飞行员冠状动脉造影39例临床研究

Clinical study on 39 pilot cases underwent coronary angiography

目的 探讨飞行人员冠心病的临床特点和冠状动脉造影在医学鉴定中的意义。 方法 对 39例飞行员冠状动脉造影病例进行回顾性分析 ,对象均为男性 ,年龄 2 5～ 5 9岁 ,通过无创检查方法均不能排除冠心病。 结果 ①通过冠状动脉造影 ,发现 8人出现明显的冠状动脉硬化 ,其中 7人有不同程度冠状动脉狭窄 (称该 8人为冠脉病变组 ) ,其余有 18人诊断为其他心血管疾病 (其他疾病组 ) ,13人未做疾病诊断 (健康组 )。②冠脉病变组年龄较大 ( 4 8～ 5 5岁 ) ,临床症状 ( 87.5 % )和平板运动试验 ( 10 0 % )阳性率最高 ;其他疾病组临床症状也较突出 ( 83.3% ) ,但平板运动试验阳性率较低( 35 .3% ) ;健康组年龄大多较轻 ,较少有临床症状 ( 30 .8% )。③经过冠状动脉造影 ,使人 2 0 / 39名飞行员重返飞行岗位 ,包括健康组全部、其他疾病组 5人、冠脉病变组 2人。 结论 本研究不支持以往调查认为中国飞行人员冠心病发病比普通人群早 10～ 15年的论点。

Objective To investigate the clinical features of coronary artery diseases (CAD) in pilots and the significance of coronary angiography in medical assessment. Methods The medical histories of 39 pilots underwent coronary angiography were reviewed. The age of this group of pilots ranged from 25 to 59, (average 42±10). They received a series of non invasive examinations, and the possibility of CAD could not be excluded. Results ①By coronary angiography, it was found that there were 8 cases with significant coronary atherosclerosis(CAD group), 18 cases with other cardiovascular diseases(other diseases group),18 cases without abnormal findings(healthy group). ②The clinical features of CAD group were elder in age (48～55), high incidence (7/8) of having clinical symptoms and high positive rate (7/7) of treadmill exercise testing (TET). In other diseases group, the incidence of having clinical symptom was high (10/13), but the positive rate of TET was relatively low (6/17).The age of most healthy group pilots (15/18) was under 40; the incidence of having clinical symptom was low (4/13) and the false positive rate of TET in this group was as high as 84.6%. ③Through coronary angiography, 20/39 pilots returned to flying, including all pilots of healthy group, 5 pilots of other disease group and 2 pilots of CAD group. Conclusions The results of this study do not support the point of view of previous investigation that the onset age of CAD in Chinese pilots is 10～15 years earlier than that of general population. Coronary angiography is very important in diagnosis and medical assessment of pilot CAD cases.