| 杨勇,王强,杨陆婷,等.低剂量电离辐射对医务放射工作人员甲状腺影响Meta分析[J].中华放射医学与防护杂志,2023,43(6):447-456.Yang Yong,Wang Qiang,Yang Luting,et al.Meta-analysis of the effects of low-dose ionizing radiation on the thyroid of medical radiation workers[J].Chin J Radiol Med Prot,2023,43(6):447-456 |
| 低剂量电离辐射对医务放射工作人员甲状腺影响Meta分析 |
| Meta-analysis of the effects of low-dose ionizing radiation on the thyroid of medical radiation workers |
| 投稿时间：2023-02-08 |
| DOI：10.3760/cma.j.cn112271-20230208-00030 |
| 中文关键词: 放射工作人员 电离辐射 甲状腺 Meta分析 |
| 英文关键词:Radiation worker Ionizing radiation Thyroid Meta analysis |
| 基金项目:杭州市科技计划引导项目（20191231Y055）；杭州市医药卫生科技项目（A20200566）；浙江省医药卫生科技计划项目（2022KY1043） |
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| 中文摘要: |
| 目的 评估低剂量电离辐射对医务放射工作人员甲状腺的影响。方法 检索1996—2022年发表的相关文献，按照纳入和排除标准筛选文献，最终纳入27篇文献，涉及22 937人。采用Stata 16.0开展Meta分析，分析血清中三碘甲状原氨酸（T3）、游离三碘甲状腺原氨酸（FT3）、甲状腺激素（T4）、游离四碘甲状腺原氨酸（FT4）、促甲状腺激素（TSH）水平和甲状腺结节检出率，并开展不同职业分类放射工作人员甲状腺功能的亚组分析。结果 采用随机效应模型分析，放射工作人员T3、T4水平的标准化均数差（SMD）分别为-0.19（-0.37，-0.01）和-0.34（-0.38，-0.30），与对照组比有降低的危险性（Z=2.07、-16.06，P<0.05）；放射工作人员FT4水平的SMD为0.22（0.06，0.39），与对照组比有升高的危险性（Z=2.61，P<0.05）；放射工作人员甲状腺结节发生相对危险度为1.47（1.19，1.82），与对照组比有升高的危险性（Z=3.58，P<0.05）。亚组分析结果表明介入放射学工作人员T3、T4、TSH水平的SMD分比为-0.29（-0.51，-0.07）、-0.31（-0.47，-0.15）、-0.43（-0.73，-0.13）（Z=-2.55、-3.86、-2.82，P<0.05），核医学工作人员T4水平SMD为-0.26（-0.45，-0.07），与对照组比有降低的危险性（Z=-2.70，P<0.05）。结论 长期低剂量电离辐射可能影响放射工作人员甲状腺素水平和甲状腺结节，尤其是介入放射学工作人员，应重点关注其放射防护。 |
| 英文摘要: |
| Objective To assess the effects of low-dose ionizing radiation on the thyroid of medical radiation workers.Methods Based on the inclusion and exclusion criteria, 27 articles, involving 22 937 individuals, were screened finally from relevant literature published from 1996 to 2022. Meta-analysis was carried out using Stata 16.0 for serum levels of triiodothyronine (T3), free triiodothyronine (FT3), thyroid hormone (T4), free thyroid hormone (FT4), thyrotropin-stimulating hormone (TSH) and thyroid nodule rates. As well, subgroup analysis were carried out of thyroid function in different types of radiation workers.Results The standardized mean difference (SMD) at T3 and T4 levels for radiation workers was -0.19 (-0.37,-0.01) and -0.34 (-0.38, -0.30), lower than that of control group (Z=2.07,-16.06,P<0.05). The SMD at FT4 levels for radiation workers was 0.22 (0.06, 0.39), higher than control group (Z=2.61, P<0.05). The relative risk of thyroid nodules in radiation workers was 1.47 (1.19,1.82), higher than that of control group (Z=-3.58, P<0.05). The analysis result for subgroup showed that the SMD for T3, T4 and TSH levels in the interventional radiology workers were -0.29 (-0.51, -0.07), -0.31 (-0.47, -0.15) and -0.43 (-0.73, -0.13) (Z=-2.55, -3.86, -2.82, P<0.05), respectively, and the SMD for T4 levels in the nuclear medicine workers was -0.26 (-0.45, -0.07), which meaned a reduced risk compared to the control group (Z=-2.70, P<0.05).Conclusions Long-term low doses of ionising radiation may have adverse effects on thyroid hormone and thyroid nodule in radiation workers, particularly in interventional radiology workers, and attention should be focused on their radiation protection. |
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