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目的研究山东济宁辐射事故2例放射病患者血清中反映肾功能损伤程度的血清尿素氮(BUN)、肌酐(Cre)、β2-微球蛋白(β2-MG)和尿酸(UA)浓度的变化情况,以评估2例放射病患者肾功能损伤的情况。方法血清BUN采用尿素酶法,血清肌酐浓度和UA采用酶促反应动力学方法,β2-微球蛋白采用免疫比浊法。结果辐射事故后,2例受照者(病例A受照剂量在20～25Gy,病例B受照剂量在9～15Gy)照后血清BUN浓度都有不同程度的升高,而且有逐渐升高的趋势。受照剂量愈大,血清BUN浓度升高愈早。与血清BUN的升高类似,2例受照者的血清Cre浓度也有逐渐升高的趋势。受照剂量愈大,血清Cre浓度升高幅度愈大,升高时间愈早。与正常参考值比较,辐射事故后2例受照者的血清尿酸浓度都在正常范围,但在此范围内都有几个增高期;血清β2-MG浓度呈逐渐升高的趋势,受照剂量愈大,浓度升高愈早。结论射线直接作用于肾脏,可直接造成肾脏组织细胞的放射性损伤;射线作用于人体的其他组织器官,也可引起机体大量的组织细胞变性坏死,毒物和变性坏死细胞的分解产物大量增加,加重了肾脏的负担,使肾功能严重受损。
Objective To study the changes of serum urea nitrogen (BUN), creatinine (Cre), β2-microglobulin (β2-MG) and uric acid (UA) in serum of 2 patients with radiotherapy from radiation accident in Jining, Shandong Province, To assess the 2 cases of radiation sickness patients with renal damage. Methods Serum BUN was determined by urease method, serum creatinine concentration and UA by enzymatic reaction kinetics, β2-microglobulin by immune turbidimetry. Results After radiation accident, the levels of serum BUN were increased to some extent in 2 irradiated patients (20 ~ 25Gy in case A and 9 ~ 15Gy in case B) trend. The larger the dose, the sooner the serum BUN level rises. Similar to the increase of serum BUN, the concentration of Cre in serum of 2 subjects also showed a gradual increase trend. The larger the dose, the greater the increase of serum Cre concentration, the earlier the rise time. Compared with the normal reference value, serum uric acid concentrations of the two irradiated subjects were in the normal range, but there were several increases in this range; serum β2-MG concentration showed a gradual upward trend, The bigger, the earlier the concentration increases. Conclusions The radiation acts directly on the kidney and can directly cause the radioactive damage of the kidney tissue cells. The radiation acts on other tissues and organs of the human body, which can also cause a large number of tissue cells to degenerate and necrosis, and the toxic and denatured necrotic cells increase greatly The burden on the kidneys, serious damage to renal function.