CAJ | 학술논문

目的分析山西省山阴县地方性砷中毒(简称地砷病)病区居民饮水砷暴露与皮肤病变间的关系,为地砷病防治研究提供流行病学依据.方法在山西省山阴县地砷病病区抽取17个村的189例地砷病患者和59例非患者(对照)作为调查对象.入户采集所有调查对象饮用水,用水砷快速检测试剂盒半定量检测水砷,并用高效液相色谱一等离子体质谱联用仪(HPLC-ICP-MS)定量检测水砷.地砷病皮肤病变按<地方性砷中毒诊断标准)(WS/T211-2001)进行诊断.结果在抽取的134份水样中,砷超标率达64.9%(87/134).水砷中位数为91.43μg/L.饮水砷暴露水平(＞50μg/L为高砷暴露,≤50μg/L为低砷暴露)与掌跖角化、色素沉着和脱失间的关联强度OR(95%CI)值分别为2.46(1.22～4.94)、3.34(1.50-7.44)和2.86(1.50-5.46).随着水砷暴露水平(按≤10、≤50、≤200、＞200μg/L分组)升高,患掌跖角化、色素沉着和色素脱失组间OR值呈增加趋势,尤其是水砷＞200μg/L组以≤10μg/L组作为参考,OR值分别为6.15、13.96、11.41,组间差异均有统计学意义(P＜0.05).皮肤色素Ⅲ度脱失患者水砷暴露水平(318.300μg/L)明显高于0、Ⅰ、Ⅱ度脱失患者(86.670、131.800、110.590μg/L,P＜0.05).结论山阴县属于中度砷暴露地区,水砷暴露是皮肤病变的危险因素.随着水砷暴露量增加,病变程度加重.
목적 분석산서성산음현지방성신중독(간칭지신병)병구거민음수신폭로여피부병변간적관계,위지신병방치연구제공류행병학의거.방법 재산서성산음현지신병병구추취17개촌적189례지신병환자화59례비환자(대조)작위조사대상.입호채집소유조사대상음용수,용수신쾌속검측시제합반정량검측수신,병용고효액상색보일등리자체질보련용의(HPLC-ICP-MS)정량검측수신.지신병피부병변안<지방성신중독진단표준)(WS/T211-2001)진행진단.결과 재추취적134빈수양중,신초표솔체64.9%(87/134).수신중위수위91.43μg/L.음수신폭로수평(＞50μg/L위고신폭로,≤50μg/L위저신폭로)여장척각화、색소침착화탈실간적관련강도OR(95%CI)치분별위2.46(1.22～4.94)、3.34(1.50-7.44)화2.86(1.50-5.46).수착수신폭로수평(안≤10、≤50、≤200、＞200μg/L분조)승고,환장척각화、색소침착화색소탈실조간OR치정증가추세,우기시수신＞200μg/L조이≤10μg/L조작위삼고,OR치분별위6.15、13.96、11.41,조간차이균유통계학의의(P＜0.05).피부색소Ⅲ도탈실환자수신폭로수평(318.300μg/L)명현고우0、Ⅰ、Ⅱ도탈실환자(86.670、131.800、110.590μg/L,P＜0.05).결론 산음현속우중도신폭로지구,수신폭로시피부병변적위험인소.수착수신폭로량증가,병변정도가중.
Objective To investigate the relationship between arsenic in drinking water and skin lesions in endemic arsenism area in Shanyin County of Shanxi Province,in order to provide epidemiologic data for further arsenism research.Methods One hundred and eighty-nine endemic arsenism patients and 59 controls were randomly selected in 17 endemic amenism countries in Shanyin County of Shanxi Province.The content of arsenic in drinking water which wa8 collected indoom was half-quantitatively screened by a kit made by Chinese Center for Disease Control and Prevention,then quantitatively determined by HPLC-ICP-MS.Patients of endemic arsenism were diagnosed by "The Standard of Diagnosis for Endemic Amenism"(WS/T 211-2001).Results There were 64.9% (87/134)samples above the arsenic level(50μg/L)of drinking water and the median value of arsenic in drinking water was 91.43 μg/L in 134 water samples.The OR(95%CI)value between arsenic in drinking water and hyperkeratosis,hyperpigmentation,depigmentation was 2.46(1.22-4.94),3.34(1.50～7.44)and 2.86(1.50-5.46),respectively.The prevalence of hyperkeratosis,hyperpigmentation and depigmentation increased,as the arsenic in drinking water increased(≤10,≤50,≤200,＞200μg/L),especially in＞200μg/L group(OR=6.15,13.96,11.41,P＜0.05).The arsenic level in drinking water of Ⅲ degree of depigmentation patients(318.300μg/L)was higher(P＜0.05)than that of 0,Ⅰ and Ⅱ degree groups(86.670,131.800,1 10.590μg/L,P＜0.05).Conclusions Shanyin County is a medial arsenic pollution area. Arsenic in drinking water is considered as a risk factor of skin lesion. The degree of skin lesions increased,as the arsenic in drinking water increased.