职业性慢性放射病临床诊断及预后

目的：探讨慢性放射病（以下简称慢放病）的诊断、治疗及预后。方法：以受照剂量，临床症状，造血功能，Ｔ淋巴细胞百分率，染色体畸变率对３０例慢性放射损伤患者进行综合分析判断，对其中１１例慢放病用胸腺肽治疗并追踪观察１０年。结果：慢放病患者受照剂量超过２Ｓｖ，白细胞下降伴有几髓造血功能障碍，Ｔ淋巴细胞百分率下降，染色体畸变率显著上升。胸腺肽能改善临床症状，显著提高细胞免疫功能。慢放病各项指标恢复依时间顺序为：Ｔ淋巴细胞百分率（２年），临床症状（３．５年），造血功能（５～８年），染色体畸变率（１０年）。结论：受照剂量是误断慢放病的重要依据；白细胞总数、骨髓造血功能改变是诊断的关键；Ｔ淋巴细胞百分率、染色体畸变率可作为鉴别诊断指标。慢放病是一种可以恢复的职业性疾病，胸腺肽治疗有助于慢放病的恢复。

Diagnosis and Prognosis of Chronic Radiation Sickness due to Occupational Exposure

Objective:To study the diagnosis,treatment and prognosis of chronic radiation sickness.Methods:Thirty cases of chronic radiation sickness were assessed comprehensively with radiation dose,clinical symptoms,hematopoiesis,T lymphocyte percentage and chromosome aberration rate;11 of 30 cases were treated with thymopeptide and followed up for ten years.Results:The cases received dose of over 2 Sv,had gradually decreased WBC counts,dysfunction in bone marrow,decreased T lymphocyte percentage and increased chromosome aberration rate.Thymopeptide treatment greatly improved the clinical symptoms and increased the immune function.In order of time,the indexes for recovery from the chronic radiation sickness were as follows:T lymphocyte percentage (2 years),clinical symptoms (3.5 years);bone marrow hematopoiesis (5 to 8 years) and chromosome aberration (10 years).Conclusion:Radiation dose may be important for diagnosing chronic radiation sickness and white blood cell counts and bone marrow hematopoiesis essential;T lymphocyte percentage and chromosome aberration can be used in differentiation diagnosis;thymopeptide may be helpful to treat chronic radiation sickness.