Objective:To improve the ability of differential diagnosis of skin diseases and the level of aeromedical assessment by exploring the diagnosis, treatment and prevention of primary cutaneous amyloidosis (PCA) in flying candidate.Methods:The clinical diagnosis and treatment of a case of PCA in a student recruited for the first inspection was retrospectively analyzed, and the diagnosis and treatment of PCA literature were reviewed.Results:One case of PCA was detected in the students who were recruited for the initial examination in January of 2022. Physical examination revealed scattered light brown macules on the skin of the right lower extremity and dorsum of the right foot, and pruritus and other symptoms were denied. In 2007, the patient presented with a reddish-brown macule on the right lower extremity for 3 years. Histopathological examination of the right lower limb lesions revealed amyloid deposits in the dermal papillae, then the PCA was diagnosed. The disease belongs to the incurable skin disease, and the physical examination concluded as unqualified.Conclusions:PCA patients are not suitable for flying occupations. The recruitment students diagnosed with PCA should be eliminated. Active flying personnel with a clear diagnosis of PCA can be identified as qualified or waivered after being cured or when the skin lesion area, pigmentation and pruritus are reduced, and no recurrence during the follow-up period. Flight surgeons should pay close attention to follow-up and observation.
Objective:To provide references for civil aviation recruitment and aeromedical assessment by analyzing the results of high resolution computerized tomography(HRCT) of paranasal sinuses in civil aviation pilots recruitment.Methods:Retrospective analysis was used. The medical imaging data of 211 flying candidates in East China underwent HRCT examination of paranasal sinuses in the Civil Aviation Shanghai Hospital from March of 2016 to June of 2018 were selected. They were divided into groups according to the reasons of physical examination failure, and the physical examination failure status of flying candidates with chronic sinusitis who used different treatment methods before and after the revision of the medical examination standard for recruitment was compared.Results:Among the 211 flying candidates, 112 (53.08%) were qualified. The first disease among unqualified flying candidates was chronic maxillary sinusitis and ethmoid sinusitis, with a composition ratio of 37.37%. After implementing the new recruitment standard, the unqualified rate of sinus HRCT examination significantly increased, with a statistically significant difference ( χ2=22.10, P<0.001). Among 37 flying candidates with a history of chronic rhinitis and sinusitis, there was no significant difference in the number of unqualified between conservative treatment group and surgical treatment group ( P>0.05). There were significant differences in the number of unqualified among simple middle/lower turbinate enlargement group, simple nasal discharge group and nasal edema with nasal discharge group ( χ2=10.88, P=0.004). The number of unqualified in high deviation of nasal septum group was higher than that in low deviation of nasal septum group (Fisher exact value=0.08, P=0.040). Conclusions:HRCT examination of paranasal sinuses is still an important method in the otorhinolaryngology department of civil aviation recruitment. Indications should be correctly grasped in order to improve the quality of physical examination in civil aviation recruitment.
