目的 探讨职业电离辐射与放射医务人员外周血象的关系,为放射医务人员防护工作提供理论依据。方法 采用横断面研究以2015—2019年在东莞市某医院进行电离辐射职业健康体检的814例放射医务人员为暴露组,以同期体检748例非放射人员为对照组,通过问卷调查、个人剂量监测及实验室检测的方式收集资料,采用广义线性回归探讨职业电离辐射暴露与放射医务人员外周血象的关联性。结果 与对照组相比,暴露组放射医务人员红细胞压积、血红蛋白、血小板分布宽度和红细胞水平高,而血小板、红细胞平均血红蛋白量、红细胞平均血红蛋白浓度、血小板平均体积、中性粒细胞及白细胞水平低,差异均有统计学意义(P值均<0.05)。广义线性回归分析显示,在控制混杂因素后,职业暴露与放射医务人员的红细胞($\beta$=0.066,95%CI:0.017~0.114)和血小板分布宽度($\beta$=0.356,95%CI:0.168~0.545)水平呈正相关,与血小板($\beta$=-7.070,95%CI:-12.481~-1.659)、红细胞平均血红蛋白量($\beta$=-0.507,95%CI:-0.804~-0.209)、红细胞平均血红蛋白浓度($\beta$=-3.561,95%CI:-4.888~-2.234)、血小板平均体积($\beta$=-0.322,95%CI:-0.469~-0.175)、中性粒细胞($\beta$=-0.207,95%CI:-0.342~-0.072)和白细胞($\beta$=-0.253,95%CI:-0.419~-0.087)水平呈负相关。结论 职业电离辐射对放射医务人员外周血象有影响。
Abstract
Objective To explore the relationship between occupational ionizing radiation and peripheral blood of medical radiologists so as to provide theoretical basis for the protection of medical radiologists. Methods In a cross-sectional study,814 medical radiologists engaged in occupational health examination of ionizing radiation in a hospital in Dongguan City from 2015 to 2019 were selected as the exposure group,and 748 non-radiologists as the control group.Data were collected through questionnaire survey,personal dose monitoring and laboratory testing.The relationship between occupational ionizing radiation exposure and peripheral blood of medical radiologists was studied by generalized linear regression. Results Compared with the control group,hematocrit,hemoglobin,platelet distribution width and red blood cell level were higher in the exposed group,while platelet,mean corpuscular hemoglobin,mean corpuscular hemoglobin concentration,mean platelet volume,neutrophil and white blood cell levels were lower,the differences were statistically significant (P <0.05).Generalized linear regression analysis showd that after controlling confounding factors,occupational exposure and medical radiologists was positively correlated with the level of red blood cell ($\beta$= 0.066,95%CI:0.017~0.114) and platelet distribution width ($\beta$=0.356,95%CI:0.168~0.545),and negatively correlated with platelet ($\beta$=-7.070,95%CI:-12.481~-1.659),mean corpuscular hemoglobin($\beta$=-0.507,95%CI:-0.804~-0.209),mean corpuscular hemoglobin concentration($\beta$=-3.561,95%CI:-4.888~-2.234),mean platelet volume($\beta$=-0.322,95%CI:-0.469~-0.175),neutrophils($\beta$=-0.207,95%CI:-0.342~-0.072) and white blood cell levels($\beta$=-0.253,95%CI:-0.419~-0.087). Conclusion Occupational ionizing radiation has influence on peripheral blood of medical radiologists.
关键词
电离辐射 /
放射医务人员 /
外周血象 /
职业暴露
Key words
Ionizing radiation /
Medical radiologists /
Peripheral blood hemogram /
Occupational exposure
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基金
东莞市社会科技发展(一般)项目(202050715005667)
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