5例飞行人员痛风临床资料分析及航空医学鉴定

Aviation medical evaluation and clinical analysis of five cases of gout among pilots

目的探讨飞行人员痛风的临床诊治及航空鉴定原则。方法收集我院2010—2015年间收治的5例痛风飞行人员临床诊治和医学鉴定资料,复习国内外相关文献,提出飞行人员痛风的航空医学鉴定原则。结果 3例因痛风反复发作入院,2例飞行不合格,1例暂时飞行不合格;2例既往有痛风发作病史,1例诊断为高血压1级,给予飞行合格结论,1例患冠心病,支架置入术后半年恢复飞行,因病情进展2年后予以暂时飞行不合格结论。结论患痛风的飞行人员,飞行结论应综合痛风发作的频率和严重程度、是否存在关节变形、肾脏受累及合并心血管疾病,使用药物种类、治疗效果及是否存在药物不良反应、飞行机种、职务、个人飞行意愿等因素进行鉴定。放飞后应密切关注血尿酸控制情况。

ObjectiveTo investigate the clinical diagnosis of and evaluation principles of aviation medicine about goutin aircrew.MethodsThe diagnosis and medical assessment of gout in 5 pilots admitted to our hospital between 2010 and 2015 were retrospectively analyzed. Suggestions regarding medical assessment of gout in aircrew were raised by summarizing the clinical data and reviewing its related literature.ResultsThree pilots were hospitalized for recurrent gout attacks, two of whom were grounded permanently and one temporarily. Two pilots had a history of gout attacks, one of whom was diagnosed with coronary artery disease （CAD） and returned to flight half a year after percutaneous coronary intervention, but was grounded temporarily 2 years later because of the progression of CAD. The other one had a better control of his elevated blood pressure and was permitted to return to flight.ConclusionEligibility for flight should be determined according to the frequency and severity of gout, deformation of joints, kidney involvement, cardiovascular disease, types of drugs, therapeutic effect, adverse drug reactions, flight missions, and the will of individual pilots. Pilots who are specially permitted to fly should control their serum uric acid.