CAJ | 학술논문

目的进一步明确飞行人员冠心病临床检查程序,探讨军事飞行人员冠心病治疗后放飞的可行性. 方法对134名不能除外冠心病的飞行人员,按照临床诊查程序进行平板运动试验、冠状动脉CT成像、心肌核素显像、冠状动脉造影等检查,评估这些检查对于冠心病诊断的有效性,并对8名治疗效果好、结论飞行合格的冠心病飞行人员进行随访,评估其飞行适应性. 结果 ①平板运动试验、冠状动脉CT成像、心肌核素显像、冠状动脉造影4项检查的灵敏度分别为66.7％、88.9％、50.0％和94.4％,特异度分别为67.6％、89.3％、94.1％和100.0％,阳性预测值分别为14.3％、57.1％、66.7％和100.0％,阴性预测值分别为96.2％、98.0％、88.9％和95.2％;②8名结论飞行合格的冠心病飞行人员,放飞24～72个月,每年飞行40～150 h,病情稳定,飞行适应性良好.结论平板运动试验和冠状动脉CT成像可作为筛查和排除飞行人员冠心病的有效手段,冠状动脉造影是目前确诊和排除冠心病的最终手段.对于运输机、直升机等机种的军事飞行人员冠心病患者,有条件放飞可以保证飞行安全.
목적 진일보명학비행인원관심병림상검사정서,탐토군사비행인원관심병치료후방비적가행성. 방법 대134명불능제외관심병적비행인원,안조림상진사정서진행평판운동시험、관상동맥CT성상、심기핵소현상、관상동맥조영등검사,평고저사검사대우관심병진단적유효성,병대8명치료효과호、결론비행합격적관심병비행인원진행수방,평고기비행괄응성. 결과 ①평판운동시험、관상동맥CT성상、심기핵소현상、관상동맥조영4항검사적령민도분별위66.7％、88.9％、50.0％화94.4％,특이도분별위67.6％、89.3％、94.1％화100.0％,양성예측치분별위14.3％、57.1％、66.7％화100.0％,음성예측치분별위96.2％、98.0％、88.9％화95.2％;②8명결론비행합격적관심병비행인원,방비24～72개월,매년비행40～150 h,병정은정,비행괄응성량호.결론 평판운동시험화관상동맥CT성상가작위사사화배제비행인원관심병적유효수단,관상동맥조영시목전학진화배제관심병적최종수단.대우운수궤、직승궤등궤충적군사비행인원관심병환자,유조건방비가이보증비행안전.
Objective To further determine the clinical checking procedure of coronary heart disease (CHD) in aircrews,and investigate possibility of the flying qualification for the military aircrew with CHD who has been cured.Methods Treadmill exercise test,coronary computed tomography angiography (CTA),single photon emission computed tomography (SPECT) myocardial perfusion imaging and coronary angiography were performed in 134 aircrews who were suspected with CHD,and their availability of the CHD diagnosis was evaluated.By following-up 8 flying qualified aircrews whose CHD had been cured,the flying adaptability was evaluated.Results The sensitivity of treadmill exercise test,coronary CTA,SPECT myocardial angiography and coronary angiography,was 66.7％,88.9％,50.0％ and 94.4％,the specificity was 67.6％,89.3％,94.1％ and 100.0％,the positive predictive value was 14.3％,57.1％,66.7 ％ and 100.0％,and the negative predictive value was 96.2％,98.0％,88.9％ and 95.2％,respectively.Eight flying qualified aircrew with CHD had returned to flying for 24-72 months and flied 40-150 h per year.Their state of illness was in stabilization and had a good flying adaptability.Conclusions Treadmill exercise test and coronary CTA can be used as effective methods to screen and exclude CHD in aircrew.Coronary angiography can be the method of finally diagnosing CHD.CHD cured aircrews who fly such airplane as transports and helicopters can be issued conditional qualification for the safety.