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目的探讨民航飞行人员接连发生急性心肌梗死（ＡＭＩ）导致空中及地面失能的原因，找出有效的预防措施。方法搜集１９７９～１９９８年中国国际航空公司飞行人员因ＡＭＩ导致空中及地面失能的案例，研究其疾病演变过程、治疗及体检鉴定标准。结果绝大多数ＡＭＩ是作为高血压的并发症作出诊断的；高血压病在诊断上断断续续；发生失能的根本原因是诊断上疏忽，已经出现Ⅱ期高血压诊断的明确指征，但直至ＡＭＩ失能之前仍然是Ⅰ期或临界高血压，甚至连高血压的诊断都没有；治疗上，缺乏系统的治疗方案，血压长期未能控制；体检鉴定标准有缺陷，尤其对高血压Ⅱ期的处理（个别评定）缺乏理论上和实践上的依据；飞行人员使用抗高血压药物的规定落后于形势。结论对患有高血压的飞行人员，要“终身戴帽”、终身监控、终身治疗；按靶器官损害程度进行高血压分期，及时做出正确的诊断是体检鉴定的核心；民航飞行人员体检鉴定标准应进行修改，引进高正常血压作为预防医学（Ⅲ级）的标准；将临界高血压、高血压Ⅰ期都归入飞行观察（Ⅳ级）的标准；增设高血压高危个体（Ⅴ级）标准；重新恢复高血压Ⅱ期飞行不合格（Ⅶ级）的标准，对于眼底动静脉交叉的改变不排除严格程序之下的特许飞行（Ⅵ级）；执照签证机关对飞行?
Objective To investigate the causes of airborne and ground disability due to successive occurrences of acute myocardial infarction (AMI) by civil aviation pilots, and to find out effective preventive measures. Methods The cases of airborne and ground incapacitation caused by AMI during the flight of Air China from 1979 to 1998 were collected to study the evolving process, treatment and physical examination standards. Results The vast majority of AMI were diagnosed as complications of hypertension. Hypertension was intermittent in diagnosis. The underlying cause of disability was diagnosis negligence. There was a clear indication of diagnosis of hypertension in stage II, but AMI Prior to disability is still stage Ⅰ or critical hypertension, and even the diagnosis of hypertension are not; treatment, the lack of systematic treatment programs, long-term blood pressure can not control; physical examination standards have flaws, especially for the treatment of hypertension Ⅱ (Individual assessment) lacks theoretical and practical basis; the provisions on the use of antihypertensive drugs by pilots lag behind the situation. Conclusion For pilots with high blood pressure, it is necessary to “wear caps for life” for life-long monitoring and lifelong treatment. Staging of hypertension according to the degree of target organ damage and making correct diagnosis in time are the core of medical examination. Physical examination of civil aviation pilots The standard should be modified to introduce high normotensive blood pressure as a standard for preventive medicine (grade III); the critical hypertension and hypertension phase I should be classified into the standard for flight observation (grade IV); the standard for high-risk high-risk individuals (grade V) ; To resume the second phase of hypertension unacceptable flight (Ⅶ level) standards, changes in the fundus arteriovenous does not exclude the strict procedure under the authorized flight (Ⅵ level); license visa authorities on the flight?