飞行人员血尿酸调查及尿酸性肾病的防治

我们对住内科体检的111名飞行员进行了血尿酸含量的调查,并与一组502名正常人血尿酸调查资料对进行对比,发现飞行员血尿酸明显高于正常人,并发泌尿系统疾病者亦较多,因此提出了高尿酸性肾脏疾病的防治意见,报告于下。 对象和方法 对象:111名均系住内科体检的男性飞行员,平均年龄32.2岁(22～58岁),分为三个年龄组:21～30岁57名;31～40岁32名;41岁以上21名。均排除了肾实质性疾病和代谢病,常规吃空勤灶,禁酒。     

民航飞行员认知功能变化对飞行影响的研究

目的研究民航飞行员的认知功能随年龄变化的规律,以及这种变化对个体的飞行成绩产生的影响,探讨能否延长飞行年限的心理学依据。方法１４７名（年龄３６～６０岁）民航飞行员,每５岁一个年龄组共５个年龄组。试验任务是三项基本认知能力测验和四项人机对话作业,试验任务结束后,对每个受试者进行了飞行情况调查。结果除一项认知作业（差别方向）外,其它１０项指标的成绩在各年龄组间有显著性差异;并且,除人机对话作业中的两个指标外,绝大部分指标的测验成绩的年龄差异出现在４０岁之前的年龄组与４０岁之后的年龄组。到４０岁后,各年龄组间没有显著性差异;另外,飞行情况调查的结果是：各个年龄组间的飞行能力和飞行训练成绩没有显著性差异。结论民航飞行员的认知功能随年龄的增长是一个下降的趋势。４０岁是一个分界线,但到４０岁后,各年龄组间没有明显的变化。另外,这种认知功能的下降,并没有对飞行员的飞行能力和飞行成绩产生影响。     

279名民航飞行员冠心病易患因素调查分析

退行性心血管疾患是中年人面临的重要临床问题，其中冠心病在40岁以上的男性中发病率最高。高血压、高脂血症、高胆周醇饮食、吸烟及有关家族史等均为冠心病易患因素。为了解飞行员心血管健康状况及其调节功能，我们有目的地对279名民航飞行员冠心病易患因素作了一次调查分析，报告如下。     

军事飞行员前庭功能稳定性训练前后效果观察

目的对军事飞行员前庭功能稳定性进行评价, 为军事飞行员前庭功能稳定性训练提供依据。方法应用电动转椅对军事飞行员进行前庭功能稳定性训练。按照入院顺序, 分别选取21～30岁、31～40岁、41～50岁、≥51岁年龄段各30名飞行员, 比较不同年龄段飞行员训练前后前庭功能稳定性的优秀率、良好率、合格率、不合格率以及耐受时间变化, 并分析年龄与耐受时间的相关性。结果 31～40岁、≥51岁组飞行员训练前后不合格率比较差异有统计学意义(χ2=4.32、4.80, P=0.038、0.028)。飞行员前庭功能稳定性训练后不合格率较训练前降低, 差异有统计学意义(χ2=13.02, P<0.001)。总耐受时间均较训练前增加, 差异有统计学意义(t=17.61, P<0.001)。不同年龄组飞行员前庭功能训练后其稳定性耐受时间均较训练前增加, 差异有统计学意义(t=6.50、8.82、9.48、13.56, P均<0.001)。随着年龄的增加, 前庭功能稳定性逐步减退, 年龄与训练耐受时间呈负相关(r=-0.38, P<0.001)。结论电动转椅训练可增强军事飞行员前庭功能...     

中国军事飞行员心电图正常值研究

目的 研究确定出中国飞行员心电图正常值范围，为飞行员选拔和心血管功能专项医学鉴定提供依据。方法 采用十二导联同步心电图仪采集1098名飞行员(其中男飞行员1043名，女飞行员55名)心电图，然后进行测量与统计分析。结果 得出了不同年龄(20～55岁)、不同机种的1043名男飞行员和55名女飞行员十二导联同步心电图有关指标的正常值范围(包括：心率、心电轴、P-R间期、QT间期、QRS波振幅、QRS波时限、P波振幅、T波振幅等)；几个主要发现是：飞行人员心率变化范围大(40～100次／rain)，≤60次／min约占25％；心电轴轻度左偏和右偏分别占3．5％(男性)、1．8％(女性)和6．2％(男性)、3．6％(女性)；P波振幅、时限均以I导联最大；QRS波时限、QT间期以V2、V3导联最大，aVL最小；R波振幅、T波振幅以V3、V4最明显；在导联之间，PR间期离散度最小(男≤11ms、女≤12ms)，而QT间期离散度最大(男≥24ms、女≥40ms)。结论 采用十二导联同步心电图采集记录方法研究确定中国飞行人员心电图正常值范围是准确可靠的，可为飞行员选拔和心血管功能专项医学鉴定提供重要依据。     

