无症状性脑梗死飞行人员头颈部动脉狭窄与停飞情况的研究  

A retrospective study of the causal relationship between cerebral and carotid artery stenosis and groundingrate in the flying personnel with silent brain infarction

作　　者：李文平[1] 石进[1] 陈雪涛[1] 邹志康[1] 陈大伟[1] 宋琛[1] 张英谦[1] Li Wenping;Shi Jin;Chen Xuetao;Zou Zhikang;Chen Dawei;Song Chen;Zhang Yingqian(Air Force General Hospital,Beijing 100142,China)

机构地区：[1]空军总医院,北京100142

出　　处：《中华航空航天医学杂志》2018年第2期114-118,共5页Chinese Journal of Aerospace Medicine

基　　金：国家军用标准项目（BKJ158012）;空军后勤科研重大项目分课题（AKJ15J003）;空军后勤科研项目（BKJ09J019）

摘　　要：目的观察36例无症状脑梗死（silentbraininfarction，SBI）飞行人员头颈部动脉狭窄情况及飞行适应性。方法回顾空军总医院近10年收治的SBI飞行人员的临床资料，根据检查结果分为头颈部动脉狭窄组和非狭窄组，比较两组的脑血管危险因素。观察在检出SBI后2年内的飞行情况。结果共纳入36例SBI飞行人员，均为男性，其中头颈部动脉狭窄10例（动脉狭窄组），非头颈部动脉狭窄26例（非狭窄组）。高血压病12例（33．33％）；糖尿病2例（5．56％）；血脂异常5例（13．89％）；吸烟史16例（44．44％）。两组飞行人员的年龄、飞行时间及高血压病患病情况差异有统计学意义（P〈0．05）。36例SBI飞行人员中在观察期内无一例发展为症状性卒中。有6名在观察期内复查MRI时发现SBI病灶增多，但均未出现神经系统功能缺损症状。停飞20例，其中动脉狭窄组停飞6人，非狭窄组停飞14人，停飞与否和头颈部动脉狭窄无明显相关性（P=1．00）。停飞的20名飞行人员中5名因SBI合并中重度血管狭窄（包括头颈部动脉和冠状动脉），7名伴随反复头晕、头痛症状，2名在地面或飞行训练中出现晕厥，4名伴随焦虑抑郁状态，2名合并其他疾病；无一例因单独的SBI而停飞。结论头颈部血管狭窄的飞行人员2年内的停飞比率未显著高于非狭窄组，SBI不是停飞的直接原因。但由于SBI存在影响飞行安全的潜在风险，应定期进行复查评估。Objective To analyze the cerebral and carotid artery stenosis and flight adaptability by observing 36 flying personnel with silent brain infarction （SBI）. Methods The clinical data of the flying personnel who were diagnosed as SBI in Air Force General Hospital in recent 10 years were reviewed. The flying personnel were divided into cerebral artery stenosis group and non-stenosis groupby the stenosis severity of cerebral and carotid artery, and the cerebrovascular risk factors were compared between groups. Two-year follow-up was conducted for the flying personnel diagnosed as SBI and their flying qualification was concerned. Results Thirty-six male flying personnel were diagnosed as SBI, including 10 cases with cerebral and carotid artery stenosis （stenosis group）, and 26 cases without cerebral and carotid artery stenosis （non-stenosis group）. There were 12 cases of hypertension （33.33%）, 2 cases of diabetes （5.56%）, 5 cases of dyslipidemia （13.89%）, and 16 cases of smoking （44.44%）. Age, flying hours and the prevalence rate of hypertension showed significant difference between stenosis group and non-stenosis group （P〈0.05）. No any symptomatic stroke was found in 36 flying personnel. More SBI lesions were seen in the MRI reexamination in the follow-up for 6 cases with brain infarction but no neurological deficits were observed. Twenty cases were grounded, including 6 cases in stenosis group and 14 cases in non-stenosis group. There was no correlation between cerebral artery stenosis diagnosed and grounding （P 〈1.00）. In 20 grounding cases, 5 cases were with moderate and severe vascular stenosis （including cerebral and carotid arteries and coronary arteries）, 7 cases were with recurrent dizziness and headache, 2 cases had syncope in ground or flight training, 4 cases were with anxiety and depression, and 2 cases associated with other diseases. None were grounded because of the single SBI reason. Conclusions The grounding rate of the flying personnel with cerebral and caro

关 键 词：脑梗死 颈动脉狭窄 危险因素 危险性评估 飞行人员 

分 类 号：R856.74[医药卫生—航空、航天与航海医学]