Clinical data analysis and aeromedical evaluation of flying personnel with myocardial bridges
王全龙 1杨惠民 2孙津津 1任兴华 1张婧 1王猛 1王俊华 1曹艳杰 1张海涛 1周晴霖
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作者信息
1. 1空军特色医学中心心血管内科，北京100142
2. 2扬州市疾病预防与控制中心 225009
折叠
摘要
目的 对飞行人员心肌桥临床特征及航空医学鉴定结果进行回顾性分析，为做好诊断为心肌桥的飞行人员航空医学鉴定工作提供参考。 方法 比较分析2010年1月至2020年1月于空军特色医学中心行冠状动脉血管成像检查、诊断为心肌桥的军事飞行人员的临床特征及航空医学鉴定结论。 结果 79例患有心肌桥的飞行人员共检出84段心肌桥病变，全部位于左冠状动脉系统，其中发生于前降支中段62段（73.81%）。79例心肌桥飞行人员中77例单段心肌桥发生在前降支，其中合并前降支粥样硬化病变者28例。航空医学鉴定结论为飞行合格者49例，暂时飞行不合格者27例，飞行不合格者3例。飞行合格组与暂时飞行不合格组在平板运动试验结果和心肌缺血症状上差异有统计学意义（χ²=7.902、7.832，P值均=0.005）。 结论 飞行人员发生心肌桥以前降支中段为主，容易合并近端冠状动脉粥样硬化病变，现有的临床评估指标尚不够精准，航空医学鉴定依据需进一步完善。 Objective To provide references for the aeromedical qualification of flying personnel with myocardial bridges by retrospectively analysising the clinical characteristics and aeromedical qualification results. Methods The clinical characteristics and aeromedical qualification of military flying personnel who underwent coronary angiography examinations and diagnosed as myocardial bridges in Air Force Medical Center from January of 2010 to January of 2020 were compared and analyzed. Results A total of 84 segments of myocardial bridge diseases were detected in 79 flying personnel diagnosed as myocardial bridges located in the left coronary artery system, of which the middle segment of the left anterior descending artery accounted for 73.81% (62/84). A total of 77 single-segment myocardial bridges occurred in the anterior descending artery in 79 flying personnel diagnosed as myocardial bridges, of which 28 cases were combined with atherosclerotic lesions of the anterior descending artery. The areomedical qualification concluded that 49 cases were qualified for flight, 27 cases were temporarily disqualified, and 3 cases were disqualified. There were significant differences in treadmill exercise results and myocardial ischemia between the qualified and temporarily disqualified groups (χ²=7.902, 7.832, both P=0.005). Conclusions Myocardial bridges in military flying personnel mainly occurs in the middle of the left anterior descending artery, which is easy to merge with proximal coronary atherosclerotic lesions, and the existing clinical evaluation indicators are not accurate enough, and the basis for areomedical qualification needs to be further improved.
Abstract
Objective To provide references for the aeromedical qualification of flying personnel with myocardial bridges by retrospectively analysising the clinical characteristics and aeromedical qualification results. Methods The clinical characteristics and aeromedical qualification of military flying personnel who underwent coronary angiography examinations and diagnosed as myocardial bridges in Air Force Medical Center from January of 2010 to January of 2020 were compared and analyzed. Results A total of 84 segments of myocardial bridge diseases were detected in 79 flying personnel diagnosed as myocardial bridges located in the left coronary artery system, of which the middle segment of the left anterior descending artery accounted for 73.81% (62/84). A total of 77 single-segment myocardial bridges occurred in the anterior descending artery in 79 flying personnel diagnosed as myocardial bridges, of which 28 cases were combined with atherosclerotic lesions of the anterior descending artery. The areomedical qualification concluded that 49 cases were qualified for flight, 27 cases were temporarily disqualified, and 3 cases were disqualified. There were significant differences in treadmill exercise results and myocardial ischemia between the qualified and temporarily disqualified groups (χ²=7.902, 7.832, both P=0.005). Conclusions Myocardial bridges in military flying personnel mainly occurs in the middle of the left anterior descending artery, which is easy to merge with proximal coronary atherosclerotic lesions, and the existing clinical evaluation indicators are not accurate enough, and the basis for areomedical qualification needs to be further improved.
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