血管内超声及血流储备分数检测对军事飞行人员冠心病的应用价值及意义  

The application of intravascular ultrasound and fractional flow reserve in the treatment of military aircrew with coronary heart disease

作　　者：张海涛[1] 孙津津[1] 黄丛春[1] 王俊华[1] 于心亚[1] 田建伟[1] 罗惠兰[2] 刘朝中[1] 

机构地区：[1]空军总医院心脏中心,北京100142 [2]空军总医院干部病房六区,北京100142

出　　处：《空军医学杂志》2015年第3期132-136,共5页Medical Journal of Air Force

基　　金：全军"十二五"重点课题(BWS11J054)

摘　　要：目的初步探讨冠状动脉造影、冠状动脉内超声以及血流储备分数检测对军事飞行人员冠心病医学鉴定的应用价值及意义。方法回顾分析冠状动脉造影、血管内超声以及血流储备分数检测在11例临床诊断军事飞行人员冠心病的应用及其相关医学鉴定情况,评价以上3种检测手段对军事飞行人员冠心病的应用价值。结果 11例军事飞行人员,年龄29~52岁,诊断为无症状性心肌缺血4例,心绞痛4例,陈旧性下壁心肌梗死2例,陈旧性前壁心肌梗死1例。11例均在我院行冠状动脉造影术,其中6例同时行冠状动脉造影＋血管内超声＋压力导丝测定,3例行冠状动脉造影＋血管内超声检测,2例行冠状动脉造影＋压力导丝测定;其中3例为支架术后复查,有3例经测定后同时行支架植入术,6例为临界病变。飞行结论3例飞行合格,给予放飞,8例飞行暂不合格,地面观察。结论冠状动脉造影结合血管内超声及血流储备分数检测可以从解剖学及功能学上清晰、准确地评估冠状动脉病变,从而为军事飞行人员冠心病的医学鉴定提供更为客观全面的依据。Objective To study the application value of coronary angiogram（CAG）intravascular ultrasound（IVUS）and fractional flow reserve（FFR） for aero-medical assessment of military aircrew with coronary heart disease（CHD）.Methods The application and aero-medical assessment about 11 military aircrew members diagnosed with CHD who performed with CAG,IVUS and FFR was analyzed retrospectively.The value of the three kinds of detection methods for the application of the CHD military aircrew was evaluated.Results Among 11 aircrew members aged from 29 to 52 years old,including 4 cases with latent coronary heart disease,4 cases were with angina,2 cases with old inferior myocardial infarction and 1 case with old myocardial infarction in anterior wall.All of the 11 cases were performed by CAG,including6 cases performed with CAG and IVUS and FFR simultaneously,3 cases with CAG and IVUS simultaneously,2 cases with CAG and FFR simultaneously.There were 3 cases as rechecked after PCI,6 cases were judged by borderline lesion,3 cases were performed with percuteneous coronary artery stents after examination.In the end,there were 3 aircrew members qualified to flight,the other 8 aircrew members were disqualified to flight and left in the ground to be observed.Conclusions The method of CAG combined with IVUS and FFR could evaluate the coronary lesion much more distinctly and accurately based on anatomical and functional degree,which could provide objective and comprehensive evidences for medical assessment of military aircrew with CHD.

关 键 词：冠心病 飞行人员 冠状动脉造影 血管内超声 血流储备分数 医学鉴定 

分 类 号：R85[医药卫生—航空、航天与航海医学]