军事飞行人员肺结节检出情况及相关因素分析

Detection of pulmonary nodules and relevant factors among military aircrews

目的探讨军事飞行人员肺结节检出情况及发生肺结节的影响因素。方法选择2022年度在海军青岛特勤疗养中心疗养的2283名军事飞行人员作为研究对象,对所有对象进行胸部低剂量螺旋计算机断层扫描检查,其中检出肺结节225例,随访均为良性结节;根据有无肺结节分为肺结节组(n=225)、无肺结节组(n=2058)。收集所有研究对象的性别、年龄、身高、体质量、飞行机种、累计飞行时间、人员类别、文化程度、出生地、肿瘤家族史、长期吸烟史、长期饮酒史、新型冠状病毒(简称新冠病毒)感染史、白细胞计数、血小板计数、长期运动锻炼、饮食习惯、睡眠时间、压力、工作或生活满意度等情况。使用χ^(2)检验或t检验比较2组间不同指标的差异。选用多因素Logistic回归分析法评估军事飞行人员肺结节的影响因素。结果2283名军事飞行人员共检出肺结节225例,检出率为9.86%。其中肺结节单发162例,多发63例,共检出肺结节数目326个。肺结节位置分布:左上叶61个,右上叶66个,右中叶32个,左下叶89个,右下叶78个。肺结节大小:直径<5mm233个,5~10mm 91个,>10~19mm 2个。肺结节密度:实性结节259个,部分实性结节26个,非实性结节(磨玻璃结节)41个。单因素分析结果显示,军事飞行人员肺结节的发生与年龄(t=8.882,P<0.001)、累计飞行时间(χ^(2)=9.511,P=0.023)、长期吸烟史(χ^(2)=15.595,P<0.001)、长期运动锻炼(χ^(2)=10.053,P=0.002)、饮食习惯(χ^(2)=6.777,P=0.009)有关。多因素Logistic回归分析结果显示,年龄增长、长期吸烟史、重口味饮食(咸、辣、油腻)是军事飞行人员发生肺结节的危险因素(OR=1.275、5.237、1.568,95%CI:1.104~2.689、1.873~8.635、1.123~3.356,P均<0.001),长期运动锻炼是军事飞行人员发生肺结节的保护因素(OR=0.572,95%CI:0.568~0.902,P<0.001)。结论军事飞行人员肺结节检出率低于普通人群,其发生与多种因素有关,其中年龄增长、长期吸烟史、重口味饮食(咸、辣、油腻)是其危险因素;长期运动锻炼是其保护因素。

Objective To explore the detection rate of pulmonary nodules and influencing factors in military aircrews.Methods A total of 2283 military aircrews who were recuperating in Qingdao Navy Special Service Recuperation Center in 2022 were selected as subjects.Low-dose spiral computed tomography(LDCT)of the chests was performed on all the subjects,and 225 cases of pulmonary nodules were detected,all of which were benign ones.These subjects were divided into the pulmonary nodule group(n=225)and non-pulmonary nodule group(n=2058).Data on their gender,age,height,weight,aircraft type,cumulative flight time,personnel type,education level,birthplace,family history of cancer,long-term smoking history,long-term drinking history,novel coronavirus(COvVID-19 for short)infection history,white blood cell count(WBC),platelet count(PLT),long-term exercise,eating habits,sleep quality,stress,work or life satisfaction was collected.χ^(2) test or t-test analysis was used to find out about the difference between the two groups.Multivariate logistic regression analysis was used to evaluate the influencing factors for pulmonary nodules in military aircrews.ResultsA total of 225 cases of pulmonary nodules were detected in 2283 military aircrews,with a detection rate of 9.86%.There were 162 cases of single pulmonary nodules and 63 cases of multiple ones.Three hundred and twenty-six pulmonary nodules were detected.Among them 61 were in the upper-left lobe,66 in the upper-right lobe,32 in the middle right lobe,89 in the lower left lobe,and 78 in the lower right lobe.Pulmonary nodule size:233 nodules with a diameter less than 5 millimeters,91 nodules with a diameter between 5 and 10 millimeters,and 2 nodules with a diameter greater than 10 to 19 millimeters.As for density,259 were solid nodules,26 partially solid nodules,and 41 nonsolid nodules(ground glass nodules).The results of single factor analysis showed that the odds of pulmonary nodules in military aircrews were related to age(t=8.882,P<0.001),cumulative flight time(χ^(2)=9.511,P=0.023),long-term smoking history(χ^(2)=15.595,P<0.001),long-term exercise(χ^(2)=10.053,P=0.002)and diet habits(χ^(2)=6.777,P=0.009).The results of multivariate Logistic regression analysis showed that the type of aircraft and personnel,age,long-term smoking history and heavy flavored diet(salty,spicy,greasy)were independent risk factors for pulmonary nodules in military aircrews(OR=1.275,5.237,1.568,95%cI:1.104~2.689,1.873~8.635,1.123~3.356,all P<0.001),while long-term exercise was an independent protective factor against pulmonary nodules(OR=0.572,95%CI:0.568~0.902,P<0.001).Conclusion1The detection rate of pulmonary nodules in military aircrews is lower than in general populations,and its occurrence is related to various factors,among which age,long-term smoking history,heavy taste diet(salty,spicy,greasy)are independent risk factors while long-term exercise is an independent protective factor.