飞行员椎间盘退行性疾病流行病学调查进展

椎间盘退行性疾病是常见的慢性退行性疾病，也是引起颈腰腿痛的首要原因。研究表明，椎间盘自18岁左右开始退变，至中老年以后，由于内外因素的共同影响，椎间盘的生化成分发生改变，导致结构和功能逐渐丧失，从而发生退行性疾病。然而，调查结果表明，椎间盘退行性疾病在飞行员特别是战斗机飞行员中患病率较高，且发病年龄比普通人更早。近年来，随着航空技术的发展，战斗机的性能不断提高，飞行员椎间盘退行性疾病患病率也不断升高，已逐渐成为飞行员主要及常见的疾病之一。在飞行员住院以及改装体检不合格疾病中，椎间盘退行性疾病也高居首位。其中尤以颈椎病、腰椎间盘突出症最为常见，且脊柱生理曲度改变为影像学最常见的早期征象，可作为诊断和干预的依据。此外，根据以往的调查研究发现，椎间盘退变与飞行员年龄、飞行时间以及驾驶的机型有相关性。由椎间盘退行性疾病引起的颈腰背痛极大地影响了飞行员的健康及精神状态，是我军医疗卫生领域的重大难题。本文归纳了近20年国内外对于飞行员特别是高性能战斗机飞行员患椎间盘退行性疾病的流行病学调查研究结果，总结了该人群中椎间盘退行性疾病的发病特征，并加以综述，为研究疾病特征、预测发展趋势、实施防治策略提供有效依据。 

Epidemiology Research Progress of Degenerative Disc Disease in Pilots

Degenerative disc disease is a common chronic degenerative disease, which is also the primary cause of neck, waist and leg pain. Studies have shown that the intervertebral disc began to degenerate from about 18 years old. In the middle-aged group and elderly, the biochemical composition of the intervertebral disc changes because of the joint influence of internal and external factors, leading to the gradual loss of structure and function, thereby resulting in degenerative diseases. However, investigation results show that the prevalence of degenerative disc disease is higher in pilots, particularly in fighter pilots, and the onset age is earlier than that of ordinary people. In recent years, with the development of aviation technology and the continuous improvement of fighter jets performance, the prevalence of degenerative disc disease in pilots also has been increasing, which has gradually become an important and common disease in pilots. Degenerative disc disease also ranked first amongst the diseases of hospitalisation and of pilots who failed to pass the physical examination. Amongst the diseases, cervical spondylosis and lumbar disc herniation are most common. The changes in spinal physiological curvature are the most common early signs of imaging, which can be used as the basis for diagnosis and intervention. In addition, previous studies have found that intervertebral disc degeneration is related to pilot age, flight duration and type of aircraft flown. Cervical and lumbar back pain caused by degenerative disc diseases has a great impact on the health and mental state of pilots, which is a major problem in the medical and health field of our armed forces. This paper reviews the epidemiological investigation results and characteristics of degenerative disc diseases in pilots, home and abroad in recent 20 years, particularly in high-performance fighter pilots, providing effective basis for the study of disease characteristics, prediction of development trend and implementation of prevention and control strategies.