飞行人员强直性脊柱炎治疗后特许飞行的临床研究

Post-treatment waivers for aircrews with ankylosing spondylitis

目的探讨飞行人员强直性脊柱炎(ankylosing spondylitis,AS)治疗后特许飞行的可行性。方法选取2010年1月—2019年8月空军特色医学中心(原空军总医院)确诊的飞行人员AS患者,根据航空医学鉴定结果分为飞行合格组及飞行不合格组(包括停飞及地面观察超过6个月),比较2组在年龄、飞行时间、病程、炎性指标及治疗方案的差异。结果共纳入飞行人员AS患者20例,飞行合格组14例,飞行不合格组6例,飞行不合格组C反应蛋白水平高于飞行合格组(t=-2.95,P<0.05),差异具有统计学意义;飞行不合格组中5例(83.3%)应用生物制剂,飞行合格组中2例(14.3%)应用生物制剂,2组比较差异具有统计学意义(83.3%vs 14.3%,P<0.01);2组在年龄、飞行时间及病程方面比较差异无统计学意义;飞行合格组在飞行期间未发生安全事故;1例患者特许飞行合格后21个月病情复发。结论部分飞行人员AS患者治疗后给予特许飞行具有可行性,飞行期间应定期进行病情评估。

Objective To investigate the feasibility of waivers for flying personnel with ankylosing spondylitis(AS)after treatment. Methods Aircrews diagnosed with AS in Air Force Medical Center between January 2010 and August 2019 were recruited, who were divided into the medical waiver group and medically grounded group(including the permanently grounded group and temporarily grounded group > 6 months)based on their results of medical evaluation. Age, hours of flight, courses of disease, inflammatory indexes and treatments were compared between the two groups. Results Twenty aircrews were recruited in this study. The medical waiver group had fourteen aircrews while the medically grounded group had six. Levels of C-reactive protein(CRP)in the medically grounded group were higher than those of the medical wavier group(t=-2.95, P<0.05). Five cases(83.3%)in the medically grounded group and two cases in the medical waiver group(14.3%)were treated with TNF-blocker, and the difference between the two groups was statistically significant(83.3% vs 14.3%, P<0.01). However, there was no significant difference in age, hours of flight or courses of disease between the two groups. There was no accident in the medical wavier group,One cases relapsed 21 months after flight wavier. Conclusion Waivers for aircrews with AS are feasible after treatment. The condition of patients should be regularly assessed in the course of waivers.