歼（强）击机飞行员心脏瓣膜生理性返流调查分析

Prevalence of physiological valvular regurgitation in fighter （attacker） pilots

目的 观察歼（强）击机飞行员心脏瓣膜生理性返流的发生情况.方法 100例歼（强）击机飞行员为观察对象,按机型不同分为高性能机组56例和普通机组44例,进行超声心动图检查,观察瓣膜运动及血流情况,测量心脏结构指标并计算其心功能.结果 100例飞行员中,共检出各种瓣膜生理性返流55例（55.00%）,其中高性能机组32例（57.14%）,普通机组23例（52.27%）.以三尖瓣返流最常见,检出率为33.00%,二尖瓣返流9.00%,联合瓣膜返流13.00%,主要为二尖瓣联合三尖瓣返流（11例）,三尖瓣联合肺动脉瓣返流1例,三尖瓣联合主动脉瓣返流1例.普通机组中,有返流组右心室内径较无返流组增加（t=1.69,P＜0.05）;其余指标均无显著性差异（P＞0.05）.100例飞行员心脏结构与功能均在正常范围.结论 歼（强）击机飞行员心脏瓣膜生理性返流检出率高,以三尖瓣返流为主;虽尚未出现心脏结构和功能的改变,但应引起关注.

Objective To investigate the prevalence of physiological valvular regurgitation and its influence in fighter （attacker） pilots. Methods One hundred pilots were divided into high performance fighter pilot group （56 pilots） and common fighter pilot group （44 pilots）. Their cardiac structure and function were examined by echocardiography. Results 55 pilots were diagnosed with physiological valvular regurgitation （55.00%）, including 32 high performance fighter pilots （57.14%） and 23 common fighter pilots （52.27%）. The prevalence of tricuspid, mitral and combined valvular regurgitation was 33. 00%, 9.00% and 13.00% respectively. There were 11 cases of mitral combined tricuspid valvular regurgitation, 1 case of tricuspid combined pulmonic valvular regurgitation and 1 ease of tricuspid combined aortic valvular regurgitation. In common fighter pilot group, right ventricular internal dimension （RVID） of the pilots with regurgitation was significantly higher than that of the pilots without regurgitation （t= 1.69, P＜0.05）. No other significant differences were observed between groups （P＞0. 05）. The cardiac structure and function of 100 pilots were in normal range. Conclusions High prevalence of physiological valvular regurgitation is found in fighter pilots, and in which tricuspid valvular regurgitation takes the highest. It is necessary to further investigate if the fighter pilot＇s specificity makes the different mechanism of physiological regurgitation from other eareer＇s and its long-term influence on pilot＇s cardiac structure and function.