某三甲医院放射工作人员淋巴细胞染色体畸变分析

Analysis of chromosome aberrations in peripheral blood lymphocyte of medical radiation workers in a tertiary hospital

目的分析医疗放射工作人员淋巴细胞染色体畸变水平及影响因素。方法于2020年7至9月,选取某三甲医院252名医疗放射工作人员作为放射组并依据工种、工龄分为不同亚组,以同期岗前体检拟从事放射工作的107名健康成年人为对照组,收集研究对照信息,采用常规细胞遗传学方法检测外周血淋巴细胞的染色体畸变,统计分析各组间检测结果。结果放射组"dic+r"率、染色体总畸变率及异常检出率均明显高于对照组(Z=2.59、3.74、9.99,P<0.05);不同工种间"dic+r"率、ace率及染色体总畸变率的差异有统计学意义(χ^(2)=8.59、8.17、11.39,P<0.05),其中介入放射学组的"dic+r"率明显高于放射诊断组(χ^(2)=2.90,P<0.05),核医学组的ace率及染色体总畸变率明显高于放射诊断组(χ^(2)=2.81、3.19,P<0.05);不同工种放射工作人员染色体畸变异常检出率差异有统计学意义(P<0.05),其中介入放射学组明显高于放射诊断组(χ^(2)=7.66,P<0.05)。不同工龄组间染色体畸变水平及异常检出率的差异均无统计学意义(P>0.05)。Possion回归分析显示,与放射诊断组比较,核医学组、放射治疗组及介入放射学组(IRR=2.31、1.66、1.78,P<0.05)导致染色体畸变风险升高。结论电离辐射对医疗放射工作人员产生一定的辐射损伤,核医学与介入放射学工作人员的染色体畸变水平相对较高,需加强辐射防护以保障相关从业人员的健康。

Objective To analyze the level of chromosome aberration in lymphocytes of medical radiation workers and its influencing factors.Methods From July to September 2020,252 medical workers in a tertiary hospital were selected as the study subjects and 107 preserviceworkers were selected as the control group.The Chromosomal aberrations of peripheral blood lymphocytes were measured using conventional cytogenetic analysis method,and the differences were analyzed.Results The frequencies of dicentric puls centric ring,total chromosome-type aberrations,and abnormal detection rate in the radiation group were significantly higher than those in the control group(Z=2.59,3.74,9.99,P<0.05).There was significant difference in the frequencies of dicentric plus centric ring and total chromosome-type aberrations among different types of work(χ^(2)=8.59,8.17,11.39,P<0.05),and the frequencies of dicentric plus centric ring were significantly higher in the interventional radiology group than those in diagnostic radiology(χ^(2)=2.90,P<0.05),While the rates of acentric fragment and total chromosome-type aberrations were significantly higher in the nuclear medicine group than those in diagnostic radiology(χ^(2)=2.81,3.19,P<0.05).The difference in the abnormal detection rate of chromosome aberrations between different types of work was statistically significant(P<0.05),and the rate in the interventional radiology group was significantly higher than that in the diagnostic radiology group(χ^(2)=7.66,P<0.05).There was no significant difference in chromosome aberration level and abnormal detection rate among different working ages(P>0.05).Poisson regression analysis indicated that the type of work is a risk factor for chromosomal aberration[IRR=2.31(nuclear medicine group),1.66(Radiation therapy),and 1.78(interventional group);P<0.05].Conclusion Ionizing radiation causes certain radiation damage to medical radiology workers,and the frequencies of chromosome aberration in the radiation workers of nuclear medicine and interventional radiology groups are relatively high,so radiation protection should be strengthened to ensure the health of relevant workers.