Verzijl J M, Wierckx F C, Hennen L A, van Dijk A, Glerum J H
Department of Pharmacy, Central Military Hospital, Ministry of Defense, Utrecht, The Netherlands.
Health Phys. 1995 Oct;69(4):521-9. doi: 10.1097/00004032-199510000-00011.
Radiocesium, an isotope released after nuclear accidents such as Chernobyl, causes damage to the health of humans after internal contamination. As a result of an internal deposit of radiocesium these persons are continuously irradiated and noxious effects may occur. Removal of this internal radiation source will reduce immediate (short-term) and future damage (long-term). In order to obtain data with respect to cesium kinetics in vivo, data obtained in dogs by Nold et al. were fitted by a computer program. On the basis of these data, simulations were carried out to evaluate the influences of extracorporeal clearance on cesium kinetics. The influence of various treatments on the committed effective dose [E(50)] as a measure of radiation harm was simulated. For this purpose an equivalence between the committed effective dose and the area under the curve, a kinetic parameter, was derived. This equivalence only holds when comparisons are made for different treatments of one subject contaminated with one isotope. Treatment with orally administered Prussian Blue salts reduces the committed effective dose by 29% (50 y). This can be insufficient to prevent deterministic effects as a result of a severe internal contamination with radiocesium. For this purpose other methods are evaluated. In simulations, extracorporeal clearance (e.g. hemoperfusion or hemodialysis) proved to be more effective in reducing E(50) (> 50%, 50 y). Extracorporeal clearance also seems to be effective in the early dose reduction and its consequent deterministic effects. Simulations revealed that effectiveness is improved when the treatment is started earlier and continued for a longer period. Effective extracorporeal clearance may be considered to be a promising method to treat victims of nuclear accidents internally contaminated with radiocesium.
放射性铯是切尔诺贝利等核事故后释放的一种同位素，人体内部受到污染后会对健康造成损害。由于放射性铯在体内沉积，这些人会持续受到辐射，可能会产生有害影响。清除体内的这种辐射源将减少即时（短期）和未来的损害（长期）。为了获得体内铯动力学的数据，诺尔德等人在狗身上获得的数据由一个计算机程序进行拟合。基于这些数据，进行了模拟以评估体外清除对铯动力学的影响。模拟了各种治疗方法对作为辐射危害度量的待积有效剂量[E(50)]的影响。为此，推导了待积有效剂量与曲线下面积（一个动力学参数）之间的等效关系。只有在对受一种同位素污染的同一受试者的不同治疗方法进行比较时，这种等效关系才成立。口服普鲁士蓝盐进行治疗可使待积有效剂量降低29%（50年）。对于因严重的放射性铯体内污染而导致的确定性效应而言，这可能不足以起到预防作用。为此，对其他方法进行了评估。在模拟中，体外清除（如血液灌流或血液透析）在降低E(50)方面被证明更有效（>50%，50年）。体外清除在早期剂量降低及其随之而来的确定性效应方面似乎也很有效。模拟结果表明，治疗开始得越早且持续时间越长，效果越好。有效的体外清除可被认为是治疗体内受到放射性铯污染的核事故受害者的一种有前景的方法。
