单中心飞行人员腰椎MRI影像学检查结果分析

Study on the lumbar MRI image results of flying personnel in a single-center

目的探索飞行人员腰椎间盘退行性变的影响因素,为飞行人员招飞、改装体检及医学鉴定提供依据。方法回顾性分析2018年3月至2019年5月于空军杭州特勤疗养中心疗养二区进行医学鉴定的458例飞行人员腰椎MRI影像及相关资料。根据Pfirrmann标准对458例飞行人员2290个腰椎间盘进行半定量评分。将每名飞行人员5个腰椎间盘半定量评分之和作为该名飞行人员腰椎间盘退行性变因子;以该因子为因变量(y),飞行人员的年龄(x_(1))、身高(x_(2))、体重(x_(3))、飞行时间(x_(4))为自变量进行线性回归分析;同时,分别以飞行机种与飞行岗位为分组标准进行亚组分析。结果本组飞行人员的腰椎间盘退行性变因子范围为5~18分,平均10.87±2.83分。总体分析显示,飞行人员腰椎间盘退行性变的影响因素为年龄和体重,回归方程为y=1.029+0.182x_(1)+0.038x_(3)(r=0.68,P<0.01)。以飞行机种分组进行亚组分析显示,飞行人员腰椎间盘退行性变的影响因素歼击机亚组中为年龄,回归方程为y=2.569+0.225x_(1)(r=0.59,P<0.01);轰运机亚组中为年龄和身高,回归方程为y=-8.848+0.186x_(1)+7.160x_(2)(r=0.69,P<0.01);直升机亚组中为飞行时间,回归方程为y=7.823+0.001x_(4)(r=0.65,P<0.01)。以飞行岗位分组进行亚组分析显示,飞行人员腰椎间盘退行性变的影响因素在飞行员亚组中为年龄,回归方程为y=3.176+0.207x_(1)(r=0.65,P<0.01);在机组成员亚组中为年龄和体重,回归方程为y=-0.113+0.171x_(1)+0.056x_(3)(r=0.74,P<0.01)。结论单中心飞行人员腰椎MRI影像学检查结果显示飞行人员腰椎间盘退行性变的主要影响因素是年龄和体重,对于不同飞行机种及飞行岗位的影响因素有所不同。但由于本研究样本规模不大,航空相关因素纳入不够全面,不排除存在其他影响飞行人员腰椎间盘退行性变的因素。

Objective To explore the influential factors of lumbar inter-vertebral disc degeneration and provide the references on flying personnel′s recruitment,physical checkup for transformation and medical identification.Methods Lumbar MRI images and relevant data of 458 flying personnel who underwent medical identification in the Second Area of Air Force Healthcare Center for Special Services Hangzhou from March 2018 to May 2019 were retrospectively analyzed.Two thousand two hundred and ninety lumbar inter-vertebral discs of 458 flying personnel were semi quantitatively scored according to the Pfirrmann standard.The sum of five inter-vertebral disc scores of each flying personnel was taken as the lumbar inter-vertebral disc degenerative factor(LIVDDF).This factor was taken as the dependent variable(y),and the age(x_(1)),height(x_(2)),weight(x_(3)),and flying hours(x_(4))of flying personnel were taken as independent variables for linear regression analysis.The subgroup analysis was carried out based on the grouping of aircraft type and flight post.Results The range of LIVDDF was 5-18,with an average of 10.87±2.83.Total analysis showed that age and weight were the influential factors of lumbar inter-vertebral disc degeneration in flying personnel.The regression equation was y=1.029+0.182x_(1)+0.038x_(3)(r=0.68,P<0.01).Subgroup analysis on the different aircraft types showed that the influential factor was age in the fighter subgroup.The regression equation was y=2.569+0.225x_(1)(r=0.59,P<0.01).Age and height were the influential factors in the trans-bomber aircraft subgroup.The regression equation was y=-8.848+0.186x_(1)+7.160x_(2)(r=0.69,P<0.01).Flying hours was the influential factor in the helicopter subgroup.The regression equation was y=7.823+0.001x_(4)(r=0.65,P<0.01).Subgroup analysis on different flight post showed that the influential factors were age in flying personnel.The regression equation was y=3.176+0.207x_(1)(r=0.65,P<0.01).Age and weight were the influential factors in crew members.The regression equation was y=-0.113+0.171x_(1)+0.056x_(3)(r=0.74,P<0.01).Conclusions Age and weight are the main influential factors of lumbar inter-vertebral disc degeneration in flying personnel,but these factors show different influence on aircraft type and flight post.Due to the small sample size in this study,aviation related factors are not fully included.So other influential factors of lumbar inter-vertebral disc degeneration of flying personnel may exist.