) pg/ml in hypertensive pilots.Comparing to the healthy the hypertensive pilots showed significantly higher plasma ET (t=12.26,P<0.01)) but lower CGRP concentrations (t=7.54,P<0.01). Conclusions The secretion maladjustment of plasma ET and CGRP would be the important reasons for inducing civil pilot's hypertension and the attentive monitoring is suggested.     

空军飞行员角膜内皮细胞的初步分析

Objegtive To preliminarily study the endothelial density baseline and the morphological characteristics of the corneal endothelial cell of Chinese Air Force pilot. Metheds Density and morphology of corneal endothelial cells were observed by Topcon-2000 noncontact specular microscope and analyzed by Imagenet 2000 software(version 2.53)on 56 pilots(112 eyes)While other 30 healthy men(60 eyes)who were with the comparable age and uncorrected visual acuity were compared and analyzed as the control group. Results The data showed that the average corneal endothelial cell density was 2797.0±330.3/mm2 in pilot group which was significantly lowet than 2917.57±318.04/mm2 in control group(t=2.286,P=0.024).The mean constituent ratio of hexagonal cell was 56.46±7.19 in pilot group compared with 60.33±7.68 in control group(t=8.253,P=O.001)and it was gradually reduced with the age growing in both groups(r=-0.395,-0.268,P=0.000.0.038).With the growing of flying hours the mean area of cell was increased under the eontrolled age factor according to partial correlation analysis(r=0.244,P=0.0 1).Conclusions Measuring of the corneaI endothelial cellular morphologic parameters and implementing corresponding analysis are helpful to know pilot's corneal endotheliurn changes in flight.     

空军飞行员角膜内皮细胞的初步分析

Objegtive To preliminarily study the endothelial density baseline and the morphological characteristics of the corneal endothelial cell of Chinese Air Force pilot. Metheds Density and morphology of corneal endothelial cells were observed by Topcon-2000 noncontact specular microscope and analyzed by Imagenet 2000 software(version 2.53)on 56 pilots(112 eyes)While other 30 healthy men(60 eyes)who were with the comparable age and uncorrected visual acuity were compared and analyzed as the control group. Results The data showed that the average corneal endothelial cell density was 2797.0±330.3/mm2 in pilot group which was significantly lowet than 2917.57±318.04/mm2 in control group(t=2.286,P=0.024).The mean constituent ratio of hexagonal cell was 56.46±7.19 in pilot group compared with 60.33±7.68 in control group(t=8.253,P=O.001)and it was gradually reduced with the age growing in both groups(r=-0.395,-0.268,P=0.000.0.038).With the growing of flying hours the mean area of cell was increased under the eontrolled age factor according to partial correlation analysis(r=0.244,P=0.0 1).Conclusions Measuring of the corneaI endothelial cellular morphologic parameters and implementing corresponding analysis are helpful to know pilot's corneal endotheliurn changes in flight.     

空军飞行员角膜内皮细胞的初步分析

Objegtive To preliminarily study the endothelial density baseline and the morphological characteristics of the corneal endothelial cell of Chinese Air Force pilot. Metheds Density and morphology of corneal endothelial cells were observed by Topcon-2000 noncontact specular microscope and analyzed by Imagenet 2000 software(version 2.53)on 56 pilots(112 eyes)While other 30 healthy men(60 eyes)who were with the comparable age and uncorrected visual acuity were compared and analyzed as the control group. Results The data showed that the average corneal endothelial cell density was 2797.0±330.3/mm2 in pilot group which was significantly lowet than 2917.57±318.04/mm2 in control group(t=2.286,P=0.024).The mean constituent ratio of hexagonal cell was 56.46±7.19 in pilot group compared with 60.33±7.68 in control group(t=8.253,P=O.001)and it was gradually reduced with the age growing in both groups(r=-0.395,-0.268,P=0.000.0.038).With the growing of flying hours the mean area of cell was increased under the eontrolled age factor according to partial correlation analysis(r=0.244,P=0.0 1).Conclusions Measuring of the corneaI endothelial cellular morphologic parameters and implementing corresponding analysis are helpful to know pilot's corneal endotheliurn changes in flight.     