高空环境对航空飞行员的影响与健康状况分析

目的：观察民航飞行员血液流变学指标的变化及相关慢性病特点,分析飞行员健康状况,为提高飞行员健康,制定相应干预措施提供依据。方法研究中选取某航空公司30岁以上飞行员中的230名作为研究对象,检测所选飞行员血液流变学、血脂、血尿酸,结合健康档案资料,另选取230名与飞行员年龄相当的地面正常人员作为对照,分析两组血液流变学检测结果。结果飞行员组与地面组比较全血粘度、红细胞压积等血液流变学指标具有统计学意义（ P＜0．05）。飞行员血细胞比积明显升高,与地面组比较具有显著差异（ P＜0．05）。高脂血症组飞行员血沉、全血粘度、血浆粘度较高,与正常血脂组飞行员比较具有显著性统计学意义（P＜0．01）。飞行员常见疾病的患病率为依次为脂肪肝32．6％,高尿酸血症20．4％,高脂血症12．2％,心脑血管疾病3．0％,其中40～49岁年龄组慢性疾病患病率高于其他年龄组,40～49岁年龄组飞行员高血脂症的发病风险也相对较高。结论高空环境能影响飞行员血液流变学指标,高压低氧环境增加了飞行员心脑血管疾病的发生率,40～49岁飞行员脂肪肝、高尿酸血症、高脂血症患病率高,应加强相应干预措施,促进航空飞行员身体素质的健康发展。     

女飞行员事件相关电位的研究

目的 研究女飞行员事件相关电位的特征。方法 运输机现役女飞行员21名,23岁～33岁11名,42岁～48岁10名。男飞行员9名,43岁～47岁。结果 42岁～48岁女飞行员及男飞行员相关任务反应时(RT)分别为503.60±35.54 ms及532.67±49.29 ms,P3波潜时分别为320.60±23.67 ms及325.89±18.77 ms(P均>0.05);23岁～33岁女飞行员组RT为503.72±35.28 ms,P3潜时为334.36±29.23 ms。结论 同年龄组女、男飞行员及不同年龄组女飞行员相比,RT及P3潜时无显著性差异。     

高原环境下飞行员的心血管功能测定

为观察高原飞行训练对心血管功能的影响，对进驻海拔3600m高原进行飞行训练3个月的10名飞行员进行了13项心血管功能指标及动态和常规心电图测定，并与同期进入高原的10名地勤人员及10名驻平原地区的飞行员作对照研究。结果表明：①除高原飞行员的有效血容量（BV）低于平原飞行员（P＜0．05）外,3组人员其余12项心功能招数之间均免显著差异；②24hHolier监测显示，高原飞行员24h平均心率、最高心率及最低心率与高原地勤人员及平原飞行员基本一致。除实性心动过速、过缓外，高原飞行员中有房性早搏者8人，室性早搏3人，均＜100次／24h或＜1次／1000心搏，为偶发早搏，无重要临床意义；③常规心电图表现，高原飞行员与其他两组人员基本一致。提示：飞行员在高原训练3个月中，心血管功能无显著改变。     

60岁民航航线飞行员双重任务能力及一年追踪研究

目的 研究60岁民航航线飞行员的认知能力状况,并进行1年的追踪观察,探讨老年航线飞行员认知能力的发展变化规律. 方法 52名60岁民航航线飞行员,在计算机上完成双重任务认知能力测试,包括单项心算4数连加任务、单项模拟飞行姿态控制任务和两者复合的双重任务.同时通过将60岁组航线飞行员各项指标的成绩与31～39岁组、40～49岁组、50～59岁组的航线飞行员进行均数差异比较,观察年龄因素的影响.以配对t检验的方法将26名航线飞行员1年前后双重任务测试成绩进行对比,检验其认知能力的变化. 结果 各项认知指标均存在明显的年龄效应(F=2.98～13.47,P＜0.05),但60岁组民航航线飞行员的认知能力仅与31～39岁组飞行员的差异有统计学意义(t—2.33～7.46,P＜0.01或P＜0.05),而与其他年龄组在绝大多数指标上的差异均没有统计学意义(P＞0.05).动态观察26名航线飞行员1年前后认知能力的变化,其双重任务的认知能力并没有出现衰减. 结论 横向比较和动态追踪的研究结果均支持60岁并非航线飞行员认知功能急剧衰减的转折点.本研究为特殊职业退休政策的制定提供一定的参考依据.     

