CAJ | 학술논문

目的掌握青海省饮水型地方性氟中毒病情变化和防治措施落实效果，为防治工作提供依据。方法 2009年，采用单纯随机抽样方法选择6个监测县，每个县根据历史资料将病区村分成轻、中、重3个类型，每个类型抽取1个病区村作为监测村。在已改水病区村采集出厂水1份和末梢水3份，在未改水病区村按东、西、南、北、中5个方位各采集1份水样，水氟测定按照《生活饮用水标准检验方法》(GB/T 5750--2006)。对监测村全部8～ 12岁儿童进行氟斑牙检查，氟斑牙诊断采用Dean法。对监测村全部16岁以上常住人口进行临床氟骨症检查，选择其中2个村，对有临床氟骨症症状的成人进行X线氟骨症检查，氟骨症诊断采用地方性氟骨症诊断标准(WS 192-2008)。每个监测村采集儿童尿样30份、成人尿样20份，采用尿中氟化物的测定离子选择电极法(WS/T 89-2006)检测尿氟。结果 6个县18个病区村中，14个村已落实改水项目，改水率为77.78％(14/18)，其中5个改水工程供水正常、9个间歇供水；共检测水样75份，水氟均值为0.48 mg/L。8～ 12岁儿童氟斑牙检出率为31.95％(285/892)；16岁以上人群临床氟骨症检出率为36.55％(1570/4295)，X线氟骨症检出率为25.64％(20/78)。共检测儿童尿样571份，尿氟几何均数为1.04 mg/L;共检测成人尿样370份，尿氟几何均数为1.52 mg/L。结论青海省饮水型氟中毒流行仍然较为严重，改水防氟措施应进一步加强和完善。
목적 장악청해성음수형지방성불중독병정변화화방치조시락실효과，위방치공작제공의거。방법 2009년，채용단순수궤추양방법선택6개감측현，매개현근거역사자료장병구촌분성경、중、중3개류형，매개류형추취1개병구촌작위감측촌。재이개수병구촌채집출엄수1빈화말소수3빈，재미개수병구촌안동、서、남、북、중5개방위각채집1빈수양，수불측정안조《생활음용수표준검험방법》(GB/T 5750--2006)。대감측촌전부8～ 12세인동진행불반아검사，불반아진단채용Dean법。대감측촌전부16세이상상주인구진행림상불골증검사，선택기중2개촌，대유림상불골증증상적성인진행X선불골증검사，불골증진단채용지방성불골증진단표준(WS 192-2008)。매개감측촌채집인동뇨양30빈、성인뇨양20빈，채용뇨중불화물적측정리자선택전겁법(WS/T 89-2006)검측뇨불。결과 6개현18개병구촌중，14개촌이락실개수항목，개수솔위77.78％(14/18)，기중5개개수공정공수정상、9개간헐공수；공검측수양75빈，수불균치위0.48 mg/L。8～ 12세인동불반아검출솔위31.95％(285/892)；16세이상인군림상불골증검출솔위36.55％(1570/4295)，X선불골증검출솔위25.64％(20/78)。공검측인동뇨양571빈，뇨불궤하균수위1.04 mg/L;공검측성인뇨양370빈，뇨불궤하균수위1.52 mg/L。결론 청해성음수형불중독류행잉연교위엄중，개수방불조시응진일보가강화완선。
Objective To investigate the development trend of drinking water type of endemic fluorosis in Qinghai province, and to provide the basis for the prevention and treatment of the disease. Methods In 2009, six monitoring counties were chosen by using simple random sampling methods, all diseased villages of the six monitoring counties were classified into light, moderate and severe disease types according to water fluorine content on the historical data, and 1 village was respectively chosen from each type. In monitoring villages with improved water, 3 tap water and one source water samples were collected, respectively. Five water samples were collected randomly in water unimproved monitoring villages according to water well locations of east, west, south, north and center. The fluorine content in water and urine was determined according to the "Standard Testing Methods for Drinking Water" (GB/T 5750-2006). Children aged 8 to 12 were examined for dental fluorosis by Dean method.Clinical osteofluorosis of all the resident over the age of 16 was examined, 2 village of these counties were randomly selected, and clinically diagnosed patients with skeletal fluorosis were examined again by X-ray using "Diagnostic Criteria of Endemic Skeletal Fluorosis" (WS 192-2008). Urine sample of 30 children aged 8 to 12 and of 20 adults over the age of 16 were randomly collected and urinary fluoride was determined by F-ion selective electrode method (WS/T 89-2006). Results Improving water projects had been implemented in 14 monitoring villages of the 18 villages in 6 counties, the rate of improved-water was 77.78％(14/18). Among the 14 projects, 5 improved-water projects ran normally, and 9 projects ran with intermittently water supply. Seventy-five water samples were tested, themean of water fluoride was 0.48 mg/L. The prevalence of dental fluorosis was 31.95％ (285/892), that of clinical skeletal fluorosis was 36.55％(1570/4295) and the X-ray detection rate of skeletal fluorosis was 25.64％ (20/78).Five hundred and seventy-one urine samples of children were determined, and geometric mean of urinary fluorine was 1.04 mg/L; 370 adult urine samples were determined, and geometric mean of urinary fluorine was 1.52 mg/L Conclusion Epidemic of drinking water type of endemic fluorosis is still serious in Qinghai province, and drinking water defluoride measures should be further strengthened and improved.