战斗机飞行员腰椎退行性病变危险因素分析  

Risk factors of lumbar degenerative diseases among fighter pilots

作　　者：马骏[1,2] 曾葭 刘雁冰 戴婕 蒋叶 李昂 高迪[3] 叶小飞[2] MA Jun;ZENG Jia;LIU Yanbing;DAI Jie;JIANG Ye;LI Ang;GAO Di;YE Xiaofei(Department of Air Duty,Naval Medical Center,Naval Medical University(Second Military Medical University),Shanghai 200355,China;Department of Military Health Statistics,Faculty of Health Services,Naval Medical University(Second Military Medical University),Shanghai 200433,China;Aviation Medical Office,No.92329 Troop of PLA,Huludao 125100,Liaoning,China)

机构地区：[1]海军军医大学(第二军医大学)海军特色医学中心空勤科,上海200355 [2]海军军医大学(第二军医大学)卫生勤务学系军队卫生与统计学教研室,上海200433 [3]中国人民解放军92329部队航医室,葫芦岛125100

出　　处：《海军军医大学学报》2024年第1期37-41,共5页Academic Journal of Naval Medical University

基　　金：国家自然科学基金(82102624);海军军医大学(第二军医大学)海军特色医学中心强基计划(23M2301)。

摘　　要：目的探讨战斗机飞行员腰椎退行性病变的危险因素,提出针对性的预防及治疗方案。方法利用问卷调查方式结合脊柱影像学资料对相关飞行员进行评价,调查问卷内容包括一般资料、生活方式、飞行训练方式等暴露因素,脊柱影像学检查项目包括腰椎MRI和腰椎X线片。将存在腰椎退行性病变的飞行员纳入退变组,无腰椎退行性病变的飞行员纳入健康组,采用单因素分析和logistic回归模型进行腰椎退行性病变的危险因素筛选。结果纳入研究的战斗机飞行员腰椎退行性病变的整体患病率为45.8%(66/144)。战斗机飞行员发生腰椎退行性病变的危险因素分别为久坐(OR=2.714,95%CI 1.351~5.375,P=0.004)、缺乏腰背肌锻炼(OR=3.136,95%CI1.536~6.037,P=0.001)、飞行中静态姿势不适(OR=8.160,95%CI 3.152~21.120,P<0.001)、飞行中腰椎矢状位不正(OR=8.397,95%CI 3.367~20.942,P<0.001)、飞行中腰椎冠状位不正(OR=2.744,95%CI 1.102~6.831,P=0.030)。结论战斗机飞行员腰椎退行性病变患病率较高,飞行中持续的静态姿势不适和腰椎冠状位、矢状位失稳是腰椎退行性病变的重要诱因,减少久坐、加强腰背肌锻炼是避免腰椎退行性病变的重要方法。Objective To investigate the risk factors of lumbar degenerative diseases among fighter pilots,and develop targeted prevention and treatment strategies.Methods Pilots were assessed by a questionnaire and spinal imaging data(including lumbar magnetic resonance imaging and X-ray scans).The questionnaire covered general information,lifestyle,flight training,and other exposure factors.Pilots with lumbar degenerative diseases were categorized into the degenerative group,while others were classified as healthy group.The risk factors of lumbar degenerative diseases were screened by univariate analysis and logistic regression model.Results The overall prevalence of lumbar degenerative diseases was 45.8%(66/144)among the fighter pilots.Sedentary lifestyle(odds ratio[OR]=2.714,95% confidence interval[CI]1.351-5.375,P=0.004),lack of lumbar and back muscle exercise(OR=3.136,95%CI 1.536-6.037,P=0.001),static postural discomfort during flight(OR=8.160,95%CI 3.152-21.120,P<0.001),lumbar sagittal misalignment during flight(OR=8.397,95%CI 3.367-20.942,P<0.001),and lumbar coronal misalignment during flight(OR=2.744,95%CI 1.102-6.831,P=0.030)were risk factors of lumbar degenerative diseases among fighter pilots.Conclusion The prevalence of lumbar degenerative diseases is high among fighter pilots,primarily due to continuous static postural discomfort and lumbar coronal and sagittal instability during flight.Reducing sedentary lifestyle and strengthening lumbar and back muscle exercise are crucial preventive measures against the development of lumbar degenerative diseases.

关 键 词：飞行员 战斗机 腰椎退行性病变 危险因素 

分 类 号：R82[医药卫生—临床医学]