67例运输机飞行人员飞行前后血尿、蛋白尿分析

目的 探讨飞行人员飞行后产生血尿、蛋白尿的可能的病理生理机理,以及飞行人员飞行后尿蛋白含量的筛查和定量在航空医学中的应用价值。方法 用干化学法检测飞行前后30min飞行人员尿液中红细胞数量、尿蛋白含量,并用尿沉渣离心镜检法、加热醋酸法验证。结果 飞行前红细胞(±)以上者3人,飞行后增至7人;飞行前尿蛋白(±)以上者9人,飞行后增至19人。结论 ①飞行人员飞行后血尿、蛋白尿阳性检出人数增多,且以蛋白尿为甚。②飞行后尿蛋白含量可作为判断飞行人员功能状态的客观指标。     

不同环境下前庭自主神经反应对暗焦点影响的研究

目的：观察地面与飞行环境中前庭自主神经反应对调节暗焦点的影响。方法：采用氦一氖激光视力计游标法，测量受试者眼暗焦点的变化。地面环境健康受试者19例，受科里奥利（Coriolis）加速度后，以Graybiel急性运动病不同严重水平诊断分类标准评定其自主神经反应程度，并测量暗焦点的变化；测量飞行学员35例飞行前后的暗焦点变化。结果：受Coriolis加速度作用后地面人员暗焦点值随自主神经反应程度加重而内移加大；飞行学员无症状、轻度症状组和飞行教员无症状组暗焦点比较，差异不显著（P〉0．05）；飞行教员轻度症状组暗焦点变化差异显著（P〈0．05）。结论：前庭自主神经反应可使暗焦点向近视方向变化，飞行中暗焦点的变化对飞行员有累积效应。     

394例飞行人员2014年度体检高尿酸血症调查分析

目的 调查分析民航飞行人员中患高尿酸血症相关危险因素及现状,为能有针对性的健康干预提供依据.方法 2014年度大体捡的飞行学员及飞行教员共394例中患高尿酸血症者从年龄、发病率、超重、血脂、血糖、血压等相关因素,进行统计分析.结果 飞行人员高尿酸血症的发生率远高于正常人群(P＜0.05);而飞行教员相对于飞行学员而言,高尿酸血症发生率进一步升高(P＜0.05).结论 飞行员普遍存在高尿酸血症高发现象,应当引起关注,积极采取干预措施,防治高尿酸血症,对预防飞行人员的心脑血管疾病有着重要的意义.     

特技飞行前后血糖、血脂、载脂蛋白A_1、B、心肌酶及免疫球蛋白的变化

为探讨特技飞行是否会增加冠心病发病的危险因素，是否能损伤心肌细胞以及是否能使某些体液免疫功能发生变化，对20例飞行员进行复杂特拉飞行前（6：00，空腹）、飞行后即刻（10：00）、6h（16：00）及24h（次日10：00）血糖、血清胆固醇（TC）、甘油三脂（TG）、载脂蛋白A1（apoA1）、B（apoB）、GOT、CPK、LDH及IgA、IgG、IgM检测。结果显示：①飞行后即刻血糖、TG及apoA1明显升高，与飞行前及飞行后6h、24h比较，均有显著性差异（P＜0．05）；②飞行后即刻血清apoB／apoA1比值与飞行前及飞行后6h、24h比较，均无显著性差异（P＞0．05）；③其余各项指标，飞行前后均无显著性变化（P＞0．05）。本研究结果提示，短时间特技飞行不会增加冠心病发病的危险因素，不会损伤心肌细胞，亦不会影响以上体液免疫功能。     

飞行条件对飞行员血浆神经肽的影响

对４８例患心血管疾病的飞行员进行了血浆神经肽中心房利钠多肽（ＡＮＦ）、精氨酸加压素（ＡＶＰ）、神经降压素（ＮＴ）、血管活性肠肽（ＶＩＰ）４种心血管调节肽飞行前后动态观察，并与３７例健康飞行员进行比较。结果，两组飞行员飞行后ＡＮＦ、ＡＶＰ均较飞行前显著升高（Ｐ＜０．０５）；ＶＩＰ、ＮＴ飞行前后均无显著性差异（ｐ＞０．０５）。飞行前后实验组ＡＶＰ均显著地高于对照组（Ｐ＜０．０５）；ＶＩＰ显著低于对照组（Ｐ＜０．０５）；两组ＡＮＦ、ＮＴ无显著差异（Ｐ＞０．０５）。结果提示，对飞行员早期心血管疾病患者，只要注意治疗，稳定病情，飞行负荷对其不会有大的生理影响和改变。     

