空軍飛行人員實施運動心電圖檢查之可行性研究

Evaluation of Post-Excrcise Electrocardiographic Screening Test for Chinese Airmen

何邦立(Bang-Lee Ho) ； 李榕生(Rong-Sheng Lee)

《Journal of Medical Sciences》 2卷1期 (1977/01) Pp. 461-467

摘要

心冠狀動脈疾病為成年人最常見的病因，佔民航飛行員永遠停飛總數的百分之四十，且為造成飛行中意外失能的主因。過去空勤體檢僅作靜態心電圖檢查，未能早期診斷出潛在性的心臟疾患；為了飛行安全，早期發現潛在性心冠狀動脈疾病，而對四十歲以上空軍飛行人員增加動態心電圖的檢查實有必要。研究之目的，乃在探討雙重二階梯檢查應用在空勤體檢中實施之可行性。此實驗對象為四百五十位年齡介於30－59歲之地勤男性軍官，凡靜態心電圖正常者，進一步做雙重二階梯試驗，心電圖由不同醫院的四位心臟專科醫師分別獨立判讀。結果發現陽性率為0.9%，且與年齡、血壓、體重有相關關係。對雙重二階梯試驗陽性者，進一步做履帶運動試驗，顯示有27.8%的陽性率。空勤人員入伍時經過嚴格體檢，預期其雙重二階梯試驗之陽性率，將不致超過地勤軍官，施行於普檢，對飛安及戰力的確保，以至人員的保健，均可顧及，故可行性甚高。由於本研究的初步結果顯示，空軍年過四十歲之飛行人員的年度定期體檢，須做雙重二階梯運動心電圖之檢查，以加強對空勤人員之維護，並策飛安。

並列摘要

Double Master Exercise Test is widely used in the diagnosis of coronary artery disease, particularly in those subjects that have normal resting electrocardiograms. The main purpose of performing this procedure at the Aerospace Medical Research Laboratory is to screen for an abnormal electrocardiographic (EKG) response to exercise in order to detect aircrew-men who represent a risk to flying safety. On the other hand, we would like to evaluate the reading results of exercise EKG with the same positive criteria and try to find out the reading variation by different cardiologists.The prevalence of positive Double Master Test was 0.9% in four hundred and fifty CAF non-flying duty officers, age ranged from 30 to 59 years old. A close relationship of positive Double Master Test with the increase of age, high blood pressure and over-weight were noted respectively. It revealed 27.8% positive result of treadmill exercise test of all the Double Master Test positive cases for the further evaluation.We can expect the grounding number less than 0.3% for the purpose of eliminating the problem cases which may be hazardous to the flying safety. For this reason, the Air Force authority decided recently that every aircrew member aged over forty must take the Double Master Test in his annual routine physical examination.