Objective:To provide references for promoting the anti-G ability of flying cadets and improving the training methods by testing the flying cadets′ relaxed +G z tolerance and analyzing the related factors. Methods:Fifty-seven healthy male flying cadets were tested for anti-G ability by cluster sampling. The indicators included relaxed +G z tolerance, maximal pedal force of lower limbs, maximal expiratory pressure (MEP) and maximum inspiratory pressure (MIP). The subjects were divided into high and low tolerance groups, and the low tolerance group was divide into 2 groups by judging if they were with or without visual change. The subjects were divided into high and low limbs strength groups by measured maximal pedal force. The questionnaire was used to get the information of human centrifuge test and the physical training of flying cadets at ordinary time. According to the results of the questionnaires, the subjects were divided into low strength (≤3 times/week) and high strength (>3 times/week) physical training groups by aerobic training intensity. Results:Relaxed +G z tolerance test results of the flying cadets were 3.5 G and 4.0 G, with an average of (3.56±0.17) G. Maximal pedal force of lower limbs was averagely (449.3±105.6) kgf (1 kgf=9.806 N). MEP was averagely (20.1±3.5) kPa. MIP was averagely (10.5±2.3) kPa. MEP of 4.0 G group was higher than that of 3.5 G group, and the difference was significant ( t=2.08, P=0.043). In the subjects of 3.5 G relaxed +G z tolerance, MEP of unchanged vision group was higher than that of changed vision group, and the difference was significant ( t=2.35, P=0.023). Relaxed +G z tolerance of high pedal force group (≥449.3 kgf) was higher than that of low pedal force group (<449.3 kgf), and the difference was significant ( t=2.20, P=0.035). 66.7% of the subjects did not learn correct anti-G maneuver; 91.2% of the subjects took long-distance running; 82.5% of the subjects took strength training; 57.9% of the subjects did lower limbs strength training, but 45.6% of them did not understand the correct methods of training muscle groups. MEP of the high training group was higher than that of low training group, and the difference was significant ( t=3.25, P=0.002). Maximal pedal force of lower limbs in the high training group was lower than that in the low training group, and the difference was significant ( t=2.35, P=0.022). Conclusions:The flying cadets′ anti-G ability is not good in centrifuge. They should be arranged to experience and trained in human centrifuge as early as possible. Anti-G physical training should be enhanced based on anaerobic exercise.
Objective:To analyze the pathogenesis, clinical diagnosis, treatment and aeromedical identification of rotator cuff injury in a fighter pilot, and to put forward prevention and treatment suggestions.Methods:The diagnosis, treatment, prognosis and aeromedical identification of bilateral rotator cuff injury in a fighter pilot were retrospectively analyzed, and the relevant literatures were reviewed.Results:After conservative treatment of the right rotator cuff injury in the past, the pilot was qualified for flight and participated in normal flight. After conservative treatment of the left rotator cuff injury, the left joint activity was normal without dysfunction. After pain relief, the pilot was qualified for flight.Conclusions:In order to do a good job in prevention and treatment, flight surgeons should improve the understanding of rotator cuff injury, understand its etiologies, pathogenesis and therapies, be familiar with relevant auxiliary examinations and conservative treatments, and master the necessary physical examinations.
Objective:To analyze the clinical characteristics, diagnosis and treatment of post-traumatic stress disorder (PTSD) in military flying personnel.Methods:The clinical treatment process of a helicopter navigator with PTSD were reported and the related literatures were reviewed.Results:The direct inducement of this case was that the helicopter navigator experienced the influence of a first-class flight accident. The main clinical manifestations of this case were repeated traumatic experience, low mood, decreased interest and continuously increased alertness, such as difficulty in falling asleep and nightmares, which met the diagnostic criteria for PTSD. After drugs with psychological treatment, the patient was clinically cured. After the observation on ground, the patient was qualified for flight.Conclusions:Emphasis should be placed on psychological screening to improve the diagnostic awareness of PTSD in military flying personnel. Drugs with psychological treatment may be a good method to cure such diseases.
