Aerosp Med Hum Perform. 2021 Dec 1;92(12):980-986. doi: 10.3357/AMHP.5885.2021.
Graves' Disease (GD) is a common cause of hyperthyroidism. Although definitive treatment with radioactive iodine (RAI) is preferred for military aircrew, there are cultural and individual differences in receptivity toward RAI, and clinical guidelines that recommend antithyroid drugs (ATD) as the first line therapy. We examined a case series of Republic of Singapore Air Force (RSAF) aviators with GD treated with ATD and the impact of their condition on aeromedical disposition. All RSAF aircrew diagnosed with GD and treated with ATD over a 15-yr period were retrospectively identified and analyzed to determine the impact on their fitness for flying duties. The mean age of the 13 aircrew was 33 ± 7.1 yr (range, 25-47 yr), with 11 (84.6%) being males. There were 10 (76.9%) who had ATD as the only treatment while 3 (23.1%) were initially treated with ATD but subsequently underwent RAI or surgery. Of the 10 treated with only ATD, 3 (30.0%) were returned to restricted flying, 6 (60.0%) were returned to unrestricted flying, and 1 (10.0%) is still undergoing ATD titration. There were 10 (76.9%) aircrew who were returned to some form of flying duties while on low doses of ATD. This case series suggests that ATD is a viable treatment modality in the aeromedical management of military aviators with GD and it is possible to return military aircrew on a stable maintenance dose of ATD to flying duties. A framework is proposed to support the aeromedical decision-making process for military aircrew in the treatment of GD.
格雷夫斯病（GD）是甲状腺功能亢进的常见原因。虽然放射性碘（RAI）的确定性治疗是军队机组人员的首选，但对 RAI 的接受程度存在文化和个体差异，并且临床指南建议抗甲状腺药物（ATD）作为一线治疗。我们研究了一组接受 ATD 治疗的新加坡空军（RSAF）飞行员的 GD 病例系列，并检查了他们的病情对航空医学处置的影响。回顾性确定并分析了在 15 年期间被诊断患有 GD 并接受 ATD 治疗的所有 RSAF 机组人员，以确定对其飞行任务适应性的影响。13 名机组人员的平均年龄为 33 ± 7.1 岁（范围 25-47 岁），其中 11 名（84.6%）为男性。有 10 名（76.9%）仅接受 ATD 治疗，而 3 名（23.1%）最初接受 ATD 治疗，但随后接受了 RAI 或手术。在仅接受 ATD 治疗的 10 名患者中，3 名（30.0%）被限制飞行，6 名（60.0%）恢复了非限制飞行，1 名（10.0%）仍在接受 ATD 滴定。有 10 名（76.9%）机组人员在服用低剂量 ATD 的情况下恢复了某种形式的飞行任务。该病例系列表明，ATD 是治疗 GD 军事飞行员的航空医学管理的可行治疗方法，并且有可能使军事机组人员在稳定的 ATD 维持剂量下恢复飞行任务。提出了一个框架来支持 GD 治疗中军事机组人员的航空医学决策过程。
