State of the gastric mucosa in workers contacting with tritium compounds

   Целью работы была оценка состояния слизистой оболочки желудка у персонала атомного предприятия, контактирующего с соединениями трития в штатных условиях производственного цикла.

   В работе представлены результаты серологического скрининга состояния желудка группы работников, подвергающихся хроническому β-облучению трития в допустимых дозах. Для выявления признаков патологических изменений состояния желудка использовался неинвазивный метод количественного определения в сыворотке крови ключевых биомаркеров структуры и функционального состояния желудка – пепсиногенов (ПГ1 и ПГ2), гастрина-17 (Г-17), и степени инфицирования желудка бактерией Helicobacter pylori (IgG антитела к Helicobacter pylori) с помощью тест-систем Гастропанель. Установлено: инфицированность Helicobacter pylori персонала зависела от возраста на дату обследования и пола, в целом составляла 55,6 %. Серологические признаки отклонений в состоянии слизистой желудка выявлены у 57,5 % работников, в 9 % – предракового состояния, атрофического гастрита, в 43 % – неатрофического Helicobacter pylori-ассоциированного гастрита с потенциальным рискоматрофических изменений слизистой, в 9,3 % –гиперсекреторного неатрофического гастрита с высоким кислотным выбросом и риском язвенной болезни. Заметный рост частоты выявления выраженных атрофических изменений слизистой желудка начинался после 50 лет. Частота серологических признаков атрофического и неатрофического гастрита в обследованной группе не превышала значений, полученных ранее в группе жителей города, никогда не контактировавших с источниками ионизирующих излучений. Около трети работников с высокими рисками тяжелой гастропатологии (36 % с признаками атрофии, 20 % с признаками эрозивно-язвенного поражения слизистой желудка) были бессимптомны, гастродуоденальных заболеваний в анамнезе не имели, за медицинской помощью не обращались.

   Выводы: инфицированность желудка Helicobacter pylori и распространенность признаков патологических изменений слизистой оболочки желудка в группе персонала, работающего с соединениями трития, соответствовала показателям последних отечественных исследований. 18,3 % работников по серологическим признакам составили группу повышенного риска рака желудка и язвенной болезни, нуждающихся в дальнейшем наблюдении с использованием базовых эндоскопических и морфологических методов и принятии медицинских решений.

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