飞行员脑血管反应性影响因素的分析

发布时间：2018-04-14 06:11

本文选题：经颅多普勒 + 脑血管反应性　；参考：《安徽医科大学》2012年硕士论文

【摘要】：目的：应用经颅多普勒超声结合屏气试验检测飞行人员脑血管反应性，观察影响其脑血管反应性的因素。方法:应用经颅多普勒超声结合屏气试验测定90名现役飞行人员大脑中动脉的屏气指数，来评估飞行员脑血管反应性。首先应用SPSS13.0统计软件对数据进行多元逐步线性回归法，以年龄、血糖、血甘油三酯、血总胆固醇、血低密度脂蛋白、红细胞计数、血红蛋白含量、收缩压、舒张压、飞行时间、所飞机型、吸烟为自变量，屏气指数为因变量。分析受试者脑血管反应性与以上检测指标的相关性。依据统计学（多元逐步线性回归）结果，将飞行人员按吸烟与否分为:飞行人员吸烟组与不吸烟组两组；按所飞机型分为：歼击机组、直升机和运输机两组。检测两组大脑中动脉的屏气指数（Breath-Holding Index,BHI），收缩期峰血流速度增加率，舒张期末血流速度增加率，搏动指数下降率和阻抗指数下降率。应用SPSS13.0统计软件对数据进行t检验方法，分别分析两组间脑血管反应性是否存在差异。应用SPSS13.0统计软件对飞行人员不吸烟组与对照组（健康不吸烟地面人员）大脑中动脉的屏气指数（BHI）进行t检验，分析差异是否有显统计学意义。结果：线性逐步回归方差分析示：吸烟与机型对屏气指数的影响有统计学意义（F=5.25、4.75，P=0.02、0.01），且吸烟与屏气指数呈负相关，偏回归系数为㧟0.17（t=㧟2.14，P=0.04），，所飞行机型与屏气指数呈正相关，偏回归系数为0.16（t=2.01，P=0.05）。年龄、血糖、甘油三酯、总胆固醇、低密度脂蛋白、红细胞计数、血红蛋白含量、收缩压、舒张压、飞行时间对屏气指数的影响无统计学意义（P＞0.10）。吸烟飞行人员、不吸烟飞行人员BHI分别为1.03±0.40，1.20±0.34，t值为2.19，P值为0.03，显示吸烟飞行人员较不吸烟飞行人员BHI明显减低（P＜0.05）。两组收缩期峰血流速度增加率，舒张期末血流速度增加率，搏动指数下降率和阻抗指数下降率相比， t值为分别为0.60，0.57,㧟0.48,㧟0.19， P值分别,0.55,0.57,0.64,0.85，差异无统计学意义（P㧐0.05）。歼击机飞行人员、直升机和运输机飞行人员BHI分别为1.21±0.38，0.98±0.35,t值为㧟2.84，提示歼击机飞行人员较直升机和运输机飞行人员BHI明显增高（P＜0.05）。两组收缩期峰血流速度增加率，舒张期末血流速度增加率，搏动指数下降率和阻抗指数下降率相比，t值为分别为㧟4.10,㧟4.04，2.11，2.64, P值分别为0.00,0.00，0.04,0.01，差异有统计学意义（P＜0.05）。不吸烟飞行人员BHI为1.20±0.34，不吸烟地面健康人员BHI为1.19±0.38，不吸烟飞行人员与地面健康人员相比BHI差异不具有统计学意义，（P＞0.05）。结论：应用经颅多普勒超声结合屏气试验测定大脑中动脉的屏气指数，可较好的评估脑血管反应性，可用于健康飞行人员选拔及鉴定。飞行人员脑血管反应性受吸烟及所飞机型的影响，吸烟可降低飞行人员脑血管反应性；歼击机飞行人员的脑血管反应性较直升机和运输机飞行人员的好。飞行人员脑血管反应性与健康地面人员差异不明显。
[Abstract]:Objective: to detect the cerebrovascular reactivity of pilots by transcranial Doppler ultrasound combined with breath holding test, and to observe the factors affecting the cerebrovascular reactivity.
Methods: 90 active pilots of middle cerebral artery by transcranial Doppler combined with breath holding test the breath holding index, to evaluate the cerebrovascular reactivity. Firstly, stepwise multiple linear regression method, with age, blood glucose, blood triglyceride on data using SPSS13.0 statistical software, blood serum total cholesterol, low density lipoprotein, red blood cell count and the content of hemoglobin, systolic blood pressure, diastolic blood pressure, time of flight, aircraft type, smoking as independent variables, the breath holding index as the dependent variable. The analysis of relationship between cerebrovascular reactivity and the above detection index.
According to statistics (multiple linear regression) results, the flight crew according to smoking status for flight personnel of the smoking group and non-smoking group two; according to the type of aircraft as fighter unit, helicopters and transport aircraft in two groups. The breath holding index detecting artery in the brain of two groups (Breath-Holding Index, BHI), systolic the peak flow velocity increase rate, end diastolic blood flow velocity increased rate, pulsatility index and impedance index decreased rate of decline rate. The t test methods of data using SPSS13.0 statistical software, analyzed two groups of vascular reactivity whether there are differences.