2022第十一届中国航空医疗救援国际会议于2022年12月3日在上海召开。本届会议以“新变革、新发展、新征程——航空医疗救援赋能健康中国高质量发展”为主题，邀请了国内外医疗、应急、航空等方面的9位专家、学者作主题演讲。笔者对其主要内容进行综述，涉及俄罗斯航空医疗后送历史、现状与未来展望；中国航空医疗救援事业的高质量发展。俄罗斯专家的演讲，生动展示了大国民用航空医疗救援的概貌与战略格局；而中国专家的演讲，除了政策解读外，主要聚焦同济大学东方医院、上海交大医学院附属瑞金医院、浙大医学院附属第二医院、北京市红十字会999急救中心、武汉亚心总医院以及中国台湾联合国际救援机构等航空医疗救援单位的实践经验和案例分享。
Objective:To provide references for the vestibular function stability training of military pilots by evaluating the stability of vestibular function of military pilots.Methods:An electric swivel chair was used to train the vestibular function stability of military pilots. According to the order of admission, they were divided into 21-30 years old, 31-40 years old, 41-50 years old and ≥51 years old group, with 30 pilots in each group. The changes of excellent rate, good rate, qualified rate, unqualified rate and tolerance time of the stability of vestibular function by training were compared among different age groups, and the correlation between age and tolerance time was analyzed.Results:There were significant differences of unqualified rate in pilots aged 31-40 and ≥51 years group before and after training ( χ2=4.32, 4.80, Ρ=0.038, 0.028). The failure rate after training was lower than that before training, with a significant difference ( χ2=13.02, P<0.001). The total tolerance time was higher than that before training, and the difference was statistically significant ( t=17.61, P<0.001). The stability tolerance time of pilots in different age groups after vestibular function training were increased compared with that before training, and the differences were statistically significant ( t=6.50, 8.82, 9.48, 13.56, all P<0.001). The stability of vestibular function of military pilots gradually declined with the increase of age, and there was a negative correlation between age and training tolerance time ( r=-0.38, P<0.001). Conclusions:The training of electric swivel chair can improve the vestibular function stability of military pilots, increase the tolerance time, and enhance the tolerance ability of military pilots when vestibular function is stimulated.
Objective:To observe the attention processing characteristics of the pilots experiencing black hole illusion, and to provide quantitative data references for flight simulation training guided by eye movement fixation based on the eye movement mode of the pilots with high flight performance score.Methods:The pilots who underwent the transformation training were selected by cluster sampling. Their original flight performance scores were converted into percentile grades. The top 10 and bottom 10 pilots were assigned as high and low score groups. Their eye movement data were recorded when they were completing the night approach and landing task on the flight illusion simulator. The correlation between eye movement data and flight performance in the simulation task were analyzed, and the eye movement patterns of pilots with different flight performance were compared.Results:Thirty-six valid subjects were selected. A total of 12 eye movement indexes were correlated with flight performance ( r=0.334-0.398, all P<0.05). Three eye movement indexes, including peak velocity of exit saccade from attitude indicator of head-up display (HUD), the percentage of total duration of fixations on airspeed indicator of HUD to the total task duration and average duration of whole fixations on attitude indicator could establish a linear regression model with flight performance ( R2=0.422, F=7.77, P<0.001). The percentage of total duration of whole fixations on airspeed indicator of HUD to the total task duration in high score group [(4.38±3.48)%] was higher than that in low score group [(1.72±1.32)%], and the difference was statistically significant ( t=2.25, P=0.045). And the average peak velocity of exit saccade from attitude indicator of HUD in high score group [(358.85±171.40)°/s] was higher than that in low score group [(221.14±92.60)°/s], and the difference was statistically significant ( t=2.24, P=0.038). Conclusions:Eye movement index in the night approach and landing task can be used as an evaluation index of attention ability of pilots in black hole illusion simulation and experience task.
Objective:To provide references for putting forward prevention and treatment strategies by analyzing the incidence of aerodontalgia in military flying personnel.Methods:Using cluster sampling, 886 male flying personnel who recuperated in Dalian Rehabilitation Center of PLA Joint Support Force were investigated by questionnaire and oral examination. The incidence of aerodontalgia in flying personnel were compared among different aircraft types and flight status.Results:A total of 72 flying personnel had aerodontalgia, and the total incidence of aerodontalgia was 8.13%. There was significant difference in the incidence of aerodontalgia among the flying personnel of different aircraft types ( χ2=15.65, P<0.001). The frequency of aerodontalgia of the flying personnel increased with the increase of flight altitude ( χ2=38.94, P<0.001). The frequency of aerodontalgia of the flying personnel among different flight speeds was significant ( χ2=9.60, P=0.008). The frequency of aerodontalgia of the flying personnel among different flight status was significant ( χ2=16.02, P<0.001). The incidence of aerodontalgia in flying personnel with oral diseases was higher than those without oral diseases, and the difference was significant ( χ2=43.43, P<0.001). Conclusions:Military flying personnel with oral diseases are easily attacked by aerodontalgia. Prevention and treatment programs should be formulated to ensure flight safety.
