Zhang Guoru, Li Yongjun, Wang Mei, Guo Bingyan, Lyu Xinhu, Liu Jin-Bo, Liu Dongchao, Chang Liang
Department of Cardiovascular Disease, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050005, China.
Department of Cardiovascular Disease, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050005, China. Emai:
Chin Med J (Engl). 2014;127(11):2058-62.
It is desirable to minimize the risk of adverse radiation effects associated with percutaneous coronary intervention. The aim of this study was to determine the impact of prolonging the interval between coronary angiography and percutaneous coronary intervention on X-ray-induced DNA double-strand breaks in blood lymphocytes using γ-H2AX immunofluorescence microscopy.
Blood samples of eight patients were taken before the first exposure to ionizing radiation, 10 minutes, 20 minutes, 30 minutes, 1 hour, and 24 hours after the last exposure to determine the γ-H2AX foci repair kinetics. Fifty-eight patients undergoing percutaneous coronary intervention were randomized to an intermittent radiation exposure group and a continuous radiation exposure group. Blood samples were taken before coronary angiography and 15 minutes after the last exposure. By enumerating γ-H2AX foci, the impact of prolonging the interval on DNA double-strand breaks was investigated. Student t-test was used to compare the difference in DNA double-strand breaks between the two groups.
An increase in foci was found in all patients received percutaneous coronary intervention. The maximum number of γ-H2AX foci was found 10-20 minutes after the end of the last exposure. There was no statistically significant difference between the two groups in γ-H2AX foci at baseline. On average there were (0.79 ± 0.15) γ-H2AX foci induced by interventional X-rays per lymphocyte in the continuous radiation exposure group and (0.66 ± 0.21) in the intermittent radiation exposure group after exposure (P < 0.05).
A significant number of γ-H2AX foci develop following the percutaneous coronary intervention procedures. The number of X-ray-induced DNA double-strand breaks may be decreased by prolonging the interval time between coronary angiography and percutaneous coronary intervention to 30 minutes.
将经皮冠状动脉介入治疗相关的不良辐射影响风险降至最低是可取的。本研究的目的是使用γ-H2AX免疫荧光显微镜确定延长冠状动脉造影与经皮冠状动脉介入治疗之间的间隔时间对血液淋巴细胞中X射线诱导的DNA双链断裂的影响。
采集8例患者在首次暴露于电离辐射前、最后一次暴露后10分钟、20分钟、30分钟、1小时和24小时的血样，以确定γ-H2AX焦点修复动力学。58例行经皮冠状动脉介入治疗的患者被随机分为间歇性辐射暴露组和持续性辐射暴露组。在冠状动脉造影前和最后一次暴露后15分钟采集血样。通过计数γ-H2AX焦点，研究延长间隔时间对DNA双链断裂的影响。采用Student t检验比较两组之间DNA双链断裂的差异。
所有接受经皮冠状动脉介入治疗的患者均发现焦点增加。在最后一次暴露结束后10 - 20分钟发现γ-H2AX焦点的最大数量。两组在基线时γ-H2AX焦点无统计学显著差异。暴露后，持续性辐射暴露组平均每个淋巴细胞由介入性X射线诱导的γ-H2AX焦点为(0.79 ± 0.15)个，间歇性辐射暴露组为(0.66 ± 0.21)个(P < 0.05)。
经皮冠状动脉介入治疗后会出现大量γ-H2AX焦点。将冠状动脉造影与经皮冠状动脉介入治疗之间的间隔时间延长至30分钟可能会减少X射线诱导的DNA双链断裂数量。
