中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2012年
12期
1243-1247
,共5页
焦永卓%牟李红%王应雄%晏维%钟朝晖%李立
焦永卓%牟李紅%王應雄%晏維%鐘朝暉%李立
초영탁%모리홍%왕응웅%안유%종조휘%리립
氟中毒,地方性%燃煤污染型%氟斑牙%氟骨症
氟中毒,地方性%燃煤汙染型%氟斑牙%氟骨癥
불중독,지방성%연매오염형%불반아%불골증
Endemic fluorosis%Coal-fired pollution%Dental fluorosis%Skeletal fluorosis
目的 了解燃煤型氟中毒病区土壤化学元素分布情况,比较采取降氟措施后重庆市巫山、奉节两县病例与对照全血中化学元素及尿氟含量差异,查找与燃煤型氟中毒相关的化学元素及阐明其发病机制.方法 采用生态学比较研究对两县各乡镇患病率与土壤化学元素水平做相关分析,并测定氟斑牙、氟骨症患者与对照组全血中铜、锌、钙、镁、铁及尿氟含量,对比分析各检测指标的含量差异.结果 巫山县土壤中镍(r＝0.553,P＝0.050)、碘(r＝0.571,P＝0.041)、氟(r＝0.303,P＝0.005)、pH值(r＝0.304,P＝0.005)与患病率有较弱的正相关关系；奉节县土壤中汞(r＝0.285,P＝0.001)、镍(r＝0.212,P＝0.00)与患病率有较弱的正相关关系.巫山县儿童病例组尿氟含量[(0.64±0.34)mg/L]高于对照组[(0.44±0.59)mg/L] (P＜0.05).奉节县儿童病例组铜[(29.63±3.32) μmol/L]、尿氟[(0.83±0.37) mg/L]含量高于对照组[(26.76±3.63)μ mol/L、(0.53±0.23)mg/L] (P＜0.05).奉节县氟斑牙儿童锌[(76.13±11.24) μmol/L]、钙[(1.87±0.25) mmol/L]、镁[(1.41±0.18) mmol/L]及尿氟[(0.83±0.37) mg/L]高于巫山县[(71.95±7.53) μmol/L、(1.43±1.34) mmol/L、(1.34±0.15)mmol/L、(0.64±0.34)mg/L] (P＜0.05).病例组成年氟骨症患者镁[(1.56±1.96)mmol/L]、铁[(8.15±1.00)mmol/L]、尿氟[(2.17±0.99)mg/L]含量均值高于对照组[分别为(1.46±0.16)mmol/L、(7.64±1.00) mmol/L、(1.44±1.22)mg/L] (P＜0.05).结论 碱性高氟土壤可能增加氟摄入量；土壤中的镉、碘、镍等环境化学元素水平可能与氟中毒的发病有关联.病区人群体内锌、钙、镁等抗氟元素水平较低.
目的 瞭解燃煤型氟中毒病區土壤化學元素分佈情況,比較採取降氟措施後重慶市巫山、奉節兩縣病例與對照全血中化學元素及尿氟含量差異,查找與燃煤型氟中毒相關的化學元素及闡明其髮病機製.方法 採用生態學比較研究對兩縣各鄉鎮患病率與土壤化學元素水平做相關分析,併測定氟斑牙、氟骨癥患者與對照組全血中銅、鋅、鈣、鎂、鐵及尿氟含量,對比分析各檢測指標的含量差異.結果 巫山縣土壤中鎳(r＝0.553,P＝0.050)、碘(r＝0.571,P＝0.041)、氟(r＝0.303,P＝0.005)、pH值(r＝0.304,P＝0.005)與患病率有較弱的正相關關繫；奉節縣土壤中汞(r＝0.285,P＝0.001)、鎳(r＝0.212,P＝0.00)與患病率有較弱的正相關關繫.巫山縣兒童病例組尿氟含量[(0.64±0.34)mg/L]高于對照組[(0.44±0.59)mg/L] (P＜0.05).奉節縣兒童病例組銅[(29.63±3.32) μmol/L]、尿氟[(0.83±0.37) mg/L]含量高于對照組[(26.76±3.63)μ mol/L、(0.53±0.23)mg/L] (P＜0.05).奉節縣氟斑牙兒童鋅[(76.13±11.24) μmol/L]、鈣[(1.87±0.25) mmol/L]、鎂[(1.41±0.18) mmol/L]及尿氟[(0.83±0.37) mg/L]高于巫山縣[(71.95±7.53) μmol/L、(1.43±1.34) mmol/L、(1.34±0.15)mmol/L、(0.64±0.34)mg/L] (P＜0.05).病例組成年氟骨癥患者鎂[(1.56±1.96)mmol/L]、鐵[(8.15±1.00)mmol/L]、尿氟[(2.17±0.99)mg/L]含量均值高于對照組[分彆為(1.46±0.16)mmol/L、(7.64±1.00) mmol/L、(1.44±1.22)mg/L] (P＜0.05).結論 堿性高氟土壤可能增加氟攝入量；土壤中的鎘、碘、鎳等環境化學元素水平可能與氟中毒的髮病有關聯.病區人群體內鋅、鈣、鎂等抗氟元素水平較低.
