本文選題：C形臂X光機 + 氧化水平��； 參考：《吉林大學》2015年碩士論文

【摘要】：目前，越來越多的C形臂X光機掃描被應用到骨科手術當中。雖然C形臂的和患者的健康產(chǎn)生了輻射損害。C形臂X光機的高頻使用或者濫用導致醫(yī)護人員和患者受到低劑量電離輻射照射，，累積的電離輻射可能導致受照人群（醫(yī)護人員、患者和家屬）發(fā)生隨機性效應或確定性效應。此外，如何做好C形臂X光機在術中的輻射防護也是放射防護領域亟需解決和關注的問題。 低劑量電離輻射誘導的效應主要包括損傷效應和有益效應，這兩種生物效應存在巨大的爭議。低劑量電離輻射誘導的有益效應包括興奮性效應和適應性反應，而損傷效應則包括確定性效應和、隨機性效應、旁效應、遺傳效應和基因組不穩(wěn)定性等。根據(jù)人群流行病學資料（日本原子彈爆炸幸存者數(shù)據(jù)），低劑量電離輻射誘導的損傷效應呈線性無閾模型，即輻射人群的癌癥風險和與輻射劑量呈線性關系�？茖W家對線性無閾模型（LNT）的主要存在有兩種截然不同的觀點，一是線性無閾模型可能過高評估了輻射致癌風險，①100mSv-50mSv的輻射劑量不能誘發(fā)顯著的生物效應；②輻射高本底的研究結果不能充分證實輻射損傷效應；③低劑量電離輻射能誘導有益效應；④電離輻射導致機體的DNA損傷，未必一定誘發(fā)癌癥或者惡性腫瘤。二是線性無閾模型可能低估了電離輻射誘導的癌癥風險，①電離輻射可以誘導旁效應；②存在輻射超敏感人群和基因組不穩(wěn)定性。研究表明C形臂單次掃描或者少量多次掃描均在低劑量電離輻射的范圍內(nèi)，低劑量電離輻射誘導的生物效應尚且存在較大爭議。所以研究C形臂X光機輻射誘導的生物效應不僅能豐富低劑量電離輻射理論，還能為輻射暴露人群提供相應的理論依據(jù)。 目的 研究C形臂X光機急性掃描對小鼠機體的生物效應 方法 將健康雄性BALB/c小鼠60只隨即分為對照組、單次、四次、八次、十二次掃描組，每組12只。對照組小鼠不掃描，掃描組用C形臂X光機對小鼠進行全身掃描。用熱釋光劑量計測量每個實驗組小鼠的吸收劑量率。在照射24小時后，制備并凍存細胞懸液、血清和小鼠的甲狀腺組織。采用生物化學方法檢測小鼠甲狀腺組織中超氧化物歧化酶（SOD）和丙二醛（MDA）的水平；采用酶聯(lián)免疫吸附試驗(ELISA)檢測血清中IL-4和IFN-γ的變化；流式細胞儀檢測各照射組小鼠外周血淋巴和骨髓細胞的凋亡水平。 結果 1.不同次數(shù)C形臂X光機掃描對小鼠甲狀腺組織中MDA水平的影響 甲狀腺組織上清經(jīng)試劑盒檢測結果：和對照組相比，八次和十二次C形臂掃描顯著增加了甲狀腺中MDA的水平，并且MDA的水平在十二次C形臂掃描后達到頂峰，甲狀腺組織中的MDA水平分別升高了2.39、3.49倍，差異具有統(tǒng)計學意義（F=8.31，P0.05）。 2.不同次數(shù)C形臂X光機掃描誘導的SOD水平變化 甲狀腺組織上清經(jīng)試劑盒檢測結果：和對照組相比，四次、八次和十二次C形臂掃描極大的降低了甲狀腺中的SOD活性，SOD水平分別降低了19.23%、25.80%和27.95%（F=4.61, P0.05）。 3.不同次數(shù)C形臂掃描誘導的血清IFN-γ和IL-4水平 血清經(jīng)ELISA試劑盒檢測結果：和對照組相比，血清IFN-γ和IL-4水平在四次、八次、十二次C形臂掃描后呈下降趨勢，在十二次C形臂掃描后兩者水平達到最低值，血清IFN-γ和IL-4水平在四次以上掃描后分別降低了14.71%和22.60%、22.99%和44.05%、31.70%和44.43%，差異有統(tǒng)計學意義（F=59.26，P0.05）; IFN-γ/IL-4比值在不同次數(shù)照射后均無顯著變化，差異無統(tǒng)計學意義（F=12.47，P0.05）。 4.不同次數(shù)C形臂掃描誘導外周血淋巴細胞凋亡水平變化 外周血淋巴細胞經(jīng)流式細胞儀檢測結果：和對照組相比，八次和十二次C形臂掃描增加了小鼠外周血淋巴細胞的凋亡水平，凋亡水分別增加了1.68、2.40倍，差異有統(tǒng)計學意義（F=23.56，P0.05）。 5.不同次數(shù)C形臂掃描誘導骨髓細胞的凋亡水平變化 骨髓細胞經(jīng)流式細胞儀檢測結果：和對照組相比，十二次C形臂掃描增加了骨髓細胞的凋亡水平，凋亡水平增加了2.02倍，差異有統(tǒng)計學意義（F=19.31，P0.05）。 結論 C形臂X光機多次掃描改變了機體的氧化水平和免疫學相關指標。另外，機體通過啟動凋亡來為維持基因組穩(wěn)定性。
[Abstract]:At present , more and more C - arm X - ray machine scanning has been applied to orthopedic surgery . Although C - arm and patient ' s health produce radiation damage , high - frequency use or abuse of C - arm X - ray machine can lead to random or deterministic effects of medical personnel and patients with low - dose ionizing radiation . Furthermore , how to do well the radiation protection of C - arm X - ray machine in operation is a problem that needs to be solved and cared for in radiation protection field .

