核电厂事故后生活在受辐射污染地区儿童骨密度增加形成机制的影响因素。

D A Bazyka, K M Bruslova, L O Lyashenko, N M Tsvetkova, T I Pushkariova, S G Galkina, V G Kondrashova, Zh S Yaroshenko, L O Gonchar, V G Boyarskyi, T O Charnysh, I V Tryhlib, L O Tsvet
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引用次数: 0

摘要

目的:根据病例史、临床和实验室数据,包括在ChNPP事故后生活在放射性污染地区(RCT)的儿童中参与骨化过程的激素测定,与规范的骨密度模式进行比较,确定骨密度增加的原因。材料与方法:289名儿童参与研究。第一组包括骨密度大于100 IU的人,第二组-骨密度正常(100-85 IU)的人。评估家族史,包括癌症、内分泌疾病、胆石症和尿石症。儿童出生时体重、骨折频率、痛症、颌骨异常、龋齿、有无肥胖、外周血计数、血液生化参数(总蛋白、肌酐、铁、碱性磷酸酶、钙)、血清垂体促甲状腺激素和皮质醇。儿童的辐射剂量是根据《切尔诺贝利事故后暴露于放射性污染的乌克兰定居点一般剂量学认证》的材料计算的。结果:不论性别,青春期后的儿童骨密度值高于正常值,青春期后的儿童骨密度值高于正常值(p < 0.001)。骨密度升高的儿童骨折频率与骨密度呈正相关(p < 0.01)。颌骨异常和龋齿发生率明显低于正常骨密度组(p < 0.05)。肥胖与骨密度之间存在直接相关性(p < 0.001)。碱性磷酸酶活性升高与骨密度呈负相关(rs = -0.21;p < 0.05)。在骨密度升高的儿童中,铁水平与家族史中内分泌疾病之间存在直接相关性(> 0.001)。血清皮质醇水平与龋病直接相关(p < 0.05)。在儿童中,无论骨密度值如何,辐射剂量、年龄和肥胖之间都存在直接相关性(p < 0.001)。结论:儿童骨密度高于标准伴随着骨折、颌骨异常、骨组织代谢改变和骨组织激素调节的频率增加,需要应用病理治疗进行成骨。
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FACTORS AFFECTING MECHANISMS OF INCREASED BONE DENSITY FORMATION IN CHILDREN LIVING ON RADIOLOGICALLY CONTAMINATED TERRITORIES AFTER THE ChNPP ACCIDENT.

Objective: to determine the causes of increased bone mineral density (BMD) based on case history, clinical and laboratory data, including the assay of hormones involved in ossification processes in children, living on radiologically contaminated territories (RCT) after the accident at the ChNPP, compared to the normative BMD patterns.

Materials and methods: There were 289 children involved in the study. The 1st group included persons with a BMD above 100 IU, 2nd group - with normative BMD (100-85 IU). Family history of diseases was assessed featuring cancer and endocrine diseases, cholelithiasis, and urolithiasis. Weight of the child at birth, frequency of bone fractures, complaints about osalgia, jaw abnormalities, dental caries, presence or absence of obesity, peripheral blood count, blood biochemical parameters (total protein, creatinine, iron, alkaline phosphatase, calcium), serum pituitary thyroid-stimulating hormone and cortisol were accounted. Children's radiation doses were calculated according to the materials of the «General dosimetric certification of settlements of Ukraine that were exposed to radioactive contamination after the Chornobyl accident».

Results: Higher than normative BMD values were found in children after puberty, while normative ones - in puberty (р < 0.001), regardless of gender. A direct correlation between the bone fractures frequency was established in children with increased BMD (р < 0.01). Jaw anomalies and dental caries occurred at that significantly less often than in normative BMD (р > 0.05). A direct correlation was established between the obesity and BMD (р < 0.001).Increased alkaline phosphatase activity was inversely correlated with BMD (rs = -0.21; р < 0.05). In children with elevated BMD a direct correlation was established between the level of iron and endocrine disorders in the family history (р > 0.001). Serum level of cortisol was directly correlated with dental caries (р < 0.05). In children, regardless of BMD value, a direct correlation was established between the radiation dose, age and obesity (р < 0.001).

Conclusions: Higher than normative BMD is accompanied by an increased frequency of bone fractures, jaw abnormalities, metabolic changes in bone tissue and bone tissue hormonal regulation in children, which requires application of pathogenetic therapy for the osteogenesis.

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Problemy radiatsiinoi medytsyny ta radiobiolohii
Problemy radiatsiinoi medytsyny ta radiobiolohii Medicine-Radiology, Nuclear Medicine and Imaging
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