Neriishi Kazuo, Nakashima Eiji, Minamoto Atsushi, Fujiwara Saeko, Akahoshi Masazumi, Mishima Hiromu K, Kitaoka Takashi, Shore Roy E
Department of Clinical Studies (Hiroshima), Radiation Effects Research Foundation, Japan.
Radiat Res. 2007 Oct;168(4):404-8. doi: 10.1667/RR0928.1.
Recent evidence argues against a high threshold dose for vision-impairing radiation-induced cataractogenesis. We conducted logistic regression analysis to estimate the dose response and used a likelihood profile procedure to determine the best-fitting threshold model among 3761 A-bomb survivors who underwent medical examinations during 2000-2002 for whom radiation dose estimates were available, including 479 postoperative cataract cases. The analyses indicated a statistically significant dose-response increase in the prevalence of postoperative cataracts [odds ratio (OR), 1.39; 95% confidence interval (CI), 1.24-1.55] at 1 Gy, with no indication of upward curvature in the dose response. The dose response was suggestive when the restricted dose range of 0 to 1 Gy was examined. A nonsignificant dose threshold of 0.1 Gy (95% CI, <0-0.8) was found. The prevalence of postoperative cataracts in A-bomb survivors increased significantly with A-bomb radiation dose. The estimate (0.1 Gy) and upper bound (0.8 Gy) of the dose threshold for operative cataract prevalence was much lower than the threshold of 2-5 Gy usually assumed by the radiation protection community and was statistically compatible with no threshold at all.
近期证据反驳了致盲性辐射诱发白内障形成存在高阈值剂量这一观点。我们进行了逻辑回归分析以估计剂量反应，并采用似然轮廓法在3761名原子弹爆炸幸存者中确定最佳拟合阈值模型，这些幸存者在2000 - 2002年期间接受了医学检查且有可用的辐射剂量估计值，其中包括479例术后白内障病例。分析表明，术后白内障患病率在1 Gy时存在统计学显著的剂量反应增加[比值比（OR）为1.39；95%置信区间（CI）为1.24 - 1.55]，且剂量反应无向上弯曲迹象。在检查0至1 Gy的受限剂量范围时，剂量反应具有提示性。发现非显著的剂量阈值为0.1 Gy（95% CI，<0 - 0.8）。原子弹爆炸幸存者中术后白内障的患病率随原子弹辐射剂量显著增加。手术性白内障患病率的剂量阈值估计值（0.1 Gy）和上限（0.8 Gy）远低于辐射防护界通常假定的2 - 5 Gy阈值，并且在统计学上与完全无阈值相符。
