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核辐射和甲状腺癌，谁需要服用碘化钾药片？

作者：goodoctor 于 2011-3-18 09:42 发表于最热闹的华人社交网络--贝壳村

作者分类:医疗信息|通用分类:健康生活|已有22评论

关键词：

连日来日本的核辐射危机，引起世界各地越来越多的关注，现在已经到了最关键的时刻。虽然美国有关当局再三强调目前辐射外泄状况不会影响到美国西海岸，但碘化钾药片或药水 (Potassium Iodide，KI ) 在美国很多地方已被抢购一空，很多药店都已经脱销，特别是加州等地区。

碘化钾药片

从医学角度来讲，核事故导致癌症风险最大的器官是甲状腺。甲状腺 (thyroid gland) 是人体最大的内分泌腺体，位于甲状软骨下紧贴在气管第三，四软骨环前面，由两侧叶和峡部组成，平均重量成大约20-25g，女性略大略重。甲状腺对碘有很强的聚集作用，虽然腺体中碘的含量比血液中高25-50倍，但每日饮食摄入的碘仍有1／3进入甲状腺，全身含碘量的90％都集中在甲状腺。甲状腺从血液中不断地获取碘，用来制造对身体有重要生理作用的甲状腺激素。

核事故会释放出一定量的放射性物质，包括碘-129和碘-131等。甲状腺本身不能区分正常碘和放射性碘，放射性物质被摄入到甲状腺后可以导致甲状腺癌。

甲状腺 (thyroid gland)

到目前为止，日本已向儿童派发了23万碘化钾药片。其作用原理是：提高血液中稳定碘元素的浓度，使甲状腺更有可能吸收这些碘而减少对放射性碘的吸收。人群中最易受到放射碘核辐射损伤的是儿童和胎儿，因为他们细胞的生长速度远远超过成人。被核辐射暴露的儿童和孕妇应该是最早服用碘化钾药片的人群。

世界最著名的肿瘤医院 New York's Memorial Sloan-Kettering Cancer Center 的内分泌专家，费金医生(Jame Fagin MD) 曾对切尔诺贝利核反应堆附近生活过，患有甲状腺癌的儿童做过深入的研究。他认为：对于年纪超过20岁的成年人来讲，服用碘化钾药没有什么帮助。美国核管制委员会 (Nuclear Regulatory Commission) 目前也不建议美国人服用碘化钾。

碘化钾是药物，是一种药物形式的稳定碘。碘化钾可引起很多副作用，如唾液腺炎，恶心，呕吐，过敏性反应等。严重的可以导致心率失常，电解质异常，出血等。对于有甲状腺疾病，如甲状腺肿，甲亢或自身免疫性甲状腺疾病的病人，或对碘化钾过敏的病人不要用碘化钾。

出生不到一个月的婴儿如果服用超过一个剂量的碘化钾，将增加甲状腺机能减退（甲状腺激素水平过低，hypothyroidism）的风险。如不进行治疗，甲状腺机能减退可以造成脑部的损害。婴儿在服用碘化钾之前必须接受甲状腺激素水平检查，并在医生指导下服用。要避免给新生儿服用重复剂量的碘化钾!

日本核辐射对人体的危害：

核事故另一个可怕之处在于它危害的长期性，切尔诺贝利事故后，放射性物质广泛的散落在附近的土地和农作物上，放射碘随着母亲(或奶牛)食入被核污染的食物后而进入体内。无论是人还是奶牛的乳腺细胞，在制造奶的过程中，都需要吸收碘，这些碘最终出现在婴儿或儿童饮用的人(牛)奶中。要清除被放射性物质污染的土地是个漫长的过程。

可以预见日本即使逃过这一劫，以后的路也不容易。在未来的几十年里，日本对外出口，特别是农产品的出口将会非常困难。

相关知识的连接：

http://www.bt.cdc.gov/radiation/ki.asp

http://www.cdph.ca.gov/Pages/RadiationFAQS2011.aspx

http://www.mskcc.org/mskcc/html/98345.cfm

刚表态过的朋友 (15 人)

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发表评论评论 (22 个评论)

1 回复 yulinw 2011-3-18 10:04: 谢谢好医生~~

1 回复 dwqdaniel 2011-3-18 10:41: 大夫：假如我们人被辐射过，会有自觉症状吗？

1 回复 ww_719 2011-3-18 12:06: 那加州这点辐射是不是对人体真的影响不大呢?是不是真的不能出门了呢?

1 回复在美一方 2011-3-18 12:18: 今天听NPR请的研究切尔诺贝利核电事故后动物生存情况的科学家讲，他们到现在都没有发现任何基因上的突变和健康问题，那里的动物活得好着呢。不仅如此，切尔诺贝利事件发生时期的孕妇后来产下的孩子也没有比正常情况下更多的缺陷。那么严重的辐射污染也不过如此，日本这个不会怎么样的，不太可能有什么严重的长期影响。
http://www.npr.org/2011/03/16/134585523/Chernobyls-Hot-Zone-Holds-Some-Surprises

WERTHEIMER: What led you to make the decision to go and study Chernobyl? Obviously, there were some very serious, radiation-related injuries and even deaths. But what did you want to look at when you went to Chernobyl?

Dr. BAKER: I really didn't know what to expect. And I'd seen the cover of Time magazine saying that there was going to be a nuclear desert. And when I went over there the first time, it was really shocking because certainly, it didn't look like a nuclear desert in my mind.

