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目的了解接触低剂量电离辐射医学放射工作人员机体免疫相关细胞因子的变化情况。方法采用典型抽样法,选取广东省7家三级甲等医院244名医学放射工作人员为研究对象,其中诊断放射学组、核医学组、放射治疗组、介入放射学组分别有61、51、74和58人。另选工作中不接触电离辐射的51名行政人员为对照组。采用热释光剂量仪对接触组人员进行为期1年的个人剂量监测。采用酶联免疫吸附实验检测各组人员血清中γ干扰素(IFN-γ)、白细胞介素10(IL-10)和转化生长因子β1(TGF-β1)表达水平。结果医学放射工作人员的最大人均年有效剂量为0.41 mSv/a,低于职业接触限值20.00 mSv/a。核医学组工作人员人均年有效剂量分别高于诊断放射学组、放射治疗组和介入放射学组(P<0.01)。男性工作人员中,诊断放射学组、放射治疗组和介入放射学组人员血清IL-10表达水平均低于对照组(P<0.05);放射治疗组人员的IL-10表达水平分别低于核医学组和介入放射学组(P<0.05);放射治疗组人员的IFN-γ/IL-10比值分别高于诊断放射学组、核医学组、介入放射学组和对照组(P<0.05)。将医学放射工作人员按人均年有效剂量分为低、中、高3个剂量组(0.03~、0.06~和>0.15 mSv/a),该3组男性工作人员的IL-10表达水平均低于对照组男性工作人员(P<0.05)。结论长期低剂量电离辐射可能对男性工作人员IL-10介导的体液免疫产生一定的抑制作用。
Objective To understand the changes of immune related cytokines in medical radiation workers exposed to low doses of ionizing radiation. Methods A typical sampling method was used to select 244 radiological radiologists from 7 third class hospitals in Guangdong Province. The diagnostic radiology, nuclear medicine, radiotherapy and interventional radiology groups were 61, 51, 74 and 58 people. The 51 administrative staff not exposed to ionizing radiation in the alternative work served as the control group. A one-year personal dose monitoring was performed on the contact group using a thermoluminescence dosimeter. Serum levels of IFN-γ, IL-10 and TGF-β1 were detected by enzyme linked immunosorbent assay (ELISA). Results The maximum per capita effective dose of medical radiation workers was 0.41 mSv / a, lower than the occupational exposure limit of 20.00 mSv / a. The annual per capita effective dose of nuclear medicine staff was higher than that of the diagnostic radiology group, radiotherapy group and interventional radiology group (P <0.01). Among male staff, the levels of IL-10 in serum of the diagnostic radiology group, radiotherapy group and interventional radiology group were lower than those of the control group (P <0.05). The levels of IL-10 in the radiotherapy group were lower than those in the control group (P <0.05). The ratio of IFN-γ / IL-10 in the radiotherapy group was higher than that in the diagnostic radiology group, the nuclear medicine group, the interventional radiology group and the control group (P <0.05) . The medical radiation workers were divided into low, medium and high dose groups (0.03 ~ 0.06 ~> 0.15 mSv / a) according to the average effective dose per day. The levels of IL-10 in the three groups of male workers were lower than Control group male staff (P <0.05). Conclusion Long-term low-dose ionizing radiation may have some inhibitory effects on IL-10-mediated humoral immunity in male workers.