목적 료해연매형불중독병구토양화학원소분포정황,비교채취강불조시후중경시무산、봉절량현병례여대조전혈중화학원소급뇨불함량차이,사조여연매형불중독상관적화학원소급천명기발병궤제.방법 채용생태학비교연구대량현각향진환병솔여토양화학원소수평주상관분석,병측정불반아、불골증환자여대조조전혈중동、자、개、미、철급뇨불함량,대비분석각검측지표적함량차이.결과 무산현토양중얼(r＝0.553,P＝0.050)、전(r＝0.571,P＝0.041)、불(r＝0.303,P＝0.005)、pH치(r＝0.304,P＝0.005)여환병솔유교약적정상관관계；봉절현토양중홍(r＝0.285,P＝0.001)、얼(r＝0.212,P＝0.00)여환병솔유교약적정상관관계.무산현인동병례조뇨불함량[(0.64±0.34)mg/L]고우대조조[(0.44±0.59)mg/L] (P＜0.05).봉절현인동병례조동[(29.63±3.32) μmol/L]、뇨불[(0.83±0.37) mg/L]함량고우대조조[(26.76±3.63)μ mol/L、(0.53±0.23)mg/L] (P＜0.05).봉절현불반아인동자[(76.13±11.24) μmol/L]、개[(1.87±0.25) mmol/L]、미[(1.41±0.18) mmol/L]급뇨불[(0.83±0.37) mg/L]고우무산현[(71.95±7.53) μmol/L、(1.43±1.34) mmol/L、(1.34±0.15)mmol/L、(0.64±0.34)mg/L] (P＜0.05).병례조성년불골증환자미[(1.56±1.96)mmol/L]、철[(8.15±1.00)mmol/L]、뇨불[(2.17±0.99)mg/L]함량균치고우대조조[분별위(1.46±0.16)mmol/L、(7.64±1.00) mmol/L、(1.44±1.22)mg/L] (P＜0.05).결론 감성고불토양가능증가불섭입량；토양중적력、전、얼등배경화학원소수평가능여불중독적발병유관련.병구인군체내자、개、미등항불원소수평교저.
Objective To understand the distribution of chemical elements in soil.To investigate the differences between patients under different state of fluorosis and normal population after preventive measurement was implemented to get rid of some chemical elements and to lower the urine fluoride levels so as to illustrate the pathogenesis of the disease.Methods Both ecological and comparative studies had been used to analyze the rates and levels of chemical elements.Teeth and skeletal from the patients with fluorosis and controls were taken and florin ion-selective-electrode method was used to determine urine the content of fluorine.Atomic Absorption Spectrometry was used to determine the copper,zinc,calcium,magnesium and iron contents in the whole blood.Differences of contents were analyzed.Results In Wushan county,the soil contents of nickel (r＝0.553,P＝0.050),iodine (r＝0.571,P＝0.041),fluorine (r＝0.303,P＝0.005),pH value (r＝0.304,P＝0.005) and the rates of fluorosis showed weaker positive relationship.In Fengjie county,the soil contents of mercury (r＝0.285,P＝0.001),nickel (r＝0.212,P＝0.00) and the rates of fluorosis also showed weaker positive relationship.In Wushan county,the urine fluoride level in the patients group [(0.64 ± 0.34) mg/L] was higher than that in the control group [(0.44 ± 0.59) mg/L],(P ＜ 0.05).In Fengjie county,copper [(29.63 ± 3.32)μmol/L] and urine fluoride [(0.83 ±0.37)mg/L] levels in the patients group showed higher than that in the control group [(26.76 ± 3.63) μmol/L,(0.53±0.23)mg/L],(P＜0.05).zinc (Zn) [(76.13 ± 11.24)μmol/L],calcium (Ca) [(1.87± 0.25)mmol/L],magnesium (Mg)[(1.41 ±0.18)mmol/L] and fluoride [(0.83 ±0.37)mg/L] levels in urine of the patients in children were higher in Fengjie than that in Wushan [(71.95 ± 7.53) μmol/L,(1.43 ±1.34) mmol/L,(1.34±0.15) mmol/L,(0.64 ±0.34)mg/L],(P＜0.05).Mg [(1.56± 1.96)mmol/L],ferrum [(8.15 ± 1.00)mmol/L] and fluoride [(2.17 ± 0.99)mg/L] levels among adult patients were significantly higher than in the control group [(1.46±0.16) mmol/L,(7.64± 1.00)mmol/L,(1.44±1.22)mg/L] (P＜0.05).Conclusion Soil,rich in alkaline and fluorosis could increase the intake of fluorine while nickel,cadmium,iodine content in soil might relate to the occurrence of fluorosis.Residents living in endemic areas where anti-fluorine elements as Zn,Ca and Mg were in shortage,might be affected by these chemical elements that related with fluorosis.
