骨髓细胞染色体畸变在山东济宁事故受照人员剂量估算中的应用

Application of chromosome aberration in bone marrow for dose estimation of exposed patients in a radiation accident in Jining, Shandong Province

目的对山东济宁“10．21”辐射事故受照者进行染色体畸变（CA）分析，并估算受照剂量。方法对2例患者（A和B）的外周血和骨髓样本进行常规CA分析，根据双着丝粒（dic）和环（r）畸变频率估算受照剂量。结果2例患者的外周血未见中期分裂细胞。骨髓获得了可供分析的细胞。2例患者的dic＋r畸变频率超过了剂量效应方程所能估计的上限剂量相对应的数值。用直接比较法估算2例患者受到比较均匀的大剂量照射，与用物理方法、微核法和ESR法所估剂量接近，与临床表现基本一致。结论用骨髓CA估算辐射事故患者的受照剂量在国内尚属首次。对肠型放射病患者A的剂量估算是迄今采用骨髓进行常规CA分析估计事故病人受照剂量的最高记录。

Objective A biological dose estimation by chromosome aberration （CA） analysis was performed on 2 exposed patients in a radiation accident in Jining, Shandong Province. Methods Conventional CA analysis and dose estimation by dicentric chromosome and ring were performed in peripheral blood and bone marrow samples on 2 patients （A and B）. Results No metaphase cell was observed in peripheral blood of 2 patients,while the metaphase cells were observed in bone marrow of 2 patients. Because the doses of A and B were higher than the upper dose limit that can be estimated by a linear quadratic calculation formula, it is estimated that those by a direct comparison method and the exposed dose of A and B were very high and comparatively uniform. The results were approximately in accordance with that estimated by physical method, mieronueleus assay, ESR method and clinical symptoms. Conclusions It is the first case report that the dose is estimated by CA in bone marrow of irradiated patient in radiation accident in our country. The estimated dose by conventional CA analysis in bone marrow of patient A in the present study is the highest among all of the radiation accident patients.