But my goal was to understand what all those kind of things did to the wolves and the mice and all of the birds and mammals that are there.

WERTHEIMER: Now, as I understand it, you're not finding long-term genetic problems.

Dr. BAKER: We have not been able to document a genetic load, a mutational load that has increased. I'm not telling you that it's not there, but I'm telling you that it's small.

WERTHEIMER: Small enough that you can't separate it out from what happens naturally?

Dr. BAKER: What we really need to do is the experiment where we bring these mice into the lab and we breed them and we can see if they have a shortened life expectancy or any of the number of things that decrease the quality of life from a genetic standpoint. But we don't know if this Chernobyl environment has really produced an inferior bank vole.

WERTHEIMER: Bank voles are teensy, weensy little rodents that...

Dr. BAKER: They're cigar-looking cigar-shaped things with a red real reddish color on their back, and they're about four inches long. And, in fact, those voles are radioactive. You can catch one and you can get the Geiger counter and, I mean, it screams. But they seem to be able to do their lifecycle things and all without great consequences. If you didn't have a Geiger counter, you would not be able to tell that there was an effect.

WERTHEIMER: What about large mammals? Have you looked at large mammals?

Dr. BAKER: Oh, the wolves are doing really well there, the moose. We have not seen red deer, but our trail cameras have picked them up. So we think that there are more we wrote a paper in which we said the world's worst nuclear power plant disaster and creation of a wildlife preserve.

WERTHEIMER: Dr. Baker, when you look at a situation like the one they have in Japan now, where a giant set of reactors is sitting on the banks of the ocean in the middle of what appears to be fairly rich farmland, what would be your that means your assessment would be that everything around there is going to recover?

Dr. BAKER: Well, it certainly will recover in time. I'm sure that there will be in 10 years, there will be mice and mammals moving back in and doing very well. But it may be that for growing food that we want to feed to our children, that won't be acceptable for 100 or 300 years.

WERTHEIMER: Hm. Do you think we should rethink a relationship to radiation as humans? I mean, do you think we should be as afraid of it as we clearly are?

Dr. BAKER: There's a World Health Organization that said that 150,000 ladies who were pregnant at the Chernobyl meltdown had an elective abortion. And the data for the children that were born to the women that did not have an elective abortion that were pregnant in the same time and in the same space do not show an elevated birth-defect rate. I think fear was the greatest yes, I think we need to rethink the fear factor.

1 回复 goodoctor 2011-3-18 12:41: 在美一方: 今天听NPR请的研究切尔诺贝利核电事故后动物生存情况的科学家讲，他们到现在都没有发现任何基因上的突变和健康问题，那里的动物活得好着呢。不仅如此，切尔诺贝利 ...
谢谢你的补充。切尔诺贝利事故后的研究很多，有好有坏，但愿对人类的影响有限。

我感觉这次对人心理上的打击是巨大的。

0 回复 goodoctor 2011-3-18 12:42: ww_719: 那加州这点辐射是不是对人体真的影响不大呢?是不是真的不能出门了呢?
放松

1 回复 ww_719 2011-3-18 12:49: goodoctor: 放松
那就是说我可以出门啦,哈哈..

1 回复 goodoctor 2011-3-18 12:50: dwqdaniel: 大夫：假如我们人被辐射过，会有自觉症状吗？
大部分无法感觉到，可以利用仪器探测。

1 回复 goodoctor 2011-3-18 12:50: yulinw: 谢谢好医生~~
你好!

1 回复老地雷 2011-3-18 12:55: 这个Dr. Richard 以前是CDC一个重要部门的主任，当过CDC代理Director,水平极高，能说会道，听过他二次现场演讲

1 回复 goodoctor 2011-3-18 13:02: 老地雷: 这个Dr. Richard 以前是CDC一个重要部门的主任，当过CDC代理Director,水平极高，能说会道，听过他二次现场演讲
这个你是行家

1 回复 goodoctor 2011-3-18 13:03: ww_719: 那就是说我可以出门啦,哈哈..
到今天为止

1 回复 ww_719 2011-3-18 13:06: goodoctor: 到今天为止

1 回复 goodoctor 2011-3-18 13:11: ww_719:
The best thing anyone can do is to stay informed.

1 回复 ww_719 2011-3-18 13:16: goodoctor: The best thing anyone can do is to stay informed.

1 回复 dwqdaniel 2011-3-18 13:52: goodoctor: 大部分无法感觉到，可以利用仪器探测。
看来碘化钾是回国必备礼品了

0 回复 leahzhang 2011-3-18 23:17: Thanks for your information good doctor!

1 回复 goodoctor 2011-3-19 10:00: dwqdaniel: 大夫：假如我们人被辐射过，会有自觉症状吗？
有多种办法可以辨别人们是否受到核辐射影响。

Geiger计数器可以探测体表、衣物上、毛发和皮肤上的辐射量。

另一种装置，碘化钠探测器，则可用于探测甲状腺的放射碘.

1 回复 goodoctor 2011-3-19 10:01: leahzhang: Thanks for your information good doctor!
thank you!
have a nice weekend

1 回复 dwqdaniel 2011-3-19 10:11: goodoctor: 有多种办法可以辨别人们是否受到核辐射影响。

Geiger计数器可以探测体表、衣物上、毛发和皮肤上的辐射量。

另一种装置，碘化钠探测器，则可用于探测甲状腺的放 ...
谢谢大夫

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