招飞青年运动试验后血尿和蛋白尿动态观察

目的：探讨运动试验后血尿和蛋白尿变化规律以及在飞行员医学选择中的价值。方法：应招青年435人,分别在运动试验瓣和运动试验后0．5、2．5、4．5、6．5、8．5及18h（次日晨）留取尿样作沉渣镜检,同时用尿液分析仪检测尿红细胞和尿蛋白。结果：运动试验前血尿阳性发生率为8．97％,并持续至运动试验后次日晨;运动试验前血尿和蛋白尿阴性者运动试验后阳性发生率均在0．5h达到高峰,在2．5h时即显著下降,少数受检者可持续至运动试验后次日晨;运动试验前蛋白尿阳性者在运动试验后不同时间段阳性率依次下降,部分受检者也可持续至次日晨。结论：运动试验后血尿和蛋白尿在不同时间段的变化有一定的规律,运动试验后次日晨检测对进一步明显成因、防止漏检、误淘以及减少医学停飞可能有一定的指导意义。     

飞行员血小板的电子显微镜分型正常值及飞行后变化

用电子显微镜方法，将血小板（PC）分为圆、树突、过渡、展平和崩解五个型。对405例飞行员和550例地面工作人员，分别进行分型计数调查。发现36岁以上飞行员中树突型百分比明显高于同年龄地面人员，随着年龄增长，树突型和展平型均呈上升趋势，其余无差别；65岁以上树突型、展平和崩解型明显高于50岁以下者；飞行前后相比，飞行后PC各型均有不同程度改变。     

飞行员飞行前后皮质醇、胰岛素、胰高血糖素、甲状腺素和环核苷酸变化的研究

已有资料表明,飞行员飞行可使体内的某些激素发生变化。为进一步研究飞行对体内某些激素的影响,我们用放射免疫法测定男性飞行员(n=38)和地勤人员(n=33)飞行前后血清皮质醇、胰岛素、胰高血糖素、甲状腺素(T_3、T_4)和环核苷酸(cAMP、cGMP)值。结果飞行员飞行前后皮质醇(497.39±148.23对623.81±296.24nmol/L,p<0.05),胰岛素(20.34±9.88对14.95±5.82mU/L,p<0.01),胰高血糖素(72.89±31.72对104.25±58.14mg/L,p<0.01)和cAMP(20.44±8.89对25.49±9.17nmol/L,p<0.05)显著改变,而T_3、T_4和cGMP无明显变化(p>0.05)。地勤人员工作前后仅胰岛素显著降低(19.78±5.03对16.91±2.95mU/L,p<0.01)。飞行前飞行员组和地勤组各激素无明显差异(p>0.05),飞行后飞行员组皮质醇、胰高血糖素和cAMP值高于地勤人员组(p<0.05)。作者认为飞行员的上述变化可能与应激、加速度等有关,研究上述变化有助于我们研究航空航天医学和卫勤保障。     

应激反应对年青飞行学员淋巴细胞亚群分布的影响

应激对免疫系统的影响已有报道。作者就应激反应对年青飞行员淋巴细胞亚群分布的影响进行了两组研究。第一组是在以教员为对照的基础上对飞行员特定飞行训练前后的淋巴细胞进行研究，同时还检测了生长激素。催乳素和皮质醇（第一组）。第二组研究对象是完成一套飞行训练课目的学员，按是否通过了最后考核进行分组研究。第一组研究结果发现，在一次特定飞行训练前后教员和学员的淋巴细胞亚群间的差异无显著性。淋巴细胞亚群的绝对计数亦无变化。然而对学员和教员淋巴细胞亚群的绝对计数和百分率进行比较发现，学员CDI淋巴细胞百分率明显比…     

三唑仑对飞行学员睡眠质量和次日飞行能力的影响

目的观察服用三唑仑对飞行学员夜间睡眠质量和次日飞行工作能力的影响,为制定飞行人员合理用药方案提供试验依据。方法将21名自愿受试的飞行学员分为两组:三唑仑组11名,在夜间22:00服用三唑仑0.25 mg;安慰剂组10名,同时服用食用淀粉,而后睡眠6.5h。起床后对夜间睡眠质量进行主观调查。服药8h 后执行飞行任务,由飞行教员对飞行操纵能力进行评价,飞行学员对飞行劳动负荷自评,并检测飞行中的心率。主持试验者比较学员飞行前后的生命体征变化。结果与安慰剂组相比,三唑仑组的主观睡眠质量明显提高,飞行操纵中的体能和精力更好。各飞行阶段两组间的心率、飞行前后的基本生命体征无明显差异。结论服用三唑仑可提高睡眠质量,用药8h 后对飞行工作能力无不良影响。     