Objective:To investigate the efficacy of strength training with physical therapy in the treatment of nonspecific low back pain in pilots.Methods:A non-randomized, parallel controlled study was used. The pilots with mild and moderate nonspecific low back pain were selected from the aviation unit by questionnaire survey. They were grouped on a voluntary basis. In the comprehensive treatment group, pilots were treated for 3 months, including strength training and physical therapy. In the control group, pilots who did not participate in the rehabilitation program, lived and worked according to daily conditions, and they were not restricted by strength training and physical therapy. The Visual Analogue Scale (VAS) pain scores, McGill Pain Questionnaire (MPQ) scores and low back muscle strength were compared between the 2 groups of pilots before and after treatment.Results:A total of 109 pilots were selected, among which 21 pilots volunteered to join the comprehensive treatment group and 88 pilots in the control group. Before treatment, there was no significant difference in VAS pain scores and MPQ scores between the 2 groups of pilots (both P>0.05). After treatment, the VAS pain scores and MPQ scores of the comprehensive treatment group were lower than those in the control group, and the difference was significant ( t=1.98, 2.31, P=0.048, 0.021). Before treatment, there was no significant difference in low back muscle strength between the 2 groups of pilots ( P>0.05). After treatment, the increments in maximum strength of left flexion, right flexion, and posterior extension of pilots in the comprehensive treatment group was higher than those in the control group, and the differences were statistically significant ( U=2.17, 2.47, 3.64, P=0.002, 0.013,<0.001). Conclusions:Strength training with physical therapy can effectively alleviate nonspecific low back pain in pilots and improve the strength of waist muscles. It can be promoted and applied in the prevention and treatment of nonspecific low back pain in pilots.
Objective:To explore the accuracy of computer optometric diopter before mydriasis in predicting artificial optometric diopter after mydriasis in the current ophthalmic standard of civil aviation recruitment, to evaluate the rationality of "0.75 D or more beyond the standard" in the current recruitment standard, and to provide a scientific basis for adjusting the recruitment diopter standard.Methods:Cluster sampling was used to select students recruited by Civil Aviation Flight University of China in Sichuan area from 2017 to 2021, including high school students and college student candidates. The values of computer optometric diopter before mydriasis and optometric diopter after mydriasis were collected, and the linear regression model was fitted to predict the optometric diopter value after mydriasis with computer optometric diopter before mydriasis as independent variable.Results:A total of 2 567 recruited students, all male, with an average age of (18.20±1.47) years were enrolled in the physical examination. There was a high correlation between computer optometric diopter before mydriasis and optometric diopter after mydriasis ( rS=0.856, P<0.001). After linear regression fitting and calculation of the predicted range of post-dilated optometric diopter, it was found that pre-dilated computer optometric diopter could explain 80.5% of the variation degree of post-dilated optometric diopter. When the computer optometric diopter before mydriasis was in the range of [-7.000,+1.500] D, the prediction accuracy of this model was ≥83.3%, and the fitting effect was good. When the computer optometric diopter before mydriasis was higher than -6.125 D, the prediction interval of 95% was higher than -4.500 D, which was beyond the recruitment standard. Conclusions:For myopic students, the predicted value of post-dilated optometric diopter exceeds the current recruitment standard if the computer optometric diopter before mydriasis exceeds -6.125 D. It is suggested to amend the corresponding item in the standard to "if the diopter exceeds 1.750 D or more, the subject can be terminated other examinations".
