目的探讨有胸痛症状或心电图异常的飞行人员采用的常用临床指标和冠状动脉造影对飞行结论的诊断价值。方法1991~2004年50例行冠状动脉造影的飞行人员患者,根据其心前区不适和(或)无创性检查提示可能存在心肌缺血分为仅有检查异常组、仅有症状组和症状检查均异常组,比较3组间的冠状动脉造影正常率以及对飞行结论的影响;按飞行结论的不同比较心血管危险因素、负荷试验结果和冠状动脉造影狭窄的发生率。结果3组冠状动脉造影正常率分别为94%、71%和60%,差异有显著性意义(P<0.01);飞行结论不合格人员中危险因素、胸痛、冠状动脉狭窄的发生率明显多于合格者(P<0.01,P=0.01和P<0.01),心电图ST-T改变和负荷试验阳性率差异无显著性意义。结论飞行鉴定中要重视有胸痛症状合并有心电图、负荷试验异常者,并结合危险因素综合判断;因造影的结果直接影响到飞行结论,应积极而合理地进行冠状动脉造影。 Objective To investigate the diagnostic value of common clinical parameters and coronary angiography in the flight conclusion of pilots with chest pain or abnormal ECG. Methods Fifty-five patients undergoing coronary angiography from 1991 to 2004 were divided into only abnormal examination group, symptomatic group and symptom check-up according to their precordial discomfort and / or non-invasive examination The abnormalities were compared between the two groups. The normal rates of coronary angiography and the effects on the flight outcomes were compared between the three groups. The cardiovascular risk factors, load test results and the incidence of coronary angiography stenosis were compared according to the flight conclusion. Results The normal rates of coronary angiography in the three groups were 94%, 71% and 60% respectively, with significant difference (P <0.01). The incidences of risk factors, chest pain and coronary artery stenosis were significantly higher in unqualified flight attendants (P <0.01, P = 0.01 and P <0.01). There was no significant difference between ST-T changes of electrocardiogram and the positive rate of load test. Conclusion In flight appraisal, attention should be paid to patients with chest pain accompanied with ECG and abnormal load test, combined with comprehensive judgment of risk factors. Coronary angiography should be performed positively and reasonably because the results of imaging directly affect the conclusion of flight.