军事飞行员原发性中枢神经系统血管炎1例并文献复习  

A case of military pilot with primary angiitis of the central nervous system and literature review

作　　者：姜甜甜 刘红巾 孙男男 刘祺洋 赵发国 尹延伟 赵梦娇 张光运 Jiang Tiantian;Liu Hongjin;Sun Nannan;Liu Qiyang;Zhao Faguo;Yin Yanwei;Zhao Mengjiao;Zhang Guangyun(raduate School of Hebei North University,Zhangjiakou 075000,China;Department of Medical Appraisal,Air Force Medical Center,Air Force Medical University,PLA,Beijing 100142,China;Department of Neurology,Air Force Medical Center,Air Force Medical University,PLA,Beijing 100142,China)

机构地区：[1]河北北方学院研究生院,张家口075000 [2]空军军医大学空军特色医学中心医学鉴定科,北京100142 [3]空军军医大学空军特色医学中心神经内科,北京100142

出　　处：《中华航空航天医学杂志》2024年第3期215-219,共5页Chinese Journal of Aerospace Medicine

摘　　要：目的探讨原发性中枢神经系统血管炎(primary angiitis of the central nervous system,PACNS)的诊断治疗,提高航空医师和体检医师对此病的鉴别诊断能力及航空医学鉴定水平。方法报道1例PACNS飞行员的临床诊疗情况,并复习相关文献。结果本例歼教机飞行员PACNS的临床表现为左手指麻木,后逐渐出现左面部及左上肢麻木、无力等症状1个月余,初始诊断为病毒性脑炎及急性播散性脑脊髓膜炎,应用激素冲击治疗后无效,最终诊断为PACNS。应用环磷酰胺冲击治疗后,患者病情改善。航空医学鉴定结论为暂时飞行不合格。结论飞行员患PACNS罕见报道,临床及影像学表现缺乏特异性,容易误诊。PACNS飞行员的航空医学鉴定应根据病情轻重、飞行机种及飞行职责等实行个体化鉴定。ObjectiveTo improve the ability of aviation physicians and physical examiners in differential diagnosis of primary angiitis of the central nervous system(PACNS)and the level of aeromedical assessment by exploring the diagnosis and treatment of PACNS.MethodsThe clinical diagnosis and treatment of a pilot with PACNS were reported and the related literatures were reviewed.ResultsThe clinical manifestation of the fighter trainer pilot was numbness of the left finger,and then gradually appeared numbness and weakness of the left face and left upper limb more than 1 month.The initial diagnosis was viral encephalitis and acute disseminated encephalomyelitis and the hormonal shock treatment was ineffective.The final diagnosis was PACNS.The patient′s condition was improved by cyclophosphamide shock treatment.Aeromedical assessment concluded that the pilot was temporarily grounded.ConclusionsPilot with PACNS is rarely reported and easy to be misdiagnosed due to the clinical and imaging findings are lack of specificity.The aeromedical assessment of PACNS pilots should be individualized according to the severity of illness,type of aircraft and flight duties.

关 键 词：血管炎 中枢神经系统 合格鉴定 飞行员 

分 类 号：R856.74[医药卫生—航空、航天与航海医学]