3例骨髓型急性放射病15年远期效应医学随访
发布时间：2018-07-18 14:54
【摘要】：目的观察骨髓型急性放射病(ARS)患者的远期效应。方法对河南省1999年钴-60(60Co)源辐射事故的3例骨髓型ARS患者"梅"、"天"和"旺"进行为期15年的远期效应医学随访观察。重点观察造血系统、免疫系统、内分泌系统、生殖系统和眼科改变情况。结果 3例患者受照后1个月内白细胞计数、血小板计数和血红蛋白均出现下降,于受照后6个月均恢复正常;3例患者粒细胞-巨噬细胞集落刺激因子在受照后6个月均偏低,分别于受照后1~2年恢复正常。"梅"受照后5、11和13年免疫球蛋白(Ig)G水平均偏高,受照6个月和2年补体3水平偏低;"天"受照后5年Ig G水平偏高。3例患者受照后6个月内T细胞亚群指标表面分化抗原(CD)3+T细胞百分比、CD3+CD4+T细胞百分比、CD3+CD8+T细胞百分比和CD3+CD4+/CD3+CD8+比值均低于正常参考值下限,受照后第2年恢复正常。"梅"受照后出现闭经;"天"受照后3个月精子数开始减少且出现死精,受照后3~7年精子数逐渐恢复至正常。"梅"和"天"受照后15年出现甲状腺结节。3例患者均出现不同程度晶状体浑浊,"梅"于受照后13年行左眼白内障摘除联合人工晶状体植入术。"梅"和"旺"周围血淋巴细胞微核率分别为3‰、1‰;染色体畸变检查显示相互易位、双着丝粒体、无着丝粒体和倒位数分别为70、8、5、3和43、2、1、1。"天"受照后12年出现冠状动脉狭窄改变,受照后13年罹患弥漫性大B细胞非霍奇金淋巴瘤。"梅"受照后7年开始心电图检查出现下壁和侧壁心肌缺血。结论60Co源辐射事故可导致ARS患者出现造血系统、免疫系统、内分泌系统、生殖系统、眼晶状体和心脏功能不同程度的远期效应。
[Abstract]:Objective to observe the long-term effects of acute radiation sickness (ARS) of bone marrow type. Methods three cases of bone marrow type ARS patients in Henan Province in 1999 were followed up for 15 years for long term effect of "Mei", "Tian" and "Wang". The changes of hematopoietic system, immune system, endocrine system, reproductive system and ophthalmology were observed. Results the leukocyte count, platelet count and hemoglobin decreased in 3 patients within one month after irradiation, and returned to normal 6 months after irradiation. The granulocyte-macrophage colony stimulating factor was lower in 3 patients at 6 months after irradiation. They returned to normal 1 ~ 2 years after exposure. " The levels of immunoglobulin G (Ig) G in 5, 11 and 13 years after irradiation were higher than those in the control group. The levels of complement 3 were low in 6 months and 2 years after exposure, and the percentage of CD3 CD4 T cells and CD3 CD8 were higher in 3 cases of patients with higher IgG level 5 years after exposure to "Tiantian" than in 6 months after exposure to radiation, and the percentage of CD3 CD4 T cells was higher than that of CD3 CD8 in the 6 months after exposure to radiation, and the percentage of CD3 CD4 T cells was higher than that of CD3 CD8. The percentage of T cells and the ratio of CD3 CD4 / CD3 CD8 were lower than the lower limit of normal reference value. Return to normal for the second year after exposure. " Mei "appeared amenorrhea after irradiation, spermatozoa began to decrease and spermatozoa appeared at 3 months after irradiation, and sperm number gradually returned to normal in 37 ~ 7 years after irradiation." After 15 years of irradiation, 3 patients with thyroid nodules developed lens opacity of varying degrees. Mei was treated with cataract extraction and intraocular lens implantation 13 years after irradiation. The micronucleus rate of blood lymphocytes around "Mei" and "Wang" was 3 鈥，
本文编号：2132250
[Abstract]:Objective to observe the long-term effects of acute radiation sickness (ARS) of bone marrow type. Methods three cases of bone marrow type ARS patients in Henan Province in 1999 were followed up for 15 years for long term effect of "Mei", "Tian" and "Wang". The changes of hematopoietic system, immune system, endocrine system, reproductive system and ophthalmology were observed. Results the leukocyte count, platelet count and hemoglobin decreased in 3 patients within one month after irradiation, and returned to normal 6 months after irradiation. The granulocyte-macrophage colony stimulating factor was lower in 3 patients at 6 months after irradiation. They returned to normal 1 ~ 2 years after exposure. " The levels of immunoglobulin G (Ig) G in 5, 11 and 13 years after irradiation were higher than those in the control group. The levels of complement 3 were low in 6 months and 2 years after exposure, and the percentage of CD3 CD4 T cells and CD3 CD8 were higher in 3 cases of patients with higher IgG level 5 years after exposure to "Tiantian" than in 6 months after exposure to radiation, and the percentage of CD3 CD4 T cells was higher than that of CD3 CD8 in the 6 months after exposure to radiation, and the percentage of CD3 CD4 T cells was higher than that of CD3 CD8. The percentage of T cells and the ratio of CD3 CD4 / CD3 CD8 were lower than the lower limit of normal reference value. Return to normal for the second year after exposure. " Mei "appeared amenorrhea after irradiation, spermatozoa began to decrease and spermatozoa appeared at 3 months after irradiation, and sperm number gradually returned to normal in 37 ~ 7 years after irradiation." After 15 years of irradiation, 3 patients with thyroid nodules developed lens opacity of varying degrees. Mei was treated with cataract extraction and intraocular lens implantation 13 years after irradiation. The micronucleus rate of blood lymphocytes around "Mei" and "Wang" was 3 鈥，
本文编号：2132250
本文链接：https://www.wllwen.com/yixuelunwen/yundongyixue/2132250.html
最近更新
教材专著