不同飞行条件飞行员训练前后凝血及纤溶指标的对比研究

目的检测不同飞行条件下飞行员飞行训练前后凝血及纤溶指标的变化,以了解飞行训练对其凝血和纤溶平衡的影响。方法应用生物活性法和免疫比浊法,检测40名飞行员飞行训练前后的静脉血凝血酶原时间（prothrombin time,PT）、凝血酶时间（thrombin time,TT）、活化部分凝血活酶时间（activated partial thromboplastin time, APTT）、纤维蛋白原（fibrinogen,Fg）和D-二聚体（D-dimer,D-D）。依不同飞行强度（1次飞行和两次飞行）、不同飞行场次（昼航和跨昼夜飞行）、不同飞行载荷（＋3Gz和＋5Gz）、不同飞行高度（3km和5km）分别各分为两组。另设30名场站地勤人员为对照组。比较自身飞行训练前后,及不同组间凝血善F溶指标的差异。结果飞行前飞行员组与对照组凝血一纤溶指标的差异无统计学意义。飞行训练后PT、TT、APTT缩短、Fg、D-D升高,分别与飞行前自身及对照组比较,差异有统计学意义（t=2．925-6．908,P〈0．01）。完成各飞行课目后分别与飞行前比较,PT、TT、APTT缩短,Fg、D-D升高,差异有统计学意义（t=2．348-8．717,P％0．01或P〈0．05）。第1次飞行后与第2次飞行后、昼航与跨昼夜飞行后、3km与5km飞行后比较,凝血-纤溶指标的差异无统计学意义。＋5Gz飞行后与＋3Gz飞行后比较,TT缩短、Fg升高,差异有统计学意义（t=2．605、5．772,P=0．013、0．000）;其他指标差异无统计学意义。结论飞行员飞行训练后凝血与纤溶指标可发生改变,属于机体应激状态下的适应性反应。     

飞行人员慢性前列腺炎/慢性骨盆疼痛综合征的调查分析及干预对策

目的 了解男性飞行人员慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)的发病情况,探讨有效的预防措施. 方法 将146名男性飞行人员、260名男性地勤人员分别按21～28岁、29～36岁、37岁以上分为3个年龄组;并将146名男性飞行人员,按1000 h以下、1001～2000 h、2001～3000 h、3001 h以上分为4个飞行时间段,及按歼击机、强击机、运输机、直升机和轰炸机分为5个机种.采用自编的前列腺健康知识调查问卷,根据美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)中的症状评分标准判定结果,及以前列腺液卵磷脂小体减少或消失,前列腺液细菌培养阴性做为诊断标准. 结果 共调查146名男性飞行人员,260名男性地勤人员.其中明确诊断为CP/CPPS的男性飞行人员和地勤人员,分别为16人和56人,且21～28岁年龄组的患病率高于其他年龄组,差异有统计学意义(P<0.05);不同飞行时间、不同飞行机种之间,CP/CPPS患病率差异无统计学意义. 结论 飞行人员中CP/CPPS的发病情况需引起重视.干预对策包括健康教育、心理辅导、饮水、适度的物理性治疗和药物治疗等方面.     

