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目的分析介入工作人员颈动脉内中膜厚度(IMT)与累积受照剂量的关系,探讨引起IMT异常的累积受照剂量阈值。方法采用整群随机抽样方法,在山东省27个医院抽取155名介入科放射工作人员作为介入组,同时以放射科工作人员620人作为对照组,对2组人员进行放射工作人员职业健康检查,收集2组人员累积受照剂量,采用医用超声仪测量其颈动脉IMT,并采用多重线性回归分析IMT与累积受照剂量的剂量-效应关系。结果介入组人员IMT为(0.70±0.11)mm,IMT异常率4.5%(7/155),对照组人员IMT为(0.68±0.09)mm,IMT异常率3.9%(24/620);2组人员IMT异常率比较,差异无统计学意义(P>0.05)。多重线性回归分析建立回归方程:y=0.007 x_1+0.001 x_2-0.098 x_3+0.223(y为IMT值,mm;x_1为年龄,岁;x_2为累积受照剂量,mSv;x_3为性别)。根据回归方程估计IMT=1 mm时对应的各年龄段的累积受照剂量结果显示,年龄越小,需要的累积受照剂量越大;女性相对于男性需要更大的累积受照剂量,才能引起IMT异常。结论放射工作人员IMT和累积受照剂量呈正相关关系,可采用线性回归方程估计IMT异常时累积受照剂量的阈值。
Objective To analyze the relationship between carotid intima-media thickness (IMT) and accumulated dose in interventional workers, and to explore the cumulative dose threshold of IMT abnormalities. Methods A cluster random sampling method was used to select 155 interventional radiology staff in 27 hospitals in Shandong Province as the intervention group. At the same time, 620 radiosurgery staff were used as the control group, and 2 groups of staff were examined for occupational health of radiological staff. The cumulative dose of two groups of patients was collected. The carotid IMT was measured by using the medical ultrasound system and the dose-response relationship between the IMT and the accumulated dose was analyzed by multiple linear regression. Results The IMT was (0.70 ± 0.11) mm and the IMT abnormality rate was 4.5% (7/155) in the intervention group. The IMT of the control group was (0.68 ± 0.09) mm and the IMT abnormality rate was 3.9% (24/620) IMT abnormal rate comparison, the difference was not statistically significant (P> 0.05). Multiple linear regression analysis established the regression equation: y = 0.007 x_1 + 0.001 x_2-0.098 x_3 + 0.223 (y is the IMT value in mm; x_1 is the age, year; x_2 is the cumulative exposure dose, mSv; x_3 is sex). According to the regression equation, the cumulative exposure dose of each age group estimated when IMT = 1 mm shows that the smaller the age, the greater the required cumulative exposure dose; the greater the cumulative exposure dose required for women than men IMT abnormal. Conclusion There is a positive correlation between IMT and cumulative exposure dose of radiation workers. The linear regression equation can be used to estimate the cumulative dose threshold of IMT abnormalities.