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（摘要）

目的探讨血管回声跟踪技术（ET）对不同年龄组男性飞行员颈动脉血管弹性的定量检测功能。方法应用ET技术检测72例男性飞行员的颈动脉血管,根据年龄不同分为3组,并参照国人颈动脉弹性正常测量值对各年龄组与正常人的血管弹性值进行对比分析。结果左右两侧之间颈动脉弹性指标无差异;20～29岁组及30～39岁组的血管弹性与正常参考值间存在差异,     

脉图在评定飞行员静态心血管功能中的作用

为探索航空航天医学监督的新方法,用脉图法监测１６９名飞行人员安静坐位时的心血管功能。发现飞行人员的静态心功能可分三种类型：完全正常７１名（占４２％）;大致正常７９名（占４６．７％）,前两者共１５０人（占８８．７％）;有功能性改变的１９名（占１１．３％）。说明脉图方法不但可进行正常人心血管功能状态的分类,而且也可对飞行员或航天员进行心血管功能状态的分类。提示：航医在平时对飞行人员的健康保障工作中,应     

Characteristics of the blood lipoprotein spectrum in commercial aviation pilots

The study of lipids of civil pilots, aged 30-59 years, showed that their average levels of cholesterol and triglycerides were higher than those in a random sample of the male population of Moscow. The average level of HDL cholesterol in pilots was lower than in the sample. The prevalence of dislipoproteinemias in pilots was significantly higher than in the sample. The above lipoprotein changes in pilots versus nonpilots and the prevalence of hyperlipidemias suggest that they are "aterogenic" and produced by the flying profession. These observations also indicate that civil pilots should be regarded as a risk group in terms of atherosclerosis and concomitant cardiovascular diseases.     

军事飞行人员冠状动脉心肌桥的航空医学鉴定

目的 探讨军事飞行人员冠状动脉心肌桥的航空医学鉴定方法.方法 回顾分析空军总医院近年通过冠状动脉造影或多层螺旋CT检查诊断的8例军事飞行人员冠状动脉心肌桥病例资料,结合文献复习,归纳提出航空医学鉴定主法.结果 ①军事飞行人员冠状动脉心肌桥多数程度较轻,无明显症状,常合并有心电图ST-T改变,但不影响心血管功能和飞行,结论飞行合格;②心肌桥造成冠状动脉狭窄程度较重,合并有胸闷、心绞痛、心律失常等临床表现时,飞行暂不合格,之后根据治疗效果进行个别评定.结论 军事飞行人员冠状动脉心肌桥的航空医学鉴定应根据是否影响心血管功能,是否合并有临床症状及心律失常等进行个别评定.     

Pilot medical history and medications found in post mortem specimens from aviation accidents

INTRODUCTION: Federal Aviation Administration (FAA) regulations require pilots to report all medications and medical conditions for review and consideration as to the overall suitability of the pilot for flight activities. METHODS: Specimens were collected by local pathologists from aviation accidents and sent to the Bioaeronautical Sciences Research Laboratory for analysis. The results of such tests were entered into the Forensic Case Management System. This database was searched to identify all pilots found positive for medications used to treat cardiovascular, psychological, or neurological conditions over the period January 1, 1993, through December 31, 2003. RESULTS: Toxicological evaluations were performed on 4143 pilots. Psychotropic drugs were found in 223 pilots. Cardiovascular medications were found in 149 pilots. Neurological medications were found in 15 pilots. Pilots reported psychological conditions in 14 of the 223 pilots found positive for psychotropic drugs. Only 1 of the 14 pilots reporting a psychological condition to the FAA reported the psychotropic medication found after the accident. Cardiovascular disease was reported by 69 of the pilots found with cardiovascular drugs in their system. Cardiovascular medications found in the pilots were reported by 29 of the 69 pilots reporting a cardiovascular condition. Only 1 of the 15 pilots reported having a neurological condition to the FAA; none of the pilots found with neurological medications reported the medication. CONCLUSIONS: Toxicology successfully identified 93% of the medications reported by the pilots. Pilots involved in fatal accidents taking psychotropic or neurological medications rarely reported the medication or their underlying medical condition to the FAA.     

151例飞行员频域心电图分析

为正常人频域心电图（ＦＣＧ）的诊断标准是否适合飞行员。采用香港ＨＢＤ－ⅡＡ仪检测了１５１例男性飞行员的频域心电电图，年龄为２２－４７岁，平均３０±６岁。结果表明：下沉人ＦＣＧ各函数图形特征和飞行员一致，各谱峰幅值和比例也基本一致。说明正常ＦＣＧ的诊断标准适用飞行员，所得结果各项数值可用于飞行员的选拔和地面训练时实时医学监督。     

加速度暴露下的心律失常及其航空医学意义

目的 探讨正加速度（＋Gz)作用下心血管自主神经调节与心律失常及G耐力的关系。方法 对36名立位耐力不良和62名健康飞行员＋Gz作用下的ECG及动态心电图进行对比分析。结果 ＋Gz作用下,立位耐力不良者心律失常发生率高,＋Gz耐力低。结论 ＋Gz作用下的心律失常可以作为评价心血管代偿功能及G致意识丧失（G－LOG）的预警指标。     

