摘要
目的分析飞行人员冠状动脉心肌桥的临床特点,探讨其航空医学鉴定原则。方法回顾分析空军总医院近5年来通过多层螺旋CT检查或冠状动脉造影诊断的15例飞行人员冠状动脉心肌桥病例资料,结合文献复习提出其航空医学鉴定原则。结果在有心电图ST-T改变或平板运动试验阳性的飞行人员中,冠状动脉心肌桥较为常见,占同期心电图异常行冠状动脉显像检查人数的30%左右,多发生在左前降支中段或中远段,多为表浅型、无明显症状,仅少部分人合并有心律失常或间断胸闷、胸痛表现;表浅型心肌桥不影响心血管功能,结论可飞行合格。有临床表现的心肌桥,如治疗效果好,双座机飞行人员飞行合格,单座机飞行员个别评定。结论冠状动脉心肌桥是造成飞行人员心电图异常的常见原因,大多程度较轻,不影响心血管功能和飞行;对于有临床症状表现的心肌桥病例,根据治疗效果和飞行机种进行个别评定。
Objective To study the aero-medical assessment principles of coronary myocardial bridge （CMB） in pilots by analyzing its clinical characteristics. Methods Clinical data about 15 pilots with CMB diagnosed by coronary angiography or spiral CTA in our hospital during the recent 5 years were retrospectively analyzed and its aero-medical assessment principles were put forward in accordance with an review of its related literature. Results CMB was frequently observed in pilots with ST-T change on ECG or at positive treadmill exercise testing, accounting for about 30% in those with abnormal ECG. CMB, usually located in the middle or distal segment of left anterior descending coronary artery, was mainly manifested as a superficial type with no obvious symptoms or as arrhythmia, interrupted chest distress or pain in a small number of patients. Since superficial CMB did not affect cardiovascular function, pilots with superficial CMB were qualified to fly a double-seat airplane while whether those flying a single-seat airplane should be assessed individually if the treatment outcome was good. Conclusion CMB is the common cause of abnormal ECG in pilots and usually manifested as a superficial type which does not affect cardiovascular function and flying. Pilots with clinical symptoms of CMB should be assessed individually according to their treatment outcome and the types of airplane they fly.
出处
《军医进修学院学报》
CAS
2012年第12期1235-1237,共3页
Academic Journal of Pla Postgraduate Medical School
基金
空军后勤科研计划课题(BKJ09J18)~~
关键词
飞行人员
冠状动脉
心肌桥
医学鉴定
aircrew
coronary artery
myocardial bridging
medical assessment
