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目的 分析民航飞行人员脑血管狭窄的特点及危险因素,并对其航空医学鉴定进行探讨. 方法 选取颅脑磁共振血管成像(magnetic resonance angiography,MRA)提示脑血管狭窄的飞行人员134例作为狭窄组,对其狭窄发生部位及狭窄程度进行分析;选取MRA提示脑血管无异常的飞行人员202例作为对照组,比较两组年龄、血脂、血压、血糖和BMI的差异,并采用Logistic回归分析以上危险因素与脑血管狭窄的相关性. 结果 ①134例脑血管狭窄飞行人员中,大脑中动脉狭窄居多(49例,36.57％),大脑前动脉狭窄最少(9例,6.72％);单侧、双侧各部位脑血管狭窄发生率差异有统计学意义(x2 =25.40、7.82,P＜0.05);不同部位的脑血管狭窄均以单侧居多(x2=9.00～22.20,P＜o.01).②各部位脑血管狭窄程度差异均有统计学意义(x2=27.00～155.70,P＜0.01);脑血管轻度狭窄显著高于中、重度狭窄及血管闭塞发生率(x2=230.00,P＜0.01).③狭窄组和对照组SBP、DBP、TG、HDL-C、LDDC差异均有统计学意义(t=1.99～2.89,P＜0.05),而年龄、血糖、BMI差异无统计学意义(P＞0.05);年龄、DBP、HDL-C是脑血管狭窄的独立危险因素(z=2.43～3.55,P＜0.05). 结论 飞行人员脑血管狭窄多发生在大脑中动脉和颈内动脉,以单侧、轻度和无症状狭窄为主,年龄、血脂和血压与飞行人员脑血管狭窄相关.对于轻度单侧脑血管狭窄且无临床症状者,应给予放飞并随访;对于重度脑血管狭窄或有临床症状者应给予不合格结论,同时应严格控制心脑血管危险因素.“,”Objective To analyze the clinical manifestation of cerebrovascular stenosis and relevant risk factors for aircrews,and to discuss the aviation medical appraisal.Methods One hundred and thirty four aircrews were assigned to stenosis group according to the MRA diagnosis.The location and severity of stenosis were analyzed.Two hundred and two aircrews,who were without cerebral vascular abnormalities,were randomly selected as the control group.The age,blood lipids,SBP,DBP,FBG,and BMI were compared between 2 groups.Logistic regression analysis was used to analyze the correlativity between risk factors and cerebral vascular stenosis.Results ①In 134cerebral artery stenosis aircrews,the middle cerebral artery stenosis accounted most for 36.57％ (49cases),the anterior cerebral artery stenosis accounted least for 6.72％ (9 cases).There was a significant difference between the incidences of unilateral cerebral vascular stenosis and bilateral cerebral vascular stenosis (x2 =25.40,7.82,P＜0.05).The unilateral cerebral vascular stenosis was most frequent despite the stenosis location (x2 =9.00-22.20,P＜0.01).②The stenosis severity showed significant difference among all locations of the cerebral vascular stenosis (x2 =27.00-155.70,P＜ 0.01).The incidence of mild cerebral vascular stenosis was significantly higher than that of moderate,severe cerebral vascular stenosis and cerebral vascular occlusion (x2=230.00,P＜0.01).③There were significant differences on SBP,DBP,TG,HDL-C and LDL-C between stenosis group and control group (t=1.99-2.89,P＜0.05),but no significant difference on age,blood glucose and BMI (P＞0.95).Age,DBP and LDL-C were the independent risk factors of cerebral vascular stenosis (z=2.43-3.55,P＜0.05).Conclusions Most of the cerebral vascular stenosis of aircrews is located at middle cerebral artery and cerebral internal carotid artery and the main manifestation is unilateral,mild and asymptomatic.For the aircrew with unilateral and asymptomatic stenosis,qualification and follow-up are suggested.But the aircrews who have severe cerebral vascular stenosis or any symptoms should be disqualified.The risk factors of cardiovascular and cerebrovascular should be closely supervised.