Objective:To analyze the results of low-dose lung CT screening for military flying personnel, and to explore its influence on aeromedical identification.Methods:The imaging and aeromedical identification data of military flying personnel who underwent annual physical examination in Air Force Healthcare Center for Special Services Hangzhou were analyzed retrospectively. According to the imaging manifestations, the enrolled low-dose lung CT results were divided into the following 6 categories: no obvious abnormality, old lesions, pulmonary nodules, pulmonary bullae, pulmonary inflammatory lesions and extrapulmonary diseases. The detection rates of various examination results were statistically analyzed. The military flying personnel were divided into 20-29 years group, 30-39 years group, 40-49 years group and 50-59 years group, and they were divided into fighter pilots, bomb-trans-helicopter pilots, and bomb-trans-helicopter crew members according to the post. The differences in various examination results of flying personnel were compared among different age groups and post groups. The influence of examination results on the aeromedical identification results was analyzed in accordance with the 3-level conclusions as not affecting the conclusion of aeromedical identification, leading to the decline of health grade and leading to temporary grounding. The overall significance level α=0.05, and the pairwise comparison with P< α/statistical times was statistically significant. Results:A total of 2 274 flying personnel was enrolled. The detection rates of various examination results from high to low was no obvious abnormality (45.82%), old lesions (37.55%), pulmonary nodules (14.86%), pulmonary bullae (6.73%), pulmonary inflammatory lesions (2.59%) and extrapulmonary diseases (1.85%). There was significant difference among examination results of different age groups ( χ2=183.43, P<0.001). The detection rate of no obvious abnormality was the highest in 20-29 years group and 30-39 years group; the detection rate of old lesions was the highest in 40-49 years group and 50-59 years group. The detection rate of no obvious abnormality decreased with age, and the detection rate of old lesions increased with age (both P< α/6=0.008). The detection rate of pulmonary nodules in 40-49 years group was higher than that in 30-39 years group; the detection rate of pulmonary bullae in 50-59 years group was higher than that in the other age groups; the detection rates of pulmonary inflammatory lesions in 40-49 years group and 50-59 years groups were higher than those in the other age groups; the detection rate of extrapulmonary diseases in 50-59 years group was higher than that in 20-29 years group, and the differences were statistically significant (all P<0.008). There was significant difference in the results of flying personnel among different post groups ( χ2=33.78, P=0.001). The detection rate of no obvious abnormality in bomb-trans-helicopter crew members group was lower than that in bomb-trans-helicopter pilots group and fighter-trainer pilots group, but the detection rates of old lesions and pulmonary nodules were higher than those in the other groups, the differences were statistically significant (all P< α/3=0.017). The detection rate of pulmonary bullae in fighter-trainer pilots group was lower than that in bomb-trans-helicopter crew members group, and the difference was statistically significant ( P<0.017). Although majority of the detected results had no effect on the results of aeromedical identification, there was a significant difference in the proportion of health grade decline and temporary grounding caused by different detected diseases (Fisher exact test value was 82.81, P<0.001). Conclusions:Low-dose lung CT screening plays an important role in the physical examination and aeromedical identification for military flying personnel. It can be routinely used during the annual physical examination for flying personnel, and the aeromedical identification standards and strategies for lung related diseases should be updated synchronously.
