放射人员淋巴细胞畸变检测方法比较及人群特征分析

发布时间：2019-07-05 05:16

【摘要】：目的1.探讨外周血淋巴细胞畸变人工阅片检测法与染色体核型自动扫描成像系统检测法的优势与劣势。2.探索低剂量长时间接触放射线对放射工作人员外周血淋巴细胞畸变的影响。方法1.采集唐山地区医疗放射人员外周静脉血167例,培养并收集淋巴细胞,对其进行吉姆萨染色涂片,分别进行人工双人法阅片检测和染色体核型自动扫描成像系统检测,对两种检测方法的检测结果进行统计学比较。2.采集898例放射人员及381例非放射人员外周血,培养并收集淋巴细胞,对其进行吉姆萨染色涂片,以人工双人盲法阅片,检测淋巴细胞畸变情况。用统计学软件对不同工种、不同性别、不同工龄阶段的放射人员外周血淋巴细胞微核样本阳性率、染色体畸变样本阳性率、淋巴细胞微核率及染色体畸变率进行分析。结果1.人工组与扫描组分别检测167例样本,淋巴细胞畸变样本阳性率分别为8.98%和13.17%,差异无统计学意义(P0.05);人工组与扫描组微核检测中各检测淋巴细胞167000个,扫描组微核率2.69‰高于人工组1.95‰,差异有统计学意义(P0.05)。两组染色体畸变检测中各检测淋巴细胞33400个,扫描组染色体畸变率19.46(?)高于人工组5.399(?),差异有统计学意义(P0.05)。2. (1)不同工种放射人员外周血淋巴细胞畸变分析结果:工业组与医疗组放射人员外周血淋巴细胞畸变样本阳性率分别为7.49%与8.42%,微核率分别为1.84‰与1.70‰,染色体畸变率分别为4.25(?)与5.20(?),均高于相应对照组的数值:样本阳性率1.49%与1.12%,微核率0.37‰与0.36‰,和染色体畸变率1.73(?)与0.56(?),差异有统计学意义(P0.05)。但三组指标在工业组和医疗组均无统计学差异(P0.05)。(2)不同性别放射人员外周血淋巴细胞畸变分析结果:工业组男性与女性外周血淋巴细胞畸变样本阳性率、微核率和染色体畸变率分别为7.58%与6.94%、1.83‰与1.85‰、4.27(?)与4.17(?),差异均无统计学意义(P0.05);医疗组男性与女性外周血淋巴细胞畸变样本阳性率、微核率和染色体畸变率分别为7.83%与9.09%、1.58‰与1.83‰、6.45(?)与3.74(?),差异均无统计学意义(P0.05)。(3)不同工龄阶段放射人员外周血淋巴细胞畸变分析结果:工业组中,淋巴细胞畸变样本阳性率在0～9年工龄组、10～19年工龄组、20～29年工龄组和30年以上工龄组的数值分别为:1.06%、9.16%与10.48%和4.55%,统计学分析显示,10～19年工龄组和20～29年工龄组高于0～9年工龄组,差异有显著性(P0.05)。淋巴细胞微核率在0～9年工龄组、10～19年工龄组及20～29年工龄组和30年以上工龄组数值分别为0.74‰、1.94‰、1.91‰和2.02‰,经统计学分析,10～19年工龄组及20～29年工龄组和30年以上工龄组高于0～9年工龄组,差异有显著性(P0.05)。淋巴细胞染色体畸变率在4个工龄组人员数值分别为:0.53(?)、4.38(?)、6.67(?)与5.68(?),经统计学分析显示,10～19年工龄组及20～29年工龄组和30年以上工龄组高于0～9年工龄组,差异有显著性(P0.05);医疗组中,0～9年工龄组放射人员外周血淋巴细胞微核样本阳性率、微核率及染色体畸变率分别为1.23%、0.58‰、0.62(?),均低于10～19年工龄组8.98%、1.96‰、5.39(?),20～29年工龄组12.22%、1.99‰、6.11(?),与 30 年以上工龄组 10.61%、2.04‰、9.09(?),经统计学分析,10～19年工龄组及20～29年工龄组和30年以上工龄组3组指标均高于0～9年工龄组,差异有显著性(P0.05)。结论1.人工阅片检测法速度较慢,存在漏检可能,适合小样本量样品分析;染色体核型自动扫描分析系统阅片检测法速度较快,漏检率低,适合数目较多的样本阅片。两种检测方法在外周血淋巴细胞畸变检测样本阳性率中差异不明显,应互补使用。2.放射工作人员外周血淋巴细胞畸变样本阳性率、淋巴细胞微核率、淋巴细胞染色体畸变率均高于对照组人员。长期低剂量接触放射线可导致放射人员外周血淋巴细胞遗传方面改变,变化程度随工龄增加而升高。需进一步加强放射人员的职业卫生健康防护工作。
文内图片：

