低剂量电离辐射对放射从业者血小板及白细胞的影响分析

Effect of low-dose ionizing radiation on platelet and leukocytes of radiation workers

目的 探讨职业低剂量电离辐射对放射从业者血小板、白细胞的影响。方法 收集2013-2015年成都市2 055名放射从业者职业健康体检的血小板及白细胞数据及从业者辐射累积暴露剂量。采用t检验、方差分析、 χ2检验、直线相关分析、协方差分析及多因素logistic回归方法进行分析。结果 协方差分析显示，随着累积暴露剂量增加，血小板、白细胞数呈降低趋势。多因素logistic回归分析显示，中等剂量及以上剂量暴露组（〉4.333 mSv）随着BMI水平增加，血小板降低的风险增加愈明显（趋势检验P〈0.05）；高剂量（〉15.639 mSv）暴露合并吸烟是血小板降低的危险因素（OR=2.33，95%CI：1.23～4.44）。低剂量（≤4.332 mSv）暴露合并锻炼〉1次/周是血小板降低的保护因素（OR=0.26，95%CI：0.09～0.70）。 结论 随着辐射累积暴露剂量增高，从业者血小板、白细胞数呈现减少的趋势，若合并超重/肥胖、吸烟则血小板减少的风险越高，而加强体育锻炼可能是白细胞减少的保护因素。

Objective To explore the effect of low-dose ionizing radiation on the platelets and leukocytes of the radiation workers. Methods We collected data from a total number of 2 055 radiation related workers and with their cumulative doses. Data on platelets and leukocytes was gathered from physical examination of the staff members, from 2013 to 2015 in Chengdu. T test, variance analysis, χ2 test, linear correlation, covariance analysis and multivariate logistic regression analysis were used to analyze the data. Results Results from the covariance analysis showed that with the increase of cumulative doses, the quantity of platelet and leukocyte appeared a decreasing trend. Multivariate logistic regression analysis showed that, with the increase of BMI levels and the medium cumulative dose and above （〉4.333 mSv）, the risk of thrombocytopenia became more obvious （trend test as P〈0.05）. In the group with high-dose exposure radiation （〉15.639 mSv） and combined factor as smoking, the risk of developing thrombocytopenia would increase （OR=2.33, 95%CI：1.23-4.44）.Staff with cumulative dose of less than 4.332 mSv and exercised more than 1 time per week, the risk of developing low leukocyte would decrease （OR=0.26, 95%CI：0.09-0.70）. Conclusions Along with the increase of cumulative doses on exposure to radiation related workers. The quantity of platelet and leukocyte showed a decreasing trend among them. When this high-dose exposure radiation combined with overweight/obesity or cigarette smoking, the risk of developing thrombocytopenia was high. However, physical exercise might have served as protective factor on leukopenia.