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核輻射和甲狀腺癌，誰需要服用碘化鉀藥片？

作者：goodoctor 於 2011-3-18 09:42 發表於最熱鬧的華人社交網路--貝殼村

作者分類:醫療信息|通用分類:健康生活|已有22評論

關鍵詞：

連日來日本的核輻射危機，引起世界各地越來越多的關注，現在已經到了最關鍵的時刻。雖然美國有關當局再三強調目前輻射外泄狀況不會影響到美國西海岸，但碘化鉀藥片或藥水 (Potassium Iodide，KI ) 在美國很多地方已被搶購一空，很多藥店都已經脫銷，特別是加州等地區。

碘化鉀藥片

從醫學角度來講，核事故導致癌症風險最大的器官是甲狀腺。甲狀腺 (thyroid gland) 是人體最大的內分泌腺體，位於甲狀軟骨下緊貼在氣管第三，四軟骨環前面，由兩側葉和峽部組成，平均重量成大約20-25g，女性略大略重。甲狀腺對碘有很強的聚集作用，雖然腺體中碘的含量比血液中高25-50倍，但每日飲食攝入的碘仍有1／3進入甲狀腺，全身含碘量的90％都集中在甲狀腺。甲狀腺從血液中不斷地獲取碘，用來製造對身體有重要生理作用的甲狀腺激素。

核事故會釋放出一定量的放射性物質，包括碘-129和碘-131等。甲狀腺本身不能區分正常碘和放射性碘，放射性物質被攝入到甲狀腺后可以導致甲狀腺癌。

甲狀腺 (thyroid gland)

到目前為止，日本已向兒童派發了23萬碘化鉀藥片。其作用原理是：提高血液中穩定碘元素的濃度，使甲狀腺更有可能吸收這些碘而減少對放射性碘的吸收。人群中最易受到放射碘核輻射損傷的是兒童和胎兒，因為他們細胞的生長速度遠遠超過成人。被核輻射暴露的兒童和孕婦應該是最早服用碘化鉀藥片的人群。

世界最著名的腫瘤醫院 New York's Memorial Sloan-Kettering Cancer Center 的內分泌專家，費金醫生(Jame Fagin MD) 曾對切爾諾貝利核反應堆附近生活過，患有甲狀腺癌的兒童做過深入的研究。他認為：對於年紀超過20歲的成年人來講，服用碘化鉀葯沒有什麼幫助。美國核管制委員會 (Nuclear Regulatory Commission) 目前也不建議美國人服用碘化鉀。

碘化鉀是藥物，是一種藥物形式的穩定碘。碘化鉀可引起很多副作用，如唾液腺炎，噁心，嘔吐，過敏性反應等。嚴重的可以導致心率失常，電解質異常，出血等。對於有甲狀腺疾病，如甲狀腺腫，甲亢或自身免疫性甲狀腺疾病的病人，或對碘化鉀過敏的病人不要用碘化鉀。

出生不到一個月的嬰兒如果服用超過一個劑量的碘化鉀，將增加甲狀腺機能減退（甲狀腺激素水平過低，hypothyroidism）的風險。如不進行治療，甲狀腺機能減退可以造成腦部的損害。嬰兒在服用碘化鉀之前必須接受甲狀腺激素水平檢查，並在醫生指導下服用。要避免給新生兒服用重複劑量的碘化鉀!

日本核輻射對人體的危害：

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核事故另一個可怕之處在於它危害的長期性，切爾諾貝利事故后，放射性物質廣泛的散落在附近的土地和農作物上，放射碘隨著母親(或奶牛)食入被核污染的食物后而進入體內。無論是人還是奶牛的乳腺細胞，在製造奶的過程中，都需要吸收碘，這些碘最終出現在嬰兒或兒童飲用的人(牛)奶中。要清除被放射性物質污染的土地是個漫長的過程。

可以預見日本即使逃過這一劫，以後的路也不容易。在未來的幾十年裡，日本對外出口，特別是農產品的出口將會非常困難。

相關知識的連接：

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

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

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

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回復 yulinw 2011-3-18 10:04: 謝謝好醫生~~

回復 dwqdaniel 2011-3-18 10:41: 大夫：假如我們人被輻射過，會有自覺癥狀嗎？

回復 ww_719 2011-3-18 12:06: 那加州這點輻射是不是對人體真的影響不大呢?是不是真的不能出門了呢?

回復在美一方 2011-3-18 12:18: 今天聽NPR請的研究切爾諾貝利核電事故后動物生存情況的科學家講，他們到現在都沒有發現任何基因上的突變和健康問題，那裡的動物活得好著呢。不僅如此，切爾諾貝利事件發生時期的孕婦後來產下的孩子也沒有比正常情況下更多的缺陷。那麼嚴重的輻射污染也不過如此，日本這個不會怎麼樣的，不太可能有什麼嚴重的長期影響。
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.

回復 goodoctor 2011-3-18 12:41: 在美一方: 今天聽NPR請的研究切爾諾貝利核電事故后動物生存情況的科學家講，他們到現在都沒有發現任何基因上的突變和健康問題，那裡的動物活得好著呢。不僅如此，切爾諾貝利 ...
謝謝你的補充。切爾諾貝利事故后的研究很多，有好有壞，但願對人類的影響有限。

我感覺這次對人心理上的打擊是巨大的。

回復 goodoctor 2011-3-18 12:42: ww_719: 那加州這點輻射是不是對人體真的影響不大呢?是不是真的不能出門了呢?
放鬆

回復 ww_719 2011-3-18 12:49: goodoctor: 放鬆
那就是說我可以出門啦,哈哈..

回復 goodoctor 2011-3-18 12:50: dwqdaniel: 大夫：假如我們人被輻射過，會有自覺癥狀嗎？
大部分無法感覺到，可以利用儀器探測。

回復 goodoctor 2011-3-18 12:50: yulinw: 謝謝好醫生~~
你好!

回復老地雷 2011-3-18 12:55: 這個Dr. Richard 以前是CDC一個重要部門的主任，當過CDC代理Director,水平極高，能說會道，聽過他二次現場演講

回復 goodoctor 2011-3-18 13:02: 老地雷: 這個Dr. Richard 以前是CDC一個重要部門的主任，當過CDC代理Director,水平極高，能說會道，聽過他二次現場演講
這個你是行家

回復 goodoctor 2011-3-18 13:03: ww_719: 那就是說我可以出門啦,哈哈..
到今天為止

回復 ww_719 2011-3-18 13:06: goodoctor: 到今天為止

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

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

回復 dwqdaniel 2011-3-18 13:52: goodoctor: 大部分無法感覺到，可以利用儀器探測。
看來碘化鉀是回國必備禮品了

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

回復 goodoctor 2011-3-19 10:00: dwqdaniel: 大夫：假如我們人被輻射過，會有自覺癥狀嗎？
有多種辦法可以辨別人們是否受到核輻射影響。

Geiger計數器可以探測體表、衣物上、毛髮和皮膚上的輻射量。

另一種裝置，碘化鈉探測器，則可用於探測甲狀腺的放射碘.

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

回復 dwqdaniel 2011-3-19 10:11: goodoctor: 有多種辦法可以辨別人們是否受到核輻射影響。

Geiger計數器可以探測體表、衣物上、毛髮和皮膚上的輻射量。

另一種裝置，碘化鈉探測器，則可用於探測甲狀腺的放 ...
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核輻射和甲狀腺癌，誰需要服用碘化鉀藥片？

剛表態過的朋友 (15 人)

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