头高位倾斜试验在飞行人员高血压医学鉴定中的应用

Application of head-up tilt test to medical evaluation of aircrew with hypertension

目的探讨头高位倾斜试验在飞行人员高血压医学鉴定中的作用与意义。方法对203名飞行人员进行头高位85°倾斜20min试验,按头高位倾斜时血压正常(血压正常组,n=178)、血压升高(立位高血压组,n=4)、平时血压增高(高血压组,n=11)以及采用药物治疗的高血压(高血压治疗组,n=10)分组统计分析头高位倾斜试验中血压和脉搏变化情况。结果从平卧位转为头高倾斜位后,正常血压组飞行人员DBP和脉搏显著增加(P<0.01),SBP仅在头高位倾斜初始阶段显著增加(P<0.01),但均在正常范围之内。立位高血压组和高血压组飞行人员头高位倾斜时,血压和脉搏变化形式与正常血压组飞行人员相类似,但DBP平均值和头高位倾斜初始阶段SBP平均值均超出正常范围。高血压药物治疗组,平卧位时血压脉搏均正常,头高倾斜位时仅脉搏显著增加(P<0.01),SBP和DBP均无明显变化或升高反应消失。结论应用头高位倾斜试验有助于对飞行人员早期高血压和体位性高血压进行检出,并可对高血压治疗效果进行评定。

Objective It was designed to investigate the significance of head-up tilt test in medical evaluation of aircrew with hypertension.Methods The 85°head-up tilt test for 20 min was performed in 203 aircrew.The changes in blood pressure and heart rate during head-up tilt test were statistically analyzed according to the groups of aircrew with normal blood pressure（n=178）,higher blood pressure（n=15） during head-up tilt and treated hypertension（n=10） respectively.Results During head-up tilt,DBP and pulse rate significantly increased and SBP just increased during the initial period in normal blood pressure group（P〈0.01）and the average values were all in the normal limits.The changes in blood pressure and pulse rate during head-up tilt in higher blood pressure group were similar to normal blood pressure group,but the average values of DBP and SBP during the initial period were all higher than the normal maximum limits.The blood pressure and pulse rate were all normal during supine in treated hypertension group,only pulse rate increased significantly（P〈0.01）and the increased responses in DBP and SBP disappeared during head-up tilt.Conclusions Aircrew with early hypertension or body postural hypertension could be detected and the treatment effect on hypertension could be evaluated by application of head-up tilt test.