A 10-year retrospective review of airline transport pilots aged 60 to 63 in Japan

BACKGROUND: On May 14, 1991, the Japanese Ministry of Transport issued an official notice allowing medically certified airline transport pilots aged 60 to 63 yr old (aged pilot) to work on non-scheduled flights. Since September 24, 1996, the official notice was revised to allow them to work on scheduled flights. The regulation requires pilots to pass both routine and additional aviation medical examinations. METHOD: Ten years have passed since the first regulation, so the medical records and the present status of aged pilots were reviewed and summarized. RESULTS: By the end of October 2000, 159 pilots had undergone their first additional examination. Two pilots failed due to coronary ischemia, two due to brain infarction, and one due to complete right bundle branch block (CRBBB) on ECG. One pilot failed the examination at the age of 62 due to coronary ischemia and another at the age of 62.5 due to atrial fibrillation. Thirteen pilots retired prior to the age of 63 for unknown reasons. At the time of review, 44 pilots had reached the age of 63 and retired. Subsequent flight time as aged pilot was 83,872 h in total (617 +/- 483 h; mean +/- SD) with monthly flight time of 41 +/- 27 h. Japan Aircraft Accident Investigation Commision reported 323 accidents, including 27 airtransport accidents in the past 10 yr. There were no accidents involving any of the aged pilots. CONCLUSION: The review suggests that the aged pilots who are deemed medically qualified by the official notice criteria are flying safely without mishap incidence.     

Prevalence of cardiovascular abnormalities in pilots involved in fatal general aviation airplane accidents

INTRODUCTION: Cardiovascular disease in general and coronary heart disease in particular remains the leading cause of morbidity and mortality in developed countries. Coronary artery disease is of concern in aviation because of its potential to cause sudden in-flight incapacitation. The purpose of this study was to analyze the cardiovascular abnormalities in pilots involved in fatal general aviation airplane accidents. METHOD: A comprehensive review was performed of all cardiovascular abnormalities detected during autopsies conducted on pilots involved in fatal fixed-wing general aviation aircraft accidents in the U.S. from 1996-1999. Data was obtained from the database maintained at Civil Aerospace Medical Institute in Oklahoma City. RESULTS: An analysis of 534 autopsy reports revealed presence of cardiovascular abnormalities in 234 pilots (prevalence rate 43.82%). Coronary artery stenosis had a prevalence rate of 37.64%. There were 41 pilots who had evidence of severe atherosclerosis of the left coronary artery. This was significantly associated with stenosis of the right coronary and circumflex arteries. There was a statistically significant relation between coronary atherosclerosis and advancing age. DISCUSSION: Although the overall prevalence of coronary atherosclerosis is lower than previously reported, evidence of severe atherosclerosis was found in a relatively high percentage of pilots and may be a cause for concern. The findings have implications for aircrew health education and primary prevention programs. There is also a need for more standardized data collection.     

Effect of Aerobatics on Plasma Adrenomedulin Level and Its Significance

目的肾上腺髓质素（Ａｄｒｅｎｏｍｅｄｕｌｉｎ，ＡＤＭ）是新近发现的对心血管系统具有重要作用的血管活性多肽，本研究旨在探讨特技飞行对血浆ＡＤＭ含量的影响及其意义。方法以１６名健康飞行人员为试验对象，另设１６名健康地勤人员为对照组。飞行人员进行复杂特技飞行，其最大加速度为＋６．５ＧＺ。飞行人员组于特技飞行前（６：００ａ．ｍ．空腹）、特技飞行后即刻（１０：００ａ．ｍ．）和特技飞行后６ｈ（４：００ｐ．ｍ．）取血，对照组于上述同步时间取血，用放免方法测定血浆ＡＤＭ含量。结果①特技飞行前，飞行人员组血浆ＡＤＭ含量明显高于对照组（Ｐ＜０．００１）。②飞行人员组血浆ＡＤＭ含量在特技飞行后即刻较飞行前明显降低（Ｐ＜０．００１），６ｈ后其血浆ＡＤＭ含量恢复到飞行前水平。③对照组血浆ＡＤＭ含量在特技飞行前、特技飞行后即刻和特技飞行后６ｈ的同步时间比较均无显著变化。结论飞行人员血浆ＡＤＭ基础含量较地勤人员高，可能与飞行人员经常承受飞行因素的影响有关。特技飞行可引起血浆ＡＤＭ含量明显降低，其主要原因可能与特技飞行时血流动力学变化有关，并对维持心脑血液供应具有重要意义