儿童脉管性疾病患者介入手术后外周血淋巴细胞染色体畸变观察  

Observation on chromosome aberration of peripheral blood lymphocytes in children with vascular diseases after interventional procedure

作　　者：马娅 侯殿俊 郭磊 宋丹 朱伟 李卫国 毛雪松 方连英 王仲文[1] Ma Ya;Hou Dianjun;Guo Lei;Song Dan;Zhu Wei;Li Weiguo;Mao Xuesong;Fang Lianying;Wang Zhongwen(China Institute of Atomic Energy,Beijing 102413,China;College of Preventive Medical Sciences(Institute of Radiation Medicine),Shandong First Medical University(Shandong Academy of Medical Sciences),Jinan 250062,China;Qilu Children's Hospital of Shandong University,Jinan 250022,China)

机构地区：[1]中国原子能科学研究院,北京102413 [2]山东第一医科大学(山东省医学科学院)预防医学科学学院(放射医学研究所),济南250062 [3]山东大学齐鲁儿童医院,济南250022

出　　处：《中华放射医学与防护杂志》2022年第2期89-94,共6页Chinese Journal of Radiological Medicine and Protection

基　　金：国家自然科学基金青年科学基金项目(32100999);山东省医药卫生科技发展计划项目(202012070680);山东省自然科学基金项目(ZR2021MH053,ZR2020QC082)。

摘　　要：目的评估儿童脉管性疾病患者在介入手术过程中接受的电离辐射(IR)对患儿染色体畸变的影响。方法在知情同意的条件下,于介入术前和术后立刻采集26名患儿的外周血1.2 ml,培养制备染色体,分析外周血淋巴细胞染色体畸变情况。结果儿童介入术后双着丝粒染色体+着丝粒环(dic+r)率明显增加,与术前比较,差异有统计学意义(U=647,P<0.01)。术后dic+r率与年龄、体重、累积剂量面积乘积(DAP)、累积剂量(CD)及估算的有效剂量(E)之间并无相关性(P>0.05),不同性别之间、不同年龄组之间及不同的病灶部位之间,术后dic+r率差异无统计学意义(P>0.05),4名患儿的术后dic+r率超过40×10-3,其中有1例高达95.83×10-3。结论脉管性疾病患儿在介入术中接受的IR可导致dic+r率增加且存在个体差异,部分儿童异常敏感。儿童介入手术的正当化与防护工作需引起高度重视。Objective To evaluate the effect of ionizing radiation on chromosome aberration of peripheral blood lymphocytes in children with vascular interventional procedure.Methods The chromosome aberration of peripheral blood lymphocytes was analyzed before and after vascular interventional procedure to assess the effect of low-dose ionizing radiation on chromosomes.Peripheral blood(PB)was collected using heparin as an anticoagulant from 26 patients before and after(within 10 minutes)vascular interventional surgery.Informed consent was obtained from the patients′parents.Results Dicentric+centric ring(dic+r)formation increased significantly(U=647,P<0.01)in peripheral blood lymphocytes of children after interventional operation.No correlation was observed between the rate of dic+r and the cumulative dose(CD),dose area product(DAP),age,body weight,gender and the estimated effective dose E(P>0.05).There was no significant difference in dic+r rate of children between different genders,ages and lesion sites(P>0.05).The dic+r rate after interventional operation exceeded 40×10-3 in 4 of 26 cases with the highest of 95.83×10-3.Conclusions The ionizing radiation during children′s vascular interventional procedure might lead to the increase of chromosome aberration of peripheral blood lymphocytes and some children are abnormally sensitive.Great attention should be paid to the justification and radiation protection during interventional procedure for children.

关 键 词：电离辐射 介入手术 儿童 双着丝粒染色体 

分 类 号：R725.4[医药卫生—儿科]