Health effects in those with acute radiation sickness from the Chernobyl accident
Health effects in those with acute radiation sickness from the Chernobyl accident
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DOI：
10.1097/01.hp.0000278843.27969.74
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发表时间：
2007-11-01
期刊：
影响因子：
2.2
通讯作者：
Gusev, Igor
中科院分区：
文献类型：
--
作者：
Mettler, Fred A., Jr.;Gus'kova, Angelina K.;Gusev, Igor
切尔诺贝利事故导致了全世界报告的近三分之一的急性放射病(ARS)病例。病例发生在工厂员工和急救人员中，但不发生在疏散人口或普通民众中。根据恶心、呕吐和腹泻的症状，237人最初被诊断为ARS。最终，134人被确诊为ARS。有28例短期死亡，其中95%发生在全身剂量超过6.5Gy时。在前2个月内，潜在的骨髓衰竭是所有死亡的主要原因。13名患者接受了同种异体骨髓移植，另外6名患者接受了人胎肝细胞移植。所有这些患者都去世了，除了一名后来被发现恢复了自己的骨髓并拒绝接受移植的人。有两三名患者被认为死于移植并发症。皮肤剂量比骨髓剂量高出10-30倍，其中至少19人被认为主要是由于大面积贝塔烧伤造成的感染。内部污染在治疗中相对较小。到2001年底，又有14名急性呼吸综合征幸存者死于各种原因。长期的治疗包括贝塔烧伤纤维化和皮肤萎缩以及白内障的治疗。
The Chernobyl accident resulted in almost one-third of the reported cases of acute radiation sickness (ARS) reported worldwide. Cases occurred among the plant employees and first responders but not among the evacuated populations or general population. The diagnosis of ARS was initially considered for 237 persons based on symptoms of nausea, vomiting, and diarrhea. Ultimately, the diagnosis of ARS was confirmed in 134 persons. There were 28 short term deaths of which 95% occurred at whole body doses in excess of 6.5 Gy. Underlying bone marrow failure was the main contributor to all deaths during the first 2 mo. Allogenic bone marrow transplantation was performed on 13 patients and an additional six received human fetal liver cells. All of these patients died except one individual who later was discovered to have recovered his own marrow and rejected the transplant. Two or three patients were felt to have died as a result of transplant complications. Skin doses exceeded bone marrow doses by a factor of 10-30, and at least 19 of the deaths were felt to be primarily due to infection from large area beta burns. Internal contamination was of relatively minor importance in treatment. By the end of 2001, an additional 14 ARS survivors died from various causes. Long term treatment has included therapy for beta burn fibrosis and skin atrophy as well as for cataracts.