招飞体检青年运动后血尿、蛋白尿试验分析

目的 研究招飞体检青年运动后血尿、蛋白尿的发生率和规律,探讨尿液检查筛选标准。方法 招飞体检青年５４３人作为试验对象,在他们进行一系列室外运动（１ｈ）前后留取尿样,用尿液分析仪检测并镜检。结果 运动后血尿蛋白尿发生率明显高于晨尿检出率,并发现１例肉眼血尿。结论 建议增加运动后尿样检测用于招飞体检,并研究制定有关筛选标准。     

不同机种飞行员颞颌关节病发病情况比较

为了探讨正加速度负荷（＋Gz）对飞行员颞颌关节可能产生的影响及临床意义,随机对617名不同机种无颞颌关节病史的飞行员调查并就出现的颞颌关节异常现象进行了分析研究。结果显示,战斗机组飞行员颞颌关节症状的出现率较运输机明显增高,提示＋Gz可能是战斗机飞行员颞凳关节紊乱病的主要因素之一。     

空军新人校飞行学员MBTI人格类型分析

目的 探讨新人校飞行学员的MBTI人格类型特征,为飞行人员的心理评估、健康教育与干预策略提供理论依据. 方法 1100名新人校飞行学员,根据入学时考试成绩分为甲、乙、丙3个班.应用修订后的中文版MBTI人格类型量表,对新人校飞行学员进行测试. 结果 新入校飞行学员在外向(E)、感觉(S)、思维(T)、判断(J)偏好上的得分均高于内向(I),直觉(N)、情感(F)、知觉(P)偏好上的得分;外倾感觉思维判断(ESTJ)人格类型最多,其次为内倾感觉思维判断(ISTJ)、外倾直觉思维判断(ENTJ)、外倾感觉情感判断(ESFJ)人格类型,内倾直觉情感判断(INFJ)、外倾直觉情感判断(ENFJ)、内倾直觉情感知觉(INFP)和内倾直觉思维知觉(INTP)人格类型人数最少.甲、乙、丙班学员在E、S、T、J偏好上的得分均高于I、N、F、P偏好:3个班中,百分比最高的人格类型均为ESTJ;百分比最少的人格类型,甲班、丙班为INFJ,乙班为ENFJ;比较甲、乙、丙班学员MBTI人格类型分布,差异均有统计学意义. 结论 新人校飞行学员大多为E、S、T、J偏好,这与军队的特殊环境和军事飞行人员所肩负的责任要求相适应;仍有少数飞行学员易发生各种心理健康问题;因在飞行学员中表现有不同的人格特征,应有针对性地进行心理卫生教育、指导和保护工作.     

飞行学员情绪稳定性评定效标的验证性因子分析模型比较

目的 建立飞行学员情绪稳定性评价模型,为飞行学员情绪稳定性的评价提供效标工具。方法 通过与63名现役飞行员和飞行教员的结构式访谈,编制出有9个项目的“飞行学员情绪稳定性效标评价量表”;由该飞行员和飞行教员采用该量表对153名19～21岁飞行学员的情绪稳定性进行评价。结果 Spearman相关分析表明,除项目1外,其余8个项目间均存达显著性相关(P＜0．05);探索性因子分析显示,9个项目分为3个次级因子;验证性因子分析显示,模型4获得最佳验证效果。结论 飞行学员情绪稳定性效标体系由飞行操作稳定性、飞行前紧张和一般外显情绪组成。     

初教机飞行学员仪表视觉空间定向训练效果

目的探索提高飞行员仪表视觉空间定向能力的有效途径。方法采用计算机图形学原理和认知特征，在自行研制的仪表视觉空间定向仪上设计了7类仪表飞行状态模式。以此训练了20名飞行时间为23h的初教机飞行学员，另外20名飞行学员作为对照组。经地面和空中飞行检验其训练效果。结果训练组飞行学员的仪表飞行状态正确识别反应时明显缩短、正确识别率明显提高，与对照组的差异达到显著性水平。训练组飞行学员实际仪表飞行成绩明显高于对照组。结论采用的仪表视觉空间定向训练模式可提高初教机飞行学员仪表视觉空间定向水平和实际仪表飞行能力。     

Aeromedical management of U.S. air force aviators who attempt suicide.

