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目的 研究胸部受电离辐射后外周血细胞的变化特点。方法 选取１９９７ ～１９９８ 年非小细胞肺癌患者３０ 例。按１∶２ 配比年龄相似，性别相同的非放疗慢性病患者作为对照组。观察胸部外照射对外周血白细胞、淋巴细胞、血小板数的影响。ＮＳＣＬＣ以医用直线加速器６ ＭＶ－ Ｘ 线，常规分割放射治疗。射野包括肿瘤及其周围１ ～２ｃｍ 正常肺组织，同侧肺门以及纵膈，有时包括锁骨上区ＦＳＺ（Ｆｉｅｌｄｓｑｕａｒｅｚｏｏｍ） ７２ ～２４６ｃｍ２ ，剂量率２Ｇｙ／ｍｉｎ ，ＳＳＤ１００ｃｍ 。采用ＳＷＧＥＡＢＡＣ－ ９２０ 型血液细胞自动分析仪检测外周血白细胞、淋巴细胞、血小板数，并严格质量控制。结果 当吸收剂量１０Ｇｙ／５ｆ／ Ｗ ，ＮＳＣＬＣ外周血细胞数量开始下降；至２０ ～３０Ｇｙ／１０ ～１５ｆ／２ ～３ Ｗ 时，其外周血细胞数量降至低谷。并且上述３ 种细胞数量较之放疗前和对照组具有显著差异（ｔ＞ ２．５８ ，Ｐ＜ ０．０１）。另外，局部照射野＞ １００ｃｍ２ 组外周血白细胞数显著低于照射野为＜ １００ｃｍ２ 组，（ Ｆ＝６ ．４６，Ｐ＜ ０ ．０１）。在缩野和改侧斜野，放疗第四周（Ｄｔ＝ ４０Ｇｙ） 后，局部受损骨髓开始修复，受照区内的毒性产物被迅速稀
Objective To study the changes of peripheral blood cells after ionizing radiation in the chest. Methods Thirty patients with non-small cell lung cancer from 1997 to 1998 were selected. By 1: 2 ratio of similar age, gender, the same non-radiotherapy chronic disease patients as a control group. To observe the effect of extrathoracic irradiation on peripheral blood leucocytes, lymphocytes and platelets. NSCLC to medical linear accelerator 6 MV-X, conventional radiotherapy. The field includes the tumor and its surrounding 1 ~ 2cm normal lung tissue, ipsilateral hilar and mediastinum, sometimes including the supraclavicular region FSZ (Fieldsquarezoom) 72 ~ 246cm2, dose rate 2Gy / min, SSD100cm. Using SWGEABAC-920 automatic blood cell analyzer to detect peripheral blood leukocytes, lymphocytes, platelets, and strict quality control. Results At the dose of 10Gy / 5f / W, the number of peripheral blood cells in NSCLC began to decline. When the cell number was 20-30Gy / 10-15f / 2 ~ 3W, the number of peripheral blood cells decreased to a low level. The number of the above three cells was significantly different from that before radiotherapy and the control group (t> 2.58, P <0.01). In addition, the number of leukocytes in peripheral blood> 100cm2 in local irradiation field was significantly lower than that in irradiation field <100cm2 group (F = 6.46, P <0.01). In the shrinking and changing the side of the field, the fourth week of radiotherapy (Dt = 40Gy), the local repair of damaged bone marrow, the irradiated area of the toxic products were rapidly diluted