近视眼是世界范围的高发疾病，我国青少年总体近视眼患病率居世界前列，近视眼防控形势严峻紧迫。青少年航空学校的建立旨在及早发现和培养素质全面的飞行学员，为培养精英飞行人才奠定基础。但过去几年青少年航校学员的视力复查情况不容乐观，每年仍有不少学员因为近视导致的不达标而在航校被淘汰。深入了解青少年航校学员近视的影响因素，制定相应的防控措施，对减少飞行学员因近视导致在航校被淘汰具有重要意义。
报道1例飞行员桥本甲状腺功能减退的筛查、诊断、治疗、转归、预后、随访及航空医学鉴定情况。桥本甲状腺功能减退在飞行人员中患病率逐年增高，严重影响飞行人员空中适应力、耐受力及应变力。甲状腺功能减退的航空医学鉴定必须经过系统规范的治疗，待症状及体征消失、甲状腺功能恢复正常且稳定后，再依据不同机种、飞行职务、飞行经验及随访观察方可特许飞行。
Objective:To compare and analyze the differences of exercise cardiopulmonary function and the correlation of different cardiopulmonary function indexes among different aircraft types in pilots.Methods:Retrospective study was used. The exercise cardiopulmonary function of 68 Air Force pilots who were qualified for flight in aeromedical identification were tested with the Italian Cosmed exercise cardiopulmonary function tester at a power increasing rate of 25 W/min. The subjects were divided into fighter group and other aircraft group according to aircraft types. The differences of exercise cardiopulmonary function between 2 groups were compared. The correlation between maximal oxygen uptake and age, body mass index, and the correlation between heart rate recovery and exercise endurance were analyzed.Results:There were significant differences in maximal heart rate, respiratory quotient and heart rate recovery value at 1 min after exercise between fighter group (32 cases) and other aircraft group (36 cases) ( t=2.28, 2.50, 2.37, P=0.026, 0.049, 0.021). There was no significant difference in other indexes. The maximal oxygen uptake was negatively correlated with age and body mass index ( r=-0.329, -0.339, both P<0.001). The values of heart rate recovery at 2 min and 3 min after exercise were positively correlated with maximal oxygen uptake and maximal exercise power ( r=0.284, 0.290, 0.306, 0.268, P=0.001, 0.026, 0.002, 0.002). Conclusions:The indexes of exercise cardiopulmonary function have significant differences among pilots in different aircraft types, and there are significant changes with age and weight gain. The heart rate after exercise can monitor the changes of cardiopulmonary function under different training conditions.
报道1例飞行员行冠状动脉CT血管造影24 h后出现迟发型过敏反应的诊断及处置。疗养机构未开展冠状动脉CT血管造影检查，对于造影剂诱发的迟发型过敏反应缺乏相应处置经验，容易出现误诊。该病例提示疗养机构要加强对此类人员的医疗管理，做好相应的登记和观察工作，若发现异常应及时采取相应的治疗措施。
报道1例民航空中乘务员2021年常规年度体检时体表心电图检出PR间期为0.46 s，较前明显延长，高度怀疑存在房室结双径路。进一步行24 h动态心电图监测，检出更多存在房室结快、慢径路的证据，最后由心内电生理检查确诊。由此可见，体表心电图对房室结双径路的诊断有很高的价值。本例无房室结内折返性心动过速的临床证据，但慢径路文氏阻滞形成的长RR间期导致心脏射血功能下降，危害飞行安全。因此，对存在房室结双径路基础的飞行人员，在空勤人员健康管理及航空医学鉴定工作中需引起重视。
Objective:To analyze the characteristics and causes of in-flight emergency medical events resulted in an alternate landing or return from 2017 to 2019, and explore the coping strategies of in-flight emergency medical events.Methods:Retrospective study was used. The in-flight emergency medical events of an airline from 2017 to 2019 were collected, and the age distribution of passengers who resulted in an alternate landing or return was calculated. The sudden diseases of passengers were classified according to the standards of International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10), and the survival of special passengers after an alternate landing or return was counted. Results:①There were 3 696 cases of in-flight emergency medical events, 84 (2.27%) of which resulted in an alternate landing or return. The total incidence of in-flight emergency medical events resulted in an alternate landing or return was 0.201/10 6 among passengers. The incidence of in-flight medical emergency medical events resulted in an alternate landing or return among passengers decreased from 2017 to 2019, and the difference was statistically significant ( χ2=515.85, P<0.001). ②There was significant difference among different age groups ( χ2=10.90, P=0.012). The incidence of in-flight emergency medical events resulted in an alternate landing or return was higher among people under 20 and over 60 years old, and the constituent ratio was 34.52%. ③Circulation system diseases (44.05%) was the commonest in the in-flight emergency medical events resulted in an alternate landing or return, then followed by nervous system diseases (15.48%) and digestive system diseases (13.10%). ④Among the passengers in the in-flight emergency medical events resulted in an alternate landing or return, 6 cases died, aged 6-73 years old, including 2 cases of cancer and 4 cases of sudden cardiac death. Conclusions:Aviation health education of passengers, pre-flight medical audit and crew first aid training should be strengthened to reduce the occurrence of in-flight emergency medical events.