BACKGROUND: Little has been published about the aeromedical management and disposition of aviators who attempt suicide, and almost no such information about military aviators exists in the open literature. The few available data are scattered and frequently anecdotal. METHODS: The authors reviewed all case reports of fliers evaluated at the USAF School of Aerospace Medicine's Aeromedical Consultation Service (ACS) between 1981-96 for possible return to flying duties after a suicide attempt, and prepared a representative case report. RESULTS: Between 1981 and 1996, the ACS evaluated 14 trained aviators (pilots and other aircrew members, excluding flight surgeons) who had attempted suicide. Of these, 11 (79%) ultimately received a recommendation for return to flying duties. CONCLUSIONS: In most instances the underlying stressors included failed intimate interpersonal relationships, administrative or legal problems, psychiatric disorders, death of spouse, or job conflicts. Evidence of abuse of alcoholor other substances was found in 54% of an earlier, larger data set of attempters. Some data on aircrew suicide completion were available and are reported. The top medical priorities after such attempts should be to diagnose what is wrong, and to treat it. In spite of the common assumption that a suicide attempt inevitably ends a military flying career, some attempters can return to safe and effective flying duty after appropriate psychotherapy. If the flier regains physical and mental health and maintains them for at least 6 mo after treatment, then that flier may be evaluated by an outside aeromedical psychiatric consultant such as the ACS (to avoid transference issues between flier and therapist) for possible return to flying duties. Waiver action should be based on the underlying psychiatric diagnosis, not the suicidal attempt itself. Follow-up may be accomplished through periodic mental health evaluations in conjunction with routine physical examination procedures. Issues involving substance abuse and security clearances must be handled through the appropriate channels.     

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.     

Neuroendocrine responses to psychological workload of instrument flying in student pilots.

BACKGROUND: Information processing and stress tolerance are necessary features for instrument flying (IFR), especially among student pilots. Psychological workload of IFR flight may lead to stress reactions such as neuroendocrine activity. METHODS: Neuroendocrine responses to an IFR flight with Vinka piston-engined primary trainer were studied in 35 male volunteers who participated in the basic military flying course of the Finnish Air Force (FAF). The student pilots performed a 40-min IFR flight mission and a control session on land in randomized order between 11.00 h and 15.00 h. The IFR flight included 3 NDB approaches and was evaluated by flight instructors. Blood samples were collected 15 min before, 5 min and 60 min after the flight as well as control session, and. Plasma ACTH, beta3-endorphin (BE), cortisol, prolactin, adrenaline (A) and noradrenaline (NA) were measured. Psychological evaluations included psychomotor test (Wiener), Multi Coordination and Attention Test, ability tests and personality tests (CMPS and 16 PF). The overall psychological evaluation was made by an aviation psychologist. RESULTS: Plasma ACTH was significantly higher before and 5 min after the flight compared with control levels, but plasma BE increased significantly only before the flight. Plasma cortisol was significantly elevated before and 5 min after the flight. Plasma prolactin, NA and A increases were significant 5 min after the flight. High A levels after the flight correlated significantly with poor IFR flight performance as well as with poor psychomotor test results. CONCLUSIONS: The plasma prolactin and NA increases after the flight represented a direct type of stress reaction to the flight situation. The plasma BE response to IFR flight was an anticipatory stress reaction, but plasma ACTH, cortisol and A responses included both anticipatory and direct types of stress reactions. Psychological factors, flight performance and neuroendocrine responses to IFR flight appear to be associated with each other. Therefore, neuroendocrine reactions as a response to the psychological workload of military flying could be used for identifying stress tolerance in military pilots.     

Hormonal responses of pilots to training flights: the effects of experience on apparent stress

INTRODUCTION: The levels of urinary noradrenaline (NAd), adrenaline (Ad) and salivary cortisol (Cor) were determined in student and instructor pilots during Phase 1 (training with propeller engine; PH1), and Phase 2 (training with jet engine; PH2) flight training. METHODS: The subjects in PH1 were 30 students and 33 instructors, and in PH2 were 17 students and 15 instructors. Urine and saliva were collected approximately 30 min before and 20 min after the flights. The ratio (post/preflight) of the hormonal levels was calculated to compare the students with the instructors and/or PH1 with PH2. RESULTS: In PH1, the levels of all three hormones for postflight were significantly higher than for preflight in students, and the ratios of all three hormones in students were significantly higher than in instructors. In PH2, the ratios of all three hormones for students and instructors did not differ significantly, and the ratios of Ad and Cor levels in students for PH2 were significantly lower than for PH1 (Ad: 1.64 +/- 0.10 vs. 2.23 +/- 0.14; Cor: 0.86 +/- 0.16 vs. 1.68 +/- 0.11, respectively). CONCLUSIONS: The results from PH1 clearly demonstrated that flight stress for students was significantly higher than for instructors. The ratios might be regarded as result of adaptation to flight stress in students. We conclude that the ratios of Ad and Cor levels are a good indicator of stress coping in student pilots.