The breath holding index (BHI) of the middle cerebral artery in flight non smoking group and control group (healthy non smoking ground personnel) was tested by t test, and whether the difference was statistically significant by SPSS13.0 statistical software.
Results: linear regression analysis of variance showed statistically significant effects of smoking and the models of the breath holding index (F=5.25,4.75, P=0.02,0.01), and smoking and breath holding index was negatively correlated with the partial regression coefficient for? 0.17 (t=? 2.14, P=0.04), the flight models and breath holding index was positively related to the number of partial regression coefficient is 0.16. (t=2.01, P=0.05). Age, blood glucose, triglyceride, total cholesterol, low density lipoprotein, erythrocyte count, hemoglobin content, systolic blood pressure, diastolic blood pressure, affect the flight time of the breath holding index was not statistically significant (P > 0.10).
Smoking flight personnel, non-smoking flight personnel BHI = 1.03 + 0.40,1.20 + 0.34, t = 2.19, P = 0.03, showed significantly less smoking smoking pilots flying personnel reduced BHI (P < 0.05). Two groups of peak systolic blood flow velocity increase rate, increase the rate of end diastolic velocity, pulsatility index the rate of decline and resistance index decline rate compared to t value were 0.60,0.57, 0.48, 0.19?? P, 0.55,0.57,0.64,0.85, respectively, the difference was not statistically significant (P? 0.05).
Fighter pilots, helicopters and transport aircraft pilots BHI = 1.21 + 0.38,0.98 + 0.35, t = 2.84?, suggesting that fighter pilots than helicopters and transport aircraft pilots BHI increased (P < 0.05). Two groups of peak systolic blood flow velocity increase rate, end diastolic blood flow velocity increase rate, pulsatility index decreased rate and resistance index decline rate compared to t value respectively? 4.10,? 4.04,2.11,2.64, P = 0.00,0.00,0.04,0.01, the difference was statistically significant (P < 0.05).
The BHI of non-smoking aircrew was 1.20 + 0.34, and the BHI of non-smoking ground health personnel was 1.19 + 0.38. There was no significant difference in BHI between non-smoking aircrew and ground health personnel (P > 0.05).
Conclusion: the middle cerebral artery was measured with transcranial Doppler ultrasound combined with breath holding test the breath holding index, can evaluate the cerebrovascular reactivity better, can be used for selection and identification of the health of pilots. The factors affecting the results of cerebral vascular reactivity by smoking and type of aircraft, smoking can reduce cerebral vascular reactivity of flying personnel; fighter pilots the cerebrovascular reactivity with helicopters and transport aircraft pilots. Pilots cerebrovascular reactivity and healthyground personnel was not significantly different.

【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R85

【参考文献】