The Study On Radiation Dose And DNA Damage In Peripheral Blood Lymphocytes Of Patients Induced By Ionizing Radiation In Cardiovascular Intervention

Objective To record and compare the dose parameters of X-ray in different types ofcardiovascular intervention.To measure the DNA damage of patients before and afterthe radiation exposure and analyse the correlation between radiation dose and DNAdamage, to discuss the effect factors of radiation dose and radiation protection.Methods1)300cases of cardiovascular intervention were selected randomly inDepartment of Cardiology,The First Affiliated Hospital of Anhui MedicalUniversity.The dose area product(DAP) and cumulative skin entrance radiationdose(CD) and fluoroscopy time(FT) and radiography frames(RF) were compared,andthe effect factors of radiation dose were analyzed.2)100patients undergoingcardiovascular intervention were divided into four groups according to thecharacteristics of intervention procedures:percutaneous coronaryintervention(PCI,n=35);percutaneous coronary angiography(CAG,n=31);radiofrequencyablation surgery(RFCA,n=20);and permanent cardiac pacemakerimplantation(PCPI,n=14).The peripheral blood was collected before and24h after theradiation exposure,then index of DNA damage were measured by neutral single cell gelelectrophoresis(SCGE):TDNA%(tail DNA content) and TM(tail moment).Finally,theradiation dose and DNA damage were compared with each other,and the correlation ofdose-response was analyzed.Results1)The DAP values of group CAG,group RFCA,group PCPI and group PCI were(34.22±14.47),(79.82±33.76),(94.65±41.2),(136.11±35.15)Gycm2;the CD valueswere(0.43±0.21),(0.73±0.41),(0.98±0.4),(1.42±0.70)Gy;and the FT valueswere(4.85±1.76),(17.11±6.31),(5.32±1.55),(16.74±6.11)min;and the RF valueswere(512±123),(35±15),(114±34),(932±258).The DAP and CD values of PCI weresignificantly higher than the other three groups(P<0.01),the FT of RFCA and PCI weresignificantly higher than CAG and PCPI(P<0.01),the RF of PCI were significantlyhigher than other groups(P<0.01) and RFCA was the lowest.2)The TDNA%and TMvalues of100patients were significantly higher24h after operation thanbefore(P<0.01),the group PCI were the highest,there was a positive correlation betweenTDNA%,TM and DAP,CD(P<0.01).Conclusion1)The radiation dose differs significantly from one to another type ofintervention procedure and is influenced by many factors,including parameters of DSAmachine, technical skill of interventional cardiologists,complexity of disease,fluoroscopy time,radiography frames and so on.2)radiation with any dose incardiovascular intervention can definitely induce DNA damage, the higher radiationdose is,the more DNA damage is.To avoid the health risk of radiation,we shouldenhance the awareness of interventional cardiologists in radiation protection andimprove protective measures for patients,and reasonable diagnosis and treatment isnecessary.to avoid the stochastic effects of radiation.