民航飞行员慢性肾炎糖皮质激素治疗后诱发中心性浆液性脉络膜视网膜病变及激素性白内障1例并文献复习  

Central serous chorioretinopathy and steroid-induced cataract caused by glucocorticoid therapy for a civil aviation pilot with chronic nephritis and literature review

作　　者：张亚辉[1] 曾晓明[1] 徐静[1] 蒙昌亮[1] 欧艺虹 Zhang Yahui;Zeng Xiaoming;Xu Jing;Meng Changliang;Ou Yihong(Aviation Health Center of China Southern Airlines Co.,Ltd.,Guangzhou 510405,China)

机构地区：[1]中国南方航空股份有限公司航空卫生中心,广州510405

出　　处：《中华航空航天医学杂志》2024年第3期223-226,共4页Chinese Journal of Aerospace Medicine

摘　　要：目的深入剖析民航飞行员眼科停飞经典案例并总结经验,为民用航空医学鉴定及航空卫生保障工作提供依据。方法回顾性分析1例民航飞行员因慢性肾炎糖皮质激素(glucocorticoid,GC)治疗后诱发中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)及激素性白内障(glucocorticoid induced cataract,GIC)导致停飞的案例,并复习相关文献。结果患者,男性,36岁,某航空公司B737机队飞行员,2020年11月8日确诊为慢性肾小球肾炎,先后给予GC、环磷酰胺和环孢素等药物治疗。2021年3月因双眼视力下降于眼科就诊后诊断为双眼CSC,双眼GIC,且双眼视力不断下降,给予双眼局部视网膜光凝术及右眼白内障超声乳化抽吸+人工晶体植入术治疗,治疗后右眼视功能无改善,视功能不符合所持体检合格证的相应医学标准,给予航空医学鉴定不合格结论。结论要重视民航飞行员使用GC可能引起的诸多眼部不良反应,需科学、合理使用GC,对其诱发的CSC及GIC要积极治疗。航空医师要对罹患上述眼病的飞行员加强健康指导、干预和跟踪管理,做好其健康管理工作。ObjectiveTo provide basis for civil aviation medical appraisal and aviation health support work by analyzing the classic case of ophthalmic suspension in civil aviation pilots and summarizing the experience.MethodsA grounding case of civil aviation pilot,who was developed central serous chorioretinopathy(CSC)and glucocorticoid induced cataract(GIC)after glucocorticoid(GC)treatment for chronic nephritis,was retrospective analyzed and the relevant literatures were reviewed.ResultsThe patient,a 36-year-old male pilot of a B737 airline fleet,was diagnosed with chronic glomerulonephritis on November 8,2020.He was treated with GC,cyclophosphamide,cyclosporine,and other medications.In March 2021,he was diagnosed with bilateral CSC and bilateral GIC after ophthalmology consultation due to his continually decreased binocular vision.The patient was treated with local retinal photocoagulation in both eyes and phacoemulsification and intraocular lens implantation for cataract in the right eye.After treatment,there was no improvement in the visual function of the right eye,and the visual function did not meet the corresponding medical standards of the medical examination certificate,resulting in he was unqualified for flight.ConclusionsCivil aviation pilots should pay attention to the possible adverse reactions that may be caused by the use of GC in the eyes.It is necessary to use GC scientifically and reasonably,and actively treat the induced CSC and GIC.Aviation physicians should strengthen health guidance,intervention,and tracking management for the pilots suffering from the above-mentioned eye diseases,and do a good job in promoting their health management.

关 键 词：糖皮质激素类 中心性浆液性脉络膜视网膜病变 合格鉴定 激素性白内障 民航飞行员 

分 类 号：R856[医药卫生—航空、航天与航海医学]