职业照射对心血管介入工作者遗传学损伤的初步探索  

Occupational X-Ray Irradiation on Genotoxicity among Interventional Cardiologists at one Hospital

作　　者：于亚梅 曹易懿[2] 奚晶[2] 邱朝晖[1] 栾洋[2] YU Ya-mei;CAO Yi-yi;XI Jing;QIU Chao-hui;LUAN Yang(Tongren Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200050,China;Hongqiao International Institute of Medicine,Faculty of Public Health,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属同仁医院,心血管内科,上海200050 [2]上海交通大学医学院虹桥国际医学研究院,公共卫生学院,上海200025

出　　处：《伤害医学（电子版）》2023年第1期1-5,共5页Injury Medicine(Electronic Edition)

摘　　要：目的探索可以用于评价心血管介入工作者遗传学损伤的实验室方法,为更好地进行介入职业防护提供依据。方法纳入上海交通大学医学院附属同仁医院心血管介入工作者14例,非介入工作者14例。收集受试者的基本信息和基础临床资料,进行血常规检测,采集肝素抗凝全血进行外周血淋巴细胞胞质分裂阻滞微核试验和外周血红细胞PIG-A基因突变试验。采用多因素泊松回归分析和多因素线性回归来分析介入相关工作人员的遗传学损伤是否与介入辐射相关。结果心血管介入组外周血淋巴细胞的微核率(3.64‰±1.57‰)和核芽率(0.71‰±0.67‰)显著高于非介入组[微核率(2.61‰±1.56‰),RR=1.80,95%CI:(1.11,2.91),P=0.02;核芽率(0.32‰±0.46‰),RR=3.71,95%CI:(1.13,12.22),P=0.03];介入组的核质桥率(0.11‰±0.29‰)和非介入组(0.21‰±0.38‰)之间的差异无统计学意义。PIG-A基因突变试验结果显示,介入组PIG-A基因突变率[(8.36±8.80)×10^(-6)]显著高于非介入组[(5.71±3.25)×10^(-6)][RR=2.36,95%CI:(1.48,3.78),P<0.001]。结论在本实验条件下,心血管介入工作人员遗传性损伤高于非介入人员,为进一步研究职业照射对相关医务工作者是否存在遗传学影响提供基础数据及参考。Objective To investigate genotoxicity in peripheral blood cells from occupational exposure to X-rays among interventional cardiologists and to provide evidence for risk assessment and occupational protection.Methods A total of 14 interventional cardiologists and 14 non-interventional cardiologists in the Department of Cardiology from Shanghai Tongren Hospital Shanghai Jiao Tong University School of Medicine were enrolled.Basic clinical data of subjects were documented and peripheral blood was collected for routine blood tests.The lymphocyte cytokinesis-block micronucleus test and erythrocyte PIG-A gene mutation assay were used to investigate genotoxicity.Multivariate poisson regression and multivariate linear regression analyses were used to analyze whether the genotoxicity was related to the interventional radiation among the cardiologists.Results The frequencies of micronuclei(MN)and nuclear buds(NBUD)(MN:3.64%±1.57%,NBUD:0.71%±0.67%)were significantly higher among the interventional cardiologists than the non-interventional cardiologists[(MN(2.61%±1.56%),RR=1.80595%CI:(1.11,2.91),P=0.02;NBUD(0.32%±0.46%),RR=3.71,95%CI:(1.13,12.22),P=0.03)].The interventional cardiologists also exhibited significantly higher PIG-A mutant frequencies[(8.36±8.80)×10^(-6)]than did the controls[(5.71±3.25)×10^(-6)],P<0.001).Conclusions The cytogenetic damage among the interventional cardiologists was higher than that of non-interventional cardiologists.The data provide theoretical basis for further studies.

关 键 词：心血管介入 职业防护 遗传性损伤 微核 PIG-A基因突变 

分 类 号：R148[医药卫生—公共卫生与预防医学]