ИСПОЛЬЗОВАНИЕ РЕЗУЛЬТАТОВ ГЕМАТОЛОГИЧЕСКИХ ТЕСТОВ ДЛЯ ПРОГНОЗИРОВАНИЯ СТЕПЕНИ ТЯЖЕСТИ ОСТРЫХ ЛУЧЕВЫХ ПОРАЖЕНИЙ НА РАННЕМ ЭТАПЕ

Abstract

Purpose: Investigation of the predictive value of information on the concentrations of neutrophils and lymphocytes in the peripheral blood of victims of radiation accidents in the first days (2 to 9) after exposure to predict the severity of acute radiation injury. Material and methods: Data on the post-radiation dynamics of the concentrations of lymphocytes and neutrophils in the peripheral blood of victims of the accident at the Chernobyl nuclear power plant in 1986 from the database on acute radiation injuries to humans of the A.I. Burnasyan Federal Medical Biophysical Center was used. Correlation analysis was used as a research method. Results: Due to the fact that in the period from the 2nd to the 9th day after irradiation, the concentration of lymphocytes in the peripheral blood does not change significantly, and the concentration of neutrophils has a persistent tendency to decrease in the dose range of more than 2 Gy, in addition to the widespread lymphocyte test, operative characteristics for dose-response analysis such as average relative rates of decline in neutrophil concentrations (neutrophil test) and the ratio of neutrophil to lymphocyte concentrations (NLR test) in peripheral blood were proposed. The results of the isolated use of the proposed tests are investigated. The analyzed parameters were the average concentration of lymphocytes on days 2–4 after irradiation and the average relative rates of decrease in the concentration of neutrophils and the ratio of the concentrations of neutrophils to lymphocytes (NLR) in the peripheral blood of the victims. Estimates show that the neutrophil test (σ = 1.16 Gy) has the highest accuracy in the dose range up to 8 Gy with the isolated use of tests compared to the lymphocyte test (σ = 1.42 Gy) and the NLR test (σ = 1.31 Gy). An algorithm for using the so-called combined test, which is a functional superposition of data on the post-radiation dynamics of the concentration of lymphocytes and neutrophils in peripheral blood in the period from 2 to 9 days after irradiation, which gives a higher predictive accuracy of the dose estimate (σ = 0.9 Gy). Conclusion: The proposed combined test has a higher predictive value in assessing the severity of acute radiation injury compared with the use of isolated lymphocytic, neutrophilic and NLR tests in clinical practice.