军事飞行人员新发原发性高血压病临床特点和航空医学鉴定

Clinical characteristics of new onset primary hypertension and aeromedical evaluation of military aircrews

目的了解军事飞行人员新发原发性高血压病的临床特点和航空医学鉴定情况,为促进军事飞行人员健康和提高航空医学鉴定质量提供依据。方法查阅电子病历,回顾分析2014年3月-2019年12月于空军杭州特勤疗养中心首次确诊原发性高血压病并完成医学鉴定的飞行人员相关临床资料。结果近6年于本疗区确诊新发原发性高血压病95例,累计发病率0.85%,平均发病年龄43.8岁,71.58%为轰炸机、运输机和直升机飞行人员,81.05%为高血压病1级,7.37%曾有不适症状(头晕或头痛);10.53%航空医学鉴定为暂时飞行不合格,均为轰炸机、运输机和直升机飞行员和机组人员,27.37%有药物治疗,随访显示所有患者后续血压均控制良好,能正常飞行,46.32%心血管风险为中危,较常见的风险因素:吸烟(35.79%),家族史(22.11%),靶器官损伤(20.00%),胆固醇异常(18.95%);靶器官损害均为颈动脉,无临床并发症或糖尿病;营养代谢相关疾病患病率:肥胖(11.58%),超重(70.53%),脂肪肝(46.32%),三酰甘油增高(41.05%)。结论军事飞行人员新发原发性高血压病具有发病率低,发病年龄小,病解,治疗效果好等特為在航空医学鉴定中采用个别评定的原则,目前保证了飞行安全。

Objective To study the clinical characteristics of new onset primary hypertension and the aeromedical evaluation of military aircrews in order to provide data for promoting the health of these crews and improving the quality of medical evaluation.Methods The clinical data on the military aircrews who were diagnosed with primary hypertension for the first time in Air Force Health Care Center for Special Services between March 2014 and December 2019 was collected and analyzed.Results A total of 95 cases were diagnosed with the primary hypertension for the first time over the past six years.The cumulative incidence was 0.85%,the average age of onset was 43.8 years old,and 71.58%of the patients were aircrews of bombers,transport planes and helicopters.81.05%of them were of hypertension grade 1 and 7.37%reported discomfort(dizziness or headache).10.53%were temporarily grounded,and 27.37%received medication.The blood pressure of all these patients was brought under effective control so that they could fly after treatment.46.32%were at intermediate risk of cardiovascular diseases.The common risk factors were smoking(35.79%),a history of family disease(22.11%),injury to target organs(20.00%),and abnormal cholesterol levels(18.95%).The impaired target organs all involved the carotid artery.The incidence of diseases related to nutrition and metabolism was 11.58%for obesity,70.53%for overweight,46.32%for fatty liver,and 41.05%for elevated triglycerides.Conclusion Primary hypertension among the mihtary aircrews is characterized by low prevalence,a young age of onset,mild symptoms,and good treatment outcomes.During aeromedical evaluation,individualized assessment can help guarantee flight safety.