空军飞行人员强直性脊柱炎诊治及航空医学鉴定

Analysis of treatment and evaluation of aircrew suffering from ankylosing spondylitis

目的：总结飞行人员强直性脊柱炎的诊治及医学鉴定经验。方法分析2003年1月-2013年11月在我院住院治疗的8例飞行人员强直性脊柱炎患者的临床资料和医学鉴定结论。结果8例HLA-B27检验全部阳性，RF均阴性。7例采用经典的柳氮磺胺吡啶＋非甾体类抗炎药＋免疫抑制剂治疗，时间3～6个月。治疗后1个月疼痛基本缓解。1例因合并髋关节积液，使用了抗-TNF-α制剂重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白治疗。目前3例仍在地面观察，5例已经恢复飞行。结论飞行人员强直性脊柱炎多因腰背痛被检查发现，治疗及时且效果好者可以特许飞行合格。

ObjectiveWe intended to summarize the treatment and evaluation of aircrew suffering from ankylosing spondylitis.MethodsThe medical information of 8 cases of aircrew inpatients suffering from ankylosing spondylitis in our hospital from January of 2003 to December of 2013 was collected. Then the medical history, diagnosis, treatments and evaluation results were analyzed.ResultsHLA-B27 of all the 8 cases was positive but RF was negative. Seven cases were treated with traditional combination of salazosulfapyridine, NSAIDS and immune inhibitor for 3 to 6 months. Their pain was almost relieved after 1 month of treatment. Anti-TNF reagent was administered on one case because his articulatio coxae was involved. Three cases were still in ground observation status, while 5 other cases returned to flying.ConclusionMost cases of ankylosing spondylitis were found backache at early stage, and most of them were able to return to flying after successful treatment in time.