白俄罗斯受切尔诺贝利放射性沉降物影响的儿童和青少年甲状腺自身抗体的患病率。

Prevalence of thyroid autoantibodies in children and adolescents from Belarus exposed to the Chernobyl radioactive fallout.

作者信息

Pacini F, Vorontsova T, Molinaro E, Kuchinskaya E, Agate L, Shavrova E, Astachova L, Chiovato L, Pinchera A

机构信息

Institute of Endocrinology, University of Pisa, Italy.

出版信息

Lancet. 1998 Sep 5;352(9130):763-6. doi: 10.1016/s0140-6736(97)11397-6.

DOI:10.1016/s0140-6736(97)11397-6

PMID:9737280

Abstract

BACKGROUND

The long-term effects of ionising radiation, including radioiodine, on thyroid function are not well known. We compared thyroid immunity and function in two groups of children from Belarus, one of whom was exposed to the radioactive fallout of Chernobyl.

METHODS

We measured serum free thyroxine 4 (free T4), free T3, and thyrotropin hormone (TSH) and the prevalence of thyroid autoantibodies (antithyroglobulin and antithyroperoxidase), in 287 children or adolescents living in Hoiniki (average caesium contamination of 5.4 Ci/km2). We also studied 208 children and adolescents living in Braslav (average contamination <0.1 Ci/km2), who were age 12 years or less at the time of the Chernobyl accident.

FINDINGS

The prevalence of antithyroglobulin or antithyroperoxidase, or both, was significantly higher (p=0.0001) in individuals living in Hoiniki (56 [19.5%] of 287) than in those living in Braslav (eight [3.8%] of 208). In both villages, no sex differences were found in the antibody prevalence before age 13 years. Thereafter, a significantly higher prevalence of thyroid autoantibodies was found in girls from Hoiniki. The increase in the prevalence of circulating antibodies in the contaminated group was already apparent in individuals who, at the time of the accident, were in utero or newborn (15.7%), and was even more pronounced in children of 9 years or more (35.1%). No major alterations of serum FT-4, FT-3, or TSH were found.

INTERPRETATION

6-8 years after the Chernobyl accident, a significant increase in thyroid autoimmunity was found in children exposed to radioactive fallout. Pubertal age in girls is a risk factor for increased prevalence of thyroid autoimmunity. The autoimmune phenomena are limited to an increased prevalence of circulating thyroid autoantibodies without evidence of significant thyroid dysfunction. The future development of clinically relevant thyroid autoimmune diseases, especially hypothyroidism, is a possibility.

摘要

背景

包括放射性碘在内的电离辐射对甲状腺功能的长期影响尚不清楚。我们比较了白俄罗斯两组儿童的甲状腺免疫和功能，其中一组儿童暴露于切尔诺贝利的放射性沉降物中。

方法

我们测量了居住在霍伊尼基（铯平均污染量为5.4居里/平方公里）的287名儿童或青少年的血清游离甲状腺素4（游离T4）、游离T3和促甲状腺激素（TSH）以及甲状腺自身抗体（抗甲状腺球蛋白和抗甲状腺过氧化物酶）的患病率。我们还研究了居住在布拉斯拉夫（平均污染量<0.1居里/平方公里）的208名儿童和青少年，他们在切尔诺贝利事故发生时年龄在12岁及以下。

研究结果

居住在霍伊尼基的个体（287名中的56名[19.5%]）中抗甲状腺球蛋白或抗甲状腺过氧化物酶或两者的患病率显著高于居住在布拉斯拉夫的个体（208名中的8名[3.8%]）（p = 0.0001）。在两个村庄，13岁之前抗体患病率均未发现性别差异。此后，霍伊尼基的女孩中甲状腺自身抗体的患病率显著更高。在受污染组中，循环抗体患病率的增加在事故发生时处于子宫内或新生儿期的个体中已经很明显（15.7%），在9岁及以上的儿童中更为明显（35.1%）。未发现血清FT - 4、FT - 3或TSH有重大改变。