^(192)Ir迁延性受照人员免疫功能变化的随访观察  

Following up Observation of Change in Immunologic Function in 52 Patients Exposed to Long-term Low Dose of ^(192)Ir Radiation

作　　者：肖扬[1] 蒋祖军[1] 高阳[1] 李力[1] 李颂文[1] 肖芷芳[1] 

机构地区：[1]广州军区广州总医院血液科,广州510010

出　　处：《华南国防医学杂志》2007年第3期13-15,共3页Military Medical Journal of South China

基　　金：广东省自然科学基金资助项目(05000138)

摘　　要：目的观察192Ir意外迁延性照射后,受照人员免疫功能的变化。方法在2002-05／07间因意外受到192Ir小剂量迁延性照射的52人,根据淋巴细胞畸变率分析(双+环)及微核分析估算其受照生物剂量分别为0．05～0．63Gy和0．05～0．66Gy,按照生物照射剂量分为A、B两组,照射后3年分别检测其血清IgG、IgA、IgM,淋巴细胞转化率,CD 3、CD 4、CD 8和NK细胞阳性率,并与同期门诊查体健康人组对照。结果受照人群血清IgA、IgM水平与对照组比较无显著变化(P>0．05),但受照B组(0．20～0．66Gy)IgG、C3、C4则明显降低(P<0．01)。CD 3、CD 4、CD 8、NK细胞阳性率、淋巴细胞转化率较对照组显著降低(P<0．01),受照A组(0．05～0．19Gy)与B组(0．20～0．66Gy)比较以上指标则无显著变化(P>0．05)。结论受192Ir小剂量迁延性照射人员随访3年后未发现免疫系统兴奋效应,其细胞免疫功能受到一定抑制,对此类人员长期随访有重要意义。Objective To observe the change in the immunologic function in patients exposed to long-term 192Ir low close radiation. Methods Fifty-two patients were accidentally exposed to 192Ir low dose radiation from May 9 to July 19, 2002. The fifty-two patients were divided into both the groups A and B according radiation close estimated by the standard dose-response curves established via the analyses of dicentric rplus rings（dic ＋ r） and cytokinesis-block micronuclei analysis. There were 29 patients exposed to 0. 05-0. 19Gy in group A, and there were 23 patients exposed to 0. 20-0. 66Gy in group B. The contents of serum IgG, IgA and IgM, T lymphocyte transformation rate, and the positive rate of CD 3, CD 4, CD 8 and NK cells were determined 3 years after the radiation in all the patients. Results The contents of serum IgA and IgM in both the groups A and B were insignificantly different from those in the control group （P〉0. 05）, but the contents of serum IgG, C4 and C4 were significantly lower in group B than those in the control group（P〈0. 01）. The positive rates of CD 3, CD 4, CD 8 and NK cells, and lymphocyte transformation rate were significantly lower in both the groups A and B than those in the control group （P〈0. 01）. The positive rates of CD 3, CD 4, CD 8 and NK cells, and lymphocyte transformation and the value of CD4^＋/CD8^＋ in the group A were insignificantly different from those in group B （P〉0. 05）. Conclusion No simulative effect of long-term low dose radiation on immunologic system is observed 3 years after the radiation. On the contrary, it is suggested the long-term dose radiation can inhibit the cellular immune response in the patients. It is very important to follow up the irradiated persons for long time.

关 键 词：192Ir照射 小剂量 免疫功能 

分 类 号：R818[医药卫生—放射医学]