Objective:To provide references for cardiovascular health management of military pilots by investigating the risk of ischemic cardiovascular diseases (ICVD) in military pilots.Methods:The physical examination data of military pilots in Air Force Healthcare Center for Special Services Hangzhou were retrospectively analyzed. The military pilots were divided into 2 groups by age (22-34 years, 35-56 years), and they were divided into 5 groups by flying hours (≤500 h, 500-≤1 000 h, 1 000-≤2 000 h, 2 000-≤3 000 h, >3 000 h). The 10-year ICVD incidence risk of pilots was evaluated according to the 10-year ICVD incidence risk assessment table of Chinese people. The distribution and influencing factors of absolute risk and relative risk of ICVD incidence in military pilots were analyzed, and the risk factors between different age groups were compared.Results:①A total of 337 military pilots were included, 194 in the 22-34 years group and 143 in the 35-56 years group. ②Absolute risk detection: there were 336 very low-risk military pilots and a low-risk military pilot. Relative risk detection: 87 (25.82%) military pilots were relatively high risk including 41 (21.13%) cases in 22-34 years group, 46 (32.17%) cases in 35-56 years group, the difference between 2 groups was statistically significant ( χ2=5.23, P=0.022); there were 250 (74.18%) relatively low-risk military pilots. ③Among the pilots aged 22-34 years, there was significant difference in relative high-risk ratio between flying hours ( χ2=17.00, P<0.001). The relative high-risk ratio of the pilots with flying hours 500-≤1 000 h was higher than that of pilots with flying hours ≤500 h, and the difference was statistically significant ( P<0.05); the proportion of pilots with elevated triglyceride and low density lipoprotein cholesterol indexes was higher than that of those with normal indicators (all P<0.05). The relative high-risk ratio of pilots with hypertension in 35-56 years group was higher than that of those with normal blood pressure ( χ2=23.70, P<0.001); the proportion of pilots with elevated triglyceride indicators was higher than that of high-risk groups ( P<0.05). ④The smoking rate, BMI and total cholesterol abnormality rate were higher in the 35-56 years group than in the 22-34 years group, and the differences were statistically significant ( χ2=9.71, 29.72, 19.17, P=0.002, <0.001,<0.001). ⑤The aggregation analysis of the risk factors of smoking, BMI, total cholesterol, systolic blood pressure and diabetes showed that the number of risk factor aggregates ≥2 species accounted for 51.04%, and the aggregation of risk factors in different age groups was statistically significant ( Z=6.38, P<0.001). Conclusions:The relative risk of ICVD in pilots is high, and the aggregation of risk factors is serious. Simply improving a single index is hardly to meet the demand of risk reduction. It needs a variety of joint interventions to improve the lifestyle and reduce the abnormal rate of total cholesterol, overweight rate, systolic blood pressure level and smoking rate. It is suggested that ICVD incidence risk prediction score should be routinely used in the risk assessment of chronic diseases in aviation medicine.
1例飞行员，男性，45岁，因“体检检出左颈内动脉海绵窦段动脉瘤6 d”入院。头颅计算机断层扫描血管成像提示左侧颈内动脉海绵窦段动脉瘤可疑。脑血管造影证实该飞行员存在右侧颈动脉-后交通动脉分叉部动脉圆锥，临床确诊为右侧颈动脉-后交通动脉分叉部动脉圆锥。鉴于颈动脉-后交通动脉分叉部动脉圆锥为一种解剖变异、具有正常的动脉壁结构、理论上不会破裂、发生空中失能风险甚小，该飞行员航空医学鉴定结论为飞行合格。