The effects of low - dose ionizing radiation mainly include damage effect and beneficial effect , and the two biological effects are controversial . The beneficial effects induced by low - dose ionizing radiation include excitatory effect and adaptive response , but the damage effects include deterministic effects , random effects , side effects , genetic effects and genomic instability .
( 2 ) The results of high radiation background can not fully confirm the effect of radiation damage ;
( 3 ) Low - dose ionizing radiation can induce beneficial effects ;
( 4 ) Ionizing radiation leads to DNA damage in the organism , which may not necessarily induce cancer or malignancy . Second , the linear non - threshold model may underestimate the risk of ionizing radiation - induced cancer , and ( 1 ) ionizing radiation can induce side effects ;
The results show that the biological effects induced by low dose ionizing radiation are not only rich in low dose ionizing radiation , but also can provide theoretical basis for radiation exposure .

Purpose

Study on the Biological Effects of Acute Scan of C - arm X - ray Machine on Mice

method

Sixty healthy male BALB / c mice were randomly divided into two groups : control group , single , four , eight , and ten second scanning groups , 12 in each group . The control group mice did not scan , the scanning group scanned the mice with C - arm X - ray machine . After 24 hours of irradiation , the cells were prepared and frozen . The levels of superoxide dismutase ( SOD ) and malondialdehyde ( MDA ) in thyroid tissues of mice were detected by biochemical method .
ELISA was used to detect the changes of IL - 4 and IFN - 緯 in serum .
Flow cytometry was used to detect the level of apoptosis in peripheral blood lymphocytes and bone marrow cells of irradiated mice .

Results

Effect of different times of C - arm X - ray machine scanning on the level of MDA in thyroid tissue of mice

Results : Compared with the control group , the levels of MDA in the thyroid were significantly increased compared with the control group , and the level of MDA increased 2.39 , 3.49 times higher than that in the thyroid tissues ( F = 8.31 , P0.05 ) .

2 . Changes of SOD level induced by X - ray machine scanning at different times

Results : Compared with the control group , four , eight and ten C - arm scans significantly decreased the SOD activity in the thyroid , and the SOD level decreased by 19.23 % , 25.80 % and 27.95 % ( F = 4.61 , P0.05 ) .

3 . Serum IFN - 緯 and IL - 4 levels induced by C - arm scans at different times

The levels of IFN - 緯 and IL - 4 decreased by 14.71 % and 22.60 % , 22.99 % and 44.05 % , 31.70 % and 44.43 % , respectively .

4 . Changes of apoptosis in peripheral blood lymphocytes induced by C - arm scans of different times

Compared with the control group , eight and ten C - arm scans increased the level of apoptosis in peripheral blood lymphocytes of mice , and the apoptotic water increased by 1 . 68 and 2 . 40 times , respectively ( F = 23.56 , P0.05 ) .

5 . Changes of apoptosis in bone marrow cells induced by C - arm scans of different times

Compared with the control group , the apoptosis level of bone marrow cells increased by 2 . 02 times , and the difference was statistically significant ( F = 19.31 , P0.05 ) .

Conclusion

C - arm X - ray machine multiple scans have changed the body ' s oxidation level and immunological correlation index . In addition , the organism can maintain genome stability by initiating apoptosis .
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R687

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