不同机种飞行人员血糖水平分析

目的 了解不同机种飞行人员血糖水平情况并分析原因,为稳定飞行人员血糖水平和保证飞行安全提供依据. 方法 2011年1月至2013年8月来我院疗养的532名飞行人员.按年龄将飞行人员分为＜30岁、30～39岁、≥40岁3组;按飞行时间分为＜1 000 h、1 000～1 999 h、≥2 000 h 3组,对不同机种飞行人员FPG水平进行分析比较. 结果 ①飞行人员FPG平均水平为（4.55±0.54）mmol/L.不同年龄组、不同飞行时间组直升机飞行人员FPG水平差异均有统计学意义（F＝4.290、5.157,P＜0.05或0.01）.不同年龄组轰炸机飞行人员FPG水平差异有统计学意义（F＝4.582,P＜0.05）.其余机种飞行人员不同年龄组、不同飞行时间组之间FPG水平差异均无统计学意义（P＞0.05）.②＜30岁组的歼击机飞行员FPG水平明显高于直升机、轰炸机、预警机飞行人员（P＜0.01）;教练机飞行员FPG水平明显高于轰炸机、预警机飞行人员（P＜0.05）.30～39岁组歼击机、直升机、教练机飞行人员FPG水平均明显高于轰炸机飞行人员（P＜0.01）;直升机、教练机飞行人员FPG水平明显高于预警机飞行人员（P＜0.05）.≥40岁组,不同机种飞行人员FPG水平差异无统计学意义（P＞0.05）.③飞行时间＜1 000 h组歼击机飞行员FPG水平明显高于直升机、轰炸机和预警机飞行人员（F＝7.655,P＜0.01）.飞行时间1 000～1 999 h组歼击机、教练机飞行人员FPG水平明显高于轰炸机飞行人员（P＜0.01或0.05）;歼击机、直升机、教练机飞行人员FPG水平均明显高于预警机飞行人员（P＜0.05）.飞行时间≥2 000 h组歼击机、直升机、教练机飞行人员FPG水平均明显高于轰炸机飞行人员（P＜0.05或0.01）. 结论 不同机种飞行人员FPG水平存在不同程度差异,应予重视.     

民航非酒精性脂肪肝飞行员血清瘦素、血糖和血脂变化的研究

目的分析2009年4月至2010年7月在民航广州医院航空体检中心体检的民航60例现役非酒精性脂肪肝（nonalcoholic fatty liver disease, NAFLD）飞行员血清瘦素、血糖、血脂的变化,探讨飞行员患NAFLD的危险因素及其预防措施。方法60例NAFLD飞行员作为试验组,体检结论正常的60例飞行员作为对照组。询问病史,空腹测量身高、体重、腰围、臀围及血压;检测血脂、空腹血糖（fasting plasma glucose,FPG）和血清瘦素水平,并进行组间比较。结果NAFLD组体重指数（bodymass index,BMI）、腰臀比、收缩压、舒张压、甘油三酯（triglyceride,TG）和血清瘦素水平较对照组显著上升（t=4．62-12．20,P〈0．01）;FPG较对照组上升（t=2．63,P〈0．05）;高密度脂蛋白胆固醇（highdensitylipid—cholesterol,HDL-C）明显下降（t=3．65,P〈0．01）。瘦素水平与TG、FPG呈正相关（r=0．72、0．82,P〈0．05）,与HDL-C呈负相关（r=-0．62,P〈0．05）。结论飞行员患NAFLD与其饮食结构及活动减少造成肥胖有关,并与瘦素水平升高密切关联。应加强对患NAFLD飞行员的预防和治疗工作,为飞行员的健康和飞行安全提供保障。     

飞行因素对飞行员血浆中肾上腺髓质素、心房钠尿肽含量的影响

目的探讨飞行因素对飞行员血浆中肾上腺髓质素(ADM)和心房钠尿肽(ANP)含量的影响与心血管疾病的关系。方法应用放射免疫法(R IA)测定151名飞行前和72名飞行后即刻飞行员及50名正常人血浆中ADM,ANP的含量。结果飞行后血浆中ADM(51.19±20.49)ng/L,ANP(160±67)ng/L含量均较飞行前[(69.07±24.20)ng/L;(273±79)ng/L]显著降低(P<0.01),飞行后ADM含量较正常组(43.92±11.43)显著升高(P<0.05),而ANP(373±94)显著降低(P<0.01);飞行前ADM含量显著高于正常组(P<0.01),ANP含量显著低于正常组(P<0.01)。结论(1)飞行因素及飞行应激造成ADM,ANP含量降低,是飞行时心脏受损的因素之一,但ADM降低的水平仍可产生一定的保护作用;(2)飞行员基础ADM,ANP含量高,可能是长期飞行引起,是机体自我良性调节的结果,是促进心脏恢复的有效手段。     