图片说明：染色体核型自动扫描成像系统
[Abstract]:Objective 1. In this paper, the advantages and disadvantages of the detection method of peripheral blood lymphocyte distortion and the detection method of autoscan imaging system of chromosome karyotype are discussed. To explore the effect of low-dose long-time exposure on the peripheral blood lymphocyte aberration of radiation workers. Method 1. The peripheral venous blood of the medical radiation personnel in the Tangshan area was collected in 167 cases, the lymphocytes were cultured and collected, and the stained smear was carried out for them, and the detection of the artificial double-person method and the automatic scanning imaging system of the chromosome were carried out, respectively. The results of the two methods of detection were statistically compared. The peripheral blood of 898 cases of radiation and 381 cases of non-radioactive personnel were collected, and the lymphocytes were cultured and collected. The positive rate of micronucleus, the positive rate of chromosome aberration, the micronucleus rate of lymphocytes and the rate of chromosome aberration were analyzed by statistical software. Results 1. The positive rates of the samples were 8.98% and 13.17%, respectively, and the difference was not significant (P <0.05). The microkernel rate of the scanning group was 2.69% higher than that of the artificial group 1.95%, respectively. The difference was significant (P0.05). In the two groups,33400 were detected in the chromosome aberration test, and the chromosome aberration rate of the scanning group was 19.46 (? ) Is higher than the manual group 5.399 (? The difference was significant (P0.05). (1) The results of the analysis of peripheral blood lymphocyte in different types of workers: The positive rate of the peripheral blood lymphocyte of the radiation personnel in the industrial group and the medical group was 7.49% and 8.42%, respectively, and the micronucleus rate was 1.84% and 1.70%, respectively, and the chromosome aberration rate was 4.25 (? ) And 5.20 (? The positive rate of the sample was 1.49% and 1.12%, the microkernel rate was 0.37% and 0.36%, and the chromosome aberration rate was 1.73 (? ) And 0.56 (? The difference was significant (P0.05). However, there was no statistical difference between the three groups in the industrial group and the medical group (P0.05). (2) The results showed that the positive rate, micronucleus rate and chromosome aberration were 7.58% and 6.94%, 1.83% and 1.85%, 4.27 (? ) And 4.17 (? The positive rate, micronucleus rate and chromosome aberration were 7.83% and 9.09%, 1.58% and 1.83%, 6.45 respectively. ) And 3.74 (? The difference was not significant (P0.05). (3) The results of the analysis of lymphocyte aberration in the peripheral blood of the radiation personnel in different service period: the positive rate of the lymphocyte aberration in the industrial group was from 0 to 9 years, and the value of the service group in the age group of 10 to 19 years, the service period of 20 to 29 years and the working length of over 30 years were: 1.06%, 9.16% and 10.48% and 4.55%, respectively. The statistical analysis showed that the working length group of 10-19 years and the working length of 20-29 years were higher than that of the working group of 0-9 years, and the difference was significant (P0.05). The lymphocyte micronucleus rate was 0.74%, 1.94%, 1.91% and 2.02% in the service group of 0 ~ 9 years, the service period of 10 ~ 19 years, and the working length of 20 ~ 29 years, respectively. The difference was significant (P0.05). The chromosome aberration rate of lymphocytes was 0.53 (?), 4.38 (?), 6.67 (? ) And 5.68 (? The results showed that the positive rate of micronucleus in the peripheral blood lymphocytes of the patients in the working group of 10 to 19 years and the working length of 20 to 29 years was higher than that of the working group of 0 to 9 years (P 0.05), and the positive rate of the micronucleus in the peripheral blood lymphocytes of the radiation personnel in the working group of 0 to 9 years in the medical group. The rate of micronucleus and chromosome aberration were 1.23%, 0.58% and 0.62 respectively. ), which is less than 8.98%, 1.96%, 5.39 (?) in the service group of 10 to 19 years, and 12.22%, 1.99% and 6.11 (?) in the service group of 20 to 29 years. ), compared with the age group of 10.61%, 2.04%, 9.09 (? The results of statistical analysis,10 to 19 years of service,20 to 29 years of service, and 3 in the service group of over 30 years were all higher than those in the age group of 0 to 9 years, and the difference was significant (P0.05). Conclusion 1. The speed of the manual reading detection method is slow, the leakage detection is possible, and the method is suitable for the sample analysis of the small sample size; the automatic scanning and analysis system of the chromosome karyotype analysis system has the advantages of high speed, low leakage detection rate and a suitable number of sample reading pieces. The difference between two detection methods in the positive rate of peripheral blood lymphocyte aberration test is not obvious, and should be used in a complementary way. The positive rate, micronucleus rate and chromosome aberration of lymphocytes in the peripheral blood of the radiation workers were higher than those in the control group. Long-term low-dose exposure to radiation can lead to changes in the genetic aspects of the peripheral blood lymphocytes of the radiation personnel, and the degree of change increases with the increase in the length of service. It is necessary to further strengthen the occupational health and health protection work of the radiological personnel.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R146

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