- 期刊
海洋性貧血（Thalassemia）之缺點免計考量
Thalassemia: aeromedical consideration and waiver guideline
摘要
海洋性貧血為最常見的遺傳疾病；在台灣，約有百分之五到八的人口帶有血色素基因缺陷，影響約一百萬人口，其中百分之四為甲型海洋性貧血，而百分之二為乙型海洋性貧血。患者因血球蛋白鏈的合成缺陷(α或β鏈)而導致小球性，低色素性貧血。航空醫學考量主要是在高空低氧暴露下，飛行員可能發生灰/黑視和有效意識時間縮短。輕型海洋性貧血通常是無症狀且不需要規則治療，然而少部分患者可能會出現輕度貧血，且需與缺鐵性貧血鑑別。針對甲型和乙型輕型海洋性貧血，缺點免計考量普遍定義血色素範圍需在12g/dl以上。然而，本文認為，更全面的考量應包含臨床症狀有無，先前的健檢資料，以及常規血色素電泳分析，方能在飛行安全與人力資源間取得最大利益。
並列摘要
Thalassemias represent the most prevalent genetic disorders worldwide. Patients with thalassemias have defective hemoglobin chains (αorβ) and may eventually cause hypochromic microcytic anemia. Nearly one million people in Taiwan (5-8% of the population) carries Thalassemia hemoglobin variants, including 4% ofα-thalassemia and 2% ofβ-thalassemia.Major aeromedical concern denotes the hypoxemia tolerance under altitude exposure, including impaired vision and shortened time of useful consciousness. Individuals with thalassemia minor are usually compatible with flying duties, but do occasionally reveal low grade anemia, which should be differentiated with iron deficiency anemia. Wavier criteria for α- and β-thalassemia minor/trait are generally defined with hemoglobin above 13g/dl. Authors of this article suggest more comprehensive consideration encompassing clinical symptoms, previous laboratory data and possible hemoglobin electrophoresis on a case by case basis, to balance between flight safety and human resource.