飞行员椎间盘退行性疾病患病率调查及危险因素分析

Prevalence and risk factors of degenerative disc disease in pilots

目的 探究飞行员椎间盘退行性疾病(degenerative disc disease, DDD)的患病率和危险因素。方法 2021年1月-2022年5月,采用整群抽样的方法,以调查问卷的形式对空军部队飞行员进行调查,并收集相关影像学资料。调查内容包括基本信息、DDD患病情况、飞行相关信息、个人习惯几个部分。计算DDD患病率,并对退变组和对照组进行单因素χ2检验、t检验等以及多因素logistic回归分析,筛选疾病的危险因素。结果 共发放问卷170份,收回有效问卷162份。DDD患病率为47.5%(77/162),其中颈椎病患病率为27.8%(45/162),腰椎间盘突出症患病率为29.6%(48/162),退行性腰椎滑脱症患病率为3.1%(5/162)。单因素分析结果显示,退变组与对照组间体质量指数(t=2.594,P=0.010)、驾龄(t=2.160,P=0.032)、最大飞行载荷(t=2.953,P=0.004)、平均飞行载荷(t=2.575,P=0.011)、失眠(χ^(2)=4.756,P=0.029)和吸烟(χ^(2)=7.977,P=0.005)差异有统计学意义。多因素logistic回归分析结果显示,驾龄[比值比(odds ratio, OR)=1.077,95%置信区间(confidence interval, CI)(1.025,1.132),P=0.004]、最大飞行载荷[OR=1.279,95%CI(1.109,1.475),P=0.001]、头盔质量[OR=1.516,95%CI(1.056,2.175),P=0.024]、失眠[OR=2.235,95%CI(1.114,4.483),P=0.024]、吸烟[OR=2.527,95%CI(1.255,5.087),P=0.009]是患DDD的影响因素。结论 飞行员DDD患病率较高。高驾龄、最大飞行载荷过高、头盔较重、失眠以及吸烟可能是患DDD的独立危险因素。

Objective To investigate the prevalence and risk factors of degenerative disc disease(DDD)in pilots.MethodsFrom January 2021 to May 2022,pilots were surveyed using a whole group sampling method and relevant imaging data were collected.The contents of the survey included basic information,DDD-related information,flightrelated information,and personal habits.The prevalence of DDD was calculated,and univariate x test,t-test,and multivariate logistic regression analysis were performed for the diseased and healthy groups to screen the risk factors of DDD.Results A total of 170 copies of questionnaire were sent out and 162 valid copies were returned.The prevalence of DDD was 47.5%(77/162),including 27.8%(45/162)for cervical spondylosis,29.6%(48/162)for lumbar disc herniation,and 3.1%(5/162)for degenerative lumbar spondylolisthesis.The results of univariate analysis showed that body mass index(t=2.594,P=0.010),driving age(t=2.160,P=0.032),maximum load in flight(t=2.953,P=0.004),mean load in flight(t=2.575,P=0.011),insomnia(x^(2)=4.756,P=0.029)and smoking(x^(2)=7.977,P=0.005)were significantly different between the diseased group and the healthy group.Multivariate logistic regression showed that driving age[odds ratio(OR)=1.077,95% confidence interval(CI)(1.025,1.132),P=0.004],maximum load in flight[OR=1.279,95%CI(1.109,1.475),P=0.001],helmet weight[OR=1.516,95% CI(1.056,2.175),P=0.024],insomnia[OR=2.235,95% CI(1.114,4.483),P=0.024],and smoking[OR=2.527,95% CI(1.255,5.087),P=0.009]were risk factors for DDD.Conclusions Theprevalence of DDD is high in pilots.High driving age,high maximum load in flight,high helmet weight,insomnia,and smoking may be independent risk factors for DDD.