介入工作人员颈动脉内中膜厚度与累积受照剂量关系及阈值探讨

Relationship between the intima-media thickness of carotid artery and the accumulated radiation dose and its threshold value in intervention workers

目的分析介入工作人员颈动脉内中膜厚度(IMT)与累积受照剂量的关系,探讨引起IMT异常的累积受照剂量阈值。方法采用整群随机抽样方法,在山东省27个医院抽取155名介入科放射工作人员作为介入组,同时以放射科工作人员620人作为对照组,对2组人员进行放射工作人员职业健康检查,收集2组人员累积受照剂量,采用医用超声仪测量其颈动脉IMT,并采用多重线性回归分析IMT与累积受照剂量的剂量-效应关系。结果介入组人员IMT为(0.70±0.11)mm,IMT异常率4.5%(7/155),对照组人员IMT为(0.68±0.09)mm,IMT异常率3.9%(24/620);2组人员IMT异常率比较,差异无统计学意义(P>0.05)。多重线性回归分析建立回归方程:y=0.007 x_1+0.001 x_2-0.098 x_3+0.223(y为IMT值,mm;x_1为年龄,岁;x_2为累积受照剂量,mSv;x_3为性别)。根据回归方程估计IMT=1 mm时对应的各年龄段的累积受照剂量结果显示,年龄越小,需要的累积受照剂量越大;女性相对于男性需要更大的累积受照剂量,才能引起IMT异常。结论放射工作人员IMT和累积受照剂量呈正相关关系,可采用线性回归方程估计IMT异常时累积受照剂量的阈值。

Objective To analyze the relationship of the intima-media thickness（ IMT） of carotid artery and accumulated radiation dose in intervention workers,and to evaluate the threshold dose leading to the abnormal IMT. Methods By cluster random sampling,155 intervention workers were selected as intervention group and 620 workers from the radiology departments were selected as control group. All workers came from 27 hospitals in Shandong Province. The workers in these two groups were given radiological occupational health check-up. Their accumulated dose of radiation was collected and IMT was measured by ultrasound. Multiple linear regression analysis was used to analyze the dose-effect between the IMT and the accumulated dose. Results In the intervention group,IMT was（ 0. 70 ± 0. 11） mm,the abnormal rate of IMT was 4. 5%（ 7 /155）. The IMT in the control group was（ 0. 68 ± 0. 09） mm,and the abnormal rate of IMT was 3. 9%（ 24 /620）. The abnormal rate of IMT between the two groups had no statistical significance（ P 〉0. 05）. The multiple linear regression equation was y = 0. 007 x1＋ 0. 001 x2- 0. 098 x3＋ 0. 223（ y means IMT,mm; x1 means age,x2 means accumulated radiation dose,mSv; x3 means gender）,and the threshold doses deduced in all ages corresponding to 1 mm of IMT showed that the threshold dose was higher with younger age,and the larger accumulated radiation dose was needed to cause the IMT abnormity in the female than in the male workers. Conclusion The IMT is positively correlated with the accumulated radiation dose in radiation workers,and the threshold dose of abnormal IMT could be estimated by the linear regression equation.