民航飞行员糖化血红蛋白Alc水平的调查

目的探讨民航飞行员糖化血红蛋白Alc（glycated hemoglobin Alc,HbAlc）水平及其在筛查空腹血糖受损（impaired fasting glucose,IFG）及2型糖尿病（type 2 diabetes mellitus,T2DM）中的应用。方法151例参加例行体检的民航飞行员纳入本次研究,同时选取96例普通体检人群作为对照组,分别测定其空腹血糖（fasting plasma glucose,FPG）、脂代谢指标、肝肾功能指标与HbAlc,所得结果用于统计分析。根据飞行员的不同HbAlc及FPG水平,分析两者之间的相关性。结果民航飞行员HbAlC水平与普通人群相比无显著差异;民航飞行员IFG组与T2DM组的HbAlc较正常组均显著增高（P〈0．01）;多因素回归分析显示FPG、γ-谷氨酰转肽酶、谷丙转氨酶、血清肌酐水平是HbAle的独立影响因素;受试者工作特征曲线显示HbAlc在5．6％与6．2％时分别是IFG与T2DM诊断与筛查的最佳临界值。结论民航飞行员中,HbAlc可作为IFG及T2DM筛查、心血管疾病危险性评估的重要指标。对于服用降糖药物的民航飞行员,飞行体检时除了将FPG作为常规监测项目外,应考虑将HbAlc作为糖代谢状况的评估指标。     

高＋Gz暴露对飞行员唾液α淀粉酶浓度的影响

目的 通过研究高正加速度（＋Gz）应激与飞行员唾液α淀粉酶（Salivary α-amylase,SAA）之间的关系,探讨SAA作为＋G2应激身体机能评价手段的可行性. 方法 47例高性能战斗机飞行员着HP抗荷服在载人离心机上进行训练,分别在＋6.5Gz、＋7.0Gz和＋8.0Gz暴露前、后取其唾液,采用酶动态比色法检测SAA水平. 结果 ①SAA、唾液皮质醇在不同＋Gz作用后的变化有统计学差异（F＝17.712、3.427,P＜0.01或0.05）;多重比较的结果显示＋6.5Gz、＋7.0Gz、＋8.0Gz暴露前与暴露后SAA差异有统计学意义（P＜0.01）,3种不同＋Gz暴露后较暴露前SAA均有明显升高（t＝5.256～5.449,P＜0.01）;＋7.0 Gz、＋8.0Gz暴露后的皮质醇浓度高于基础值（P＜0.05或0.01）,＋8.0Gz暴露后较＋6.5Gz、＋7.0Gz、＋8.0Gz前唾液皮质醇浓度显著升高（P＜0.05）.②机种、年龄、飞行总时间对不同＋Gx暴露后飞行员SAA及唾液皮质醇浓度变化无影响.③飞行员唾液皮质醇浓度与年龄、飞行机种呈负相关（r＝-0.328、-0.694,P＜0.05）,与飞行总时间、＋Gz值呈正相关（r＝0.466、0.141,P＜0.05）,飞行员SAA与＋Gz值呈正相关（r＝ 0.354,P＜0.01）.④不同＋Gz暴露前后唾液皮质醇与SAA之间无显著相关性. 结论 SAA可随＋Gz应激快速灵敏地升高,并迅速恢复至基础值,可作为＋Gz应激的有效评价指标.     

