摘要
目的分析长期接触低剂量电离辐射医疗职业人群甲状腺激素水平的变化以及甲状腺结节的患病情况，为制订电离辐射防护标准和开展职业人群辐射防护提供科学依据。方法整理2016年南京市放射工作人员健康体检中12家三甲医院的724名医疗职业人员基本信息及职业性健康体检资料。资料包括问卷调查、职业体检数据、甲状腺激素水平检测数据和甲状腺超声检查结果。将724名研究对象依其从事的工作类别进行分类，其中放射诊断组以医学影像科为主；放射治疗组以肿瘤科、放疗科、脑外科为主；介入放射组以心内导管室、消化科、介入科为主；核医学组则以核医学科为主。用Logistic回归模型分析甲状腺机能相关的影响因素。结果（1）724名研究对象共检出甲状腺结节168例，占总频数的23.20%，甲状腺单侧、双侧囊肿及其他异常情况共101例，占总频数的13.95%。人群总甲状腺异常率为37.15%。（2）接触射线工龄1-9、10-19、20-29、〉30年的医务人员TSH的均值水平差异明显，差异具有统计学意义（P〈 0.05）。（3）多因素Logistic回归分析发现性别（OR=0.627；95%CI：0.446-0.882）、年龄（OR=1.058；95%CI：1.041-1.074）均为甲状腺结节异常的独立危险因素。结论 长期接触低剂量电离辐射可引起医疗职业人群的甲状腺损伤，应当予以关注。
Objective We evaluated the effect of low-dose of ionizing radiation on thyroid function of medical occupational group with long-term exposure;furthermore;we analyzed the relationship between the thyroid hormones and the risk factors;such as exposure length;department.Ultimately;providing the scientific basis for setting the ionizing radiation protection standards.MethodsThe population who engaged radiodiagnosis and radiotherapy in a tertiary-A hospital were set up as occupational exposure;724 medical professionals as the research object.We figured out the basic information and general condition of the groups by face-to-face questionnaire survey;By means of the thyroid hormone testing;we analyzed the thyroid hormone levels with different population;occupational exposure factors.Then;obtained the prevalence of thyroid nodules by the thyroid ultrasound.Besides;we used the logistic regression model to analyze the risk factors related to thyroid nodule.Applying Epidata、Excel in data management.All the data was analyzed by statistical software package Stata12.0.Descriptive statistics;single factor analysis of variance and other statistical methods were used for data analysis.Test standard：α=0.05、P〈0.05 statistical significant.Results1.Based on the work experience;we divided the study population into four groups;such as 1-9;10-19;20-29;and〉30 years.The difference of the TSH level among the four groups was statistically significant（P〈0.05）.2.The multiple logistic regression showed that sex and seniority were the independent risk factors for the abnormal rate of thyroid nodules.
Conclusion Long-term exposure to low-dose ionizing radiatiom could induce the thyroid damage of medical occupational population;which should be broader concerned.
作者
涂雷
王守林
董秋
宋海燕
李秀婷
谭成普
董翔
Tu Lei;Wang Shoulin;Dong qiu;Song Haiyan;Li Xiuting;Tan Chengpu;Dong Xiang(Nanjing Prevention and Treatment Center for Occupational Diseases, Nanjing 210042, China)
出处
《中华劳动卫生职业病杂志》
CAS
CSCD
北大核心
2018年第2期91-94,共4页
Chinese Journal of Industrial Hygiene and Occupational Diseases
基金
南京市科技计划项目（201715060）
