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目的了解长期接触低剂量电离辐射对放射医护人员甲状腺功能,尤其是甲状腺FT_3、FT_4和TSH水平的影响,为完善相关国家标准和行业标准提供依据。方法以北京某三甲医院在职放射医护人员153人为射线组,以同期进行健康检查的非放射作业的健康成人145人为对照组。免疫化学发光法测定血清中游离三碘甲状腺原氨酸(FT_3)、游离甲状腺素(FT_4)和促甲状腺素(TSH)的水平,并进行统计学分析。结果射线医护人员的血清中FT_3水平明显低于对照组(t=22.245,P<0.05)。对照组中,女性血清中FT_3水平较男性低(t=6.821,P<0.05),FT_4和TSH水平与男性相比无显著性差异;而射线组中,女性放射医护人员除血清中FT_3水平较男性低(t=6.479,P<0.05)以外,FT_4水平略低于男性(t=4.547,P<0.05),TSH水平明显高于男性(t=2.762,P<0.05);进一步考虑血清中甲状腺激素与年龄之间的关系,发现血清中FT_3与年龄之间存在负相关,相关系数为-0.210(P<0.05);而血清FT_4及TSH水平与年龄之间无相关性。结论长期低剂量电离辐射对放射医护人员的甲状腺功能具有抑制作用,尤其以甲状腺FT_3降低较为明显,可考虑放射医护人员职业健康检查加入甲状腺FT_3、FT_4的检验,完善相关国家标准及行业标准。
Objective To understand the effect of long-term exposure to low doses of ionizing radiation on thyroid function, especially thyroid FT_3, FT_4 and TSH levels of radiologists and provide the basis for improving the relevant national and industrial standards. Methods A total of 153 radiotherapy and nursing staff in a top three hospital in Beijing were taken as radiotherapy group, and 145 healthy adults without radiological examinations during the same period were taken as control group. The levels of free triiodothyronine (FT_3), free thyroxine (FT_4) and thyroid stimulating hormone (TSH) in serum were determined by immunochemical chemiluminescence and analyzed statistically. Results The level of FT_3 in serum of radiographers was significantly lower than that of the control group (t = 22.245, P <0.05). In the control group, FT_3 levels in female serum were lower than those in male (t = 6.821, P <0.05), and there was no significant difference between FT_4 and TSH levels in males. In radiation group, the levels of FT_3 The level of FT 4 was slightly lower than that of males (t = 4.547, P <0.05), and the level of TSH was significantly higher than that of males (t = 2.762, P <0.05) There was a negative correlation between serum FT_3 and age, the correlation coefficient was -0.210 (P <0.05). There was no correlation between serum FT_4 and TSH levels and age. Conclusion Long-term low-dose ionizing radiation has an inhibitory effect on the thyroid function of radiologists. In particular, the decrease of FT_3 in the thyroid gland is more obvious. The examination of FT_3 and FT_4 in the thyroid gland may be considered in the occupational health examination of radiological staff, and the relevant national and industry standards can be perfected.