深海实潜中下潜人员的心率变异性研究

目的研究深海实潜作业中交感-迷走神经对下潜人员心脏功能的调控作用,为评价潜航员工作负荷提供参考。方法 2名潜航员和3名技术人员(作为乘员)参加实验。每次潜航为1名潜航员操作"蛟龙号"携带1名乘员(技术支持)进行实潜作业,持续时间约11 h。记录他们在潜航前和潜航作业全程的心电图,提取R-R间期,计算心率,并对心率变异性(heart rate variability,HRV)的时域和频域指标进行计算和分析。结果下潜人员的心率都在1 h达到最大并逐渐下降,其中潜航员的心率在1 h~6 h显著高于对照水平(P0.05或P0.01),乘员的心率在1 h~4 h显著高于对照水平(P0.05或P0.01),之后均恢复到对照水平。相比于对照值,在1 h,10 h,11 h,潜航员的LF/HF升高,HF/TP降低(P0.01);乘员的SDNN在8 h、9 h和11 h显著高于对照水平(P0.01)。结论在下潜和上浮阶段,潜航员的交感神经活性升高、迷走神经活性降低,可能与这两个阶段潜航员的工作负荷较高有关。在下潜阶段下潜人员心率的显著升高提示可能存在精神紧张和应激反应。潜航过程中,潜航员的心率逐渐稳定,交感神经兴奋仍有出现,提示在评价潜航员工作负荷时,HRV可能是比心率更敏感的指标。     

模拟持续飞行双重任务操作诱发高性能战斗机飞行员脑认知疲劳模型的研究

目的 通过模拟持续飞行操作诱发脑认知疲劳(cognitive fatigue,CF)的实验模型,动态观察计算机模拟飞行双重任务操作绩效与主观疲劳评价指标的变化特征,为CF评价和制定相应航卫保障措施提供平台. 方法 男性战斗机飞行员30人,平均年龄(38.4±8.5)岁,分别在计算机上完成四数连加心算任务、模拟飞行姿态控制任务和二者复合的双重任务基础值测试,以及1～5 h的四数连加心算任务和模拟飞行双重任务的持续操作测试.同时对四数连加心算及模拟飞行期间出现的CF进行斯坦福嗜睡量表(Stanford sleepiness scales,SSS)评定. 结果 在单独完成四数连加任务时,其绩效指标和SSS主观评定分数在第1～5小时之间无显著变化.而完成双重任务时,双重任务正确率及双重任务保持率在基础值及第1～5小时之间差异均有统计学意义(F=16.25、23.42,P＜0.01).进一步两两比较,双重任务保持率在第2小时、第3小时、第4小时、第5小时降低,与基础值相比,差异均有统计学意义(P＜0.05);双重任务正确率在第3小时、第4小时、第5小时降低,与基础值相比,差异均有统计学意义(P＜0.05).完成双重任务时SSS评分在第3小时、第4小时、第5小时降低,与基础值相比,差异均有统计学意义(P＜0.05). 结论 计算机控制的模拟飞行双重操作任务是诱发CF的敏感方法 ,利用该模型可进一步开展相关疲劳监测方法 的研究,为制定相应航卫保障措施提供理论依据. Abstract： Objective To observe the working efficiency in simulated dual-task and the characters of subjective evaluation of fatigue by studying the model of cerebral cognitive fatigue (CF)that induced by consecutive simulated flight, to accumulate the experience on CF evaluation and to provide reference to aeromedical service. Methods Thirty male pilots [average age:(38.4±8.5)yrs] were firstly tested by mental arithmetic of 4-figure consecutive addition and computer simulated flying attitude control tasks for obtaining reference baseline and then by the consecutive dual-task which composed by above two tasks for 1-5 hours. The CF that induced by tasks was evaluated by Stanford Sleepiness Scales (SSS). Results There was no significant change either in accuracy of calculation or SSS score for 1-5 h consecutive addition task. The true responding rate and true maintaining rate of dual-task showed significant differences between the baseline's and the dual-task's for 1-5 h (F=16.25, 23.42, P＜0.01). The true maintaining rate at the 2nd, 3rd, 4th and 5th hours of dual-task were all decreased and showed significant differences with the baseline's (P＜0.05). The same situation was also found for true responding rate at the 3rd, 4th and 5th hours of dual-task (P＜0.05). Statistic was significant for dual-task due to the SSS score decreased at 3rd, 4th and 5th hour (P＜0.05). Conclusions Performing consecutive simulated dual-task flight is sensitive to induce CF and the corresponding model could be used to evaluate the methodology of fatigue and be referenced to aeromedical service.