本文選題：經(jīng)顱多普勒 + 腦血管反應(yīng)性��； 參考：《安徽醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的：應(yīng)用經(jīng)顱多普勒超聲結(jié)合屏氣試驗(yàn)檢測飛行人員腦血管反應(yīng)性，觀察影響其腦血管反應(yīng)性的因素。 方法:應(yīng)用經(jīng)顱多普勒超聲結(jié)合屏氣試驗(yàn)測定90名現(xiàn)役飛行人員大腦中動脈的屏氣指數(shù)，來評估飛行員腦血管反應(yīng)性。首先應(yīng)用SPSS13.0統(tǒng)計(jì)軟件對數(shù)據(jù)進(jìn)行多元逐步線性回歸法，以年齡、血糖、血甘油三酯、血總膽固醇、血低密度脂蛋白、紅細(xì)胞計(jì)數(shù)、血紅蛋白含量、收縮壓、舒張壓、飛行時間、所飛機(jī)型、吸煙為自變量，屏氣指數(shù)為因變量。分析受試者腦血管反應(yīng)性與以上檢測指標(biāo)的相關(guān)性。 依據(jù)統(tǒng)計(jì)學(xué)（多元逐步線性回歸）結(jié)果，將飛行人員按吸煙與否分為:飛行人員吸煙組與不吸煙組兩組；按所飛機(jī)型分為：殲擊機(jī)組、直升機(jī)和運(yùn)輸機(jī)兩組。檢測兩組大腦中動脈的屏氣指數(shù)（Breath-Holding Index,BHI），收縮期峰血流速度增加率，舒張期末血流速度增加率，搏動指數(shù)下降率和阻抗指數(shù)下降率。應(yīng)用SPSS13.0統(tǒng)計(jì)軟件對數(shù)據(jù)進(jìn)行t檢驗(yàn)方法，分別分析兩組間腦血管反應(yīng)性是否存在差異。 應(yīng)用SPSS13.0統(tǒng)計(jì)軟件對飛行人員不吸煙組與對照組（健康不吸煙地面人員）大腦中動脈的屏氣指數(shù)（BHI）進(jìn)行t檢驗(yàn)，分析差異是否有顯統(tǒng)計(jì)學(xué)意義。 結(jié)果：線性逐步回歸方差分析示：吸煙與機(jī)型對屏氣指數(shù)的影響有統(tǒng)計(jì)學(xué)意義（F=5.25、4.75，P=0.02、0.01），且吸煙與屏氣指數(shù)呈負(fù)相關(guān)，偏回歸系數(shù)為㧟0.17（t=㧟2.14，P=0.04），，所飛行機(jī)型與屏氣指數(shù)呈正相關(guān)，偏回歸系數(shù)為0.16（t=2.01，P=0.05）。年齡、血糖、甘油三酯、總膽固醇、低密度脂蛋白、紅細(xì)胞計(jì)數(shù)、血紅蛋白含量、收縮壓、舒張壓、飛行時間對屏氣指數(shù)的影響無統(tǒng)計(jì)學(xué)意義（P＞0.10）。 吸煙飛行人員、不吸煙飛行人員BHI分別為1.03±0.40，1.20±0.34，t值為2.19，P值為0.03，顯示吸煙飛行人員較不吸煙飛行人員BHI明顯減低（P＜0.05）。兩組收縮期峰血流速度增加率，舒張期末血流速度增加率，搏動指數(shù)下降率和阻抗指數(shù)下降率相比， t值為分別為0.60，0.57,㧟0.48,㧟0.19， P值分別,0.55,0.57,0.64,0.85，差異無統(tǒng)計(jì)學(xué)意義（P㧐0.05）。 殲擊機(jī)飛行人員、直升機(jī)和運(yùn)輸機(jī)飛行人員BHI分別為1.21±0.38，0.98±0.35,t值為㧟2.84，提示殲擊機(jī)飛行人員較直升機(jī)和運(yùn)輸機(jī)飛行人員BHI明顯增高（P＜0.05）。兩組收縮期峰血流速度增加率，舒張期末血流速度增加率，搏動指數(shù)下降率和阻抗指數(shù)下降率相比，t值為分別為㧟4.10,㧟4.04，2.11，2.64, P值分別為0.00,0.00，0.04,0.01，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。 不吸煙飛行人員BHI為1.20±0.34，不吸煙地面健康人員BHI為1.19±0.38，不吸煙飛行人員與地面健康人員相比BHI差異不具有統(tǒng)計(jì)學(xué)意義，（P＞0.05）。 結(jié)論：應(yīng)用經(jīng)顱多普勒超聲結(jié)合屏氣試驗(yàn)測定大腦中動脈的屏氣指數(shù)，可較好的評估腦血管反應(yīng)性，可用于健康飛行人員選拔及鑒定。飛行人員腦血管反應(yīng)性受吸煙及所飛機(jī)型的影響，吸煙可降低飛行人員腦血管反應(yīng)性；殲擊機(jī)飛行人員的腦血管反應(yīng)性較直升機(jī)和運(yùn)輸機(jī)飛行人員的好。飛行人員腦血管反應(yīng)性與健康地面人員差異不明顯。
[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.

【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R85

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