轻型地中海贫血对民航飞行学生缺氧耐力影响初探  

Preliminary study of the effects of mild thalassemia on hypoxia tolerance of civil aviation student pilots

作　　者：蒋纪文[1] 郑晓艳[1] 李谦 刘敏[1] 谢菲 Jiang Jiwen;Zheng Xiaoyan;Li Qian;Liu Min;Xie Fei(Hospital of Civil Aviation Flight University of China,Guanghan 618307,China)

机构地区：[1]中国民航飞行学院医院,四川省广汉市618307 [2]民航医学中心空勤人员体检鉴定所,北京100123

出　　处：《中华航空航天医学杂志》2018年第3期220-224,共5页Chinese Journal of Aerospace Medicine

摘　　要：目的调查轻型地中海贫血对民航飞行学生缺氧耐力的影响,为民航飞行人员地中海贫血的航空医学鉴定提供依据。方法选取飞行学院参加招飞体检的学生和在校飞行学生1711名,进行静脉血红细胞参数和Hb分析,对表现为小细胞低色素性贫血的学生进行地中海贫血基因检测以确定是否为地中海贫血。按就近原则在检出的地中海贫血者中选取留有联系电话的轻型地中海贫血者25例,健康者19例,用2007型抗荷抗缺氧能力检测仪模拟7,5km高空低氧环境,进行低氧模拟测试,并记录测试进行20s、60s及120s时受试者的SaO2、心率及血压,若未达到120s而SaO2已低于60%则终止测试并记录终止时的SaO2、心率及血压。缺氧前后受试者按照有效意识时间测定方法进行倒写数字测试;在模拟7,5km高空环境下(缺氧后)若测试时间未达到120s而SaO2已低于60%则终止测试并记录实际测试时间。结果①1711名学生中共检出的地中海贫血97例(5,67%),均为轻型;海南省受检学生中检出率为20,00%,比例最高。②在模拟7,5km高空低氧环境中,轻型地中海贫血组和健康组低氧测试时间差异有统计学意义(Z=3,630,P<0,01);两组SaO2在测试进行60s时差异无统计学意义(P>0,05),在结束时差异具有统计学意义(t=5,248,P<0,01);两组心率在进行60s时和结束时差异均无统计学意义(P>0,05);两组收缩压在测试进行60s时差异有统计学意义(t=2,215,P=0,029),在结束时两组舒张压差异有统计学意义(t=2,518,P=0,018);两组倒写数字测试在缺氧前差异无统计学意义(P>0,05),缺氧后差异有统计学意义(t=3,489,P<0,01)。结论轻型地中海贫血者的缺氧耐受力低于健康人群,建议对地中海贫血者招飞时从严把握,地中海贫血者应尽量减少高原飞行。Objective To investigate the effects of mild thalassemia on hypoxia tolerance of civil aviation student pilots,and provide the basis for aviation medical identification of thalassemia in civil aviation pilots. Methods The parameters of red blood cells and hemoglobin were analyzed in 1 711 subjects including the student candidates who were checked in the physical examination for recruitment and the student pilots of flight college. The thalassemia gene tests were performed for the subjects with small cell and low pigmented anemia to diagnose if they were with thalassemia. Twenty-five mild thalassemia cases and 19 healthy cases were chosen for the comparison according to the principles of proximity and phone call reachable. The hypoxia test was conducted at 7.5km simulated altitude by Model 2007 anti-G/anti-hypoxia Detector. SaO2,heart rate and blood pressure were respectively recorded at 20s,60s and 120s of the test. In case of the test did not reach to 120s but the SaO2 had been lower than 60% the test was terminated and the SaO2,heart rate and blood pressure were marked at the moment. The subjects were tested by writing digits with down sequence before and after hypoxia test. In 7.5km simulated altitude test if the SaO2 level had decreased to 60% within 120s the test would be terminated and the actual test duration was recorded. Results ①Ninety-seven cases of thalassemia were found in 1 711 students(5.67%) and all cases were mild thalassemia. The highest detection rate was found in the students of Hainan Province,accounting for 20%.②The difference of test duration was statistically significant between mild thalassemia group and health group under simulated 7.5km altitude hypoxia environment(Z=3.630,P<0.01). The difference of SaO2 at 60s was not statistically significant between two groups(P>0.05),but the difference at the end of test was statistically significant(t=5.248,P<0.01). The differences of heart rate at 60s and at the end of test were not statistically significant between two groups(P>0.05). The dif

关 键 词：地中海贫血 缺氧 血氧测定法 意识 飞行学生 

分 类 号：R856.5[医药卫生—航空、航天与航海医学] R852.LL[医药卫生—临床医学]