中华地方病学杂志
中華地方病學雜誌
중화지방병학잡지
Chinese Journal of Endemiology
2014年
3期
315-319
,共5页
氟中毒,牙%茶%尿%少数民族
氟中毒,牙%茶%尿%少數民族
불중독,아%다%뇨%소수민족
Fluorosis,dental%Tea%Urine%Minority groups
目的 探讨饮茶型氟中毒地区藏、蒙古、哈萨克、汉4个民族的氟中毒病情是否存在差异及引起差异的可能原因.方法 在青海省果洛州藏族居住地区、内蒙古自治区呼伦贝尔市蒙古族居住地区、新疆维吾尔自治区阿勒泰哈萨克族居住地区各选择了2个县,每个县分别选择人口相对集中的3～4个病区乡为调查点.选择调查点内16岁以上少数民族及汉族人群进行问卷调查,调查内容包括调查对象的一般情况、日均砖茶水摄入量等;并采集调查点的居民家中饮用水样,以及调查对象的砖茶水、尿样进行氟含量测定;使用便携式数字化X光机(DR)对调查对象的前臂、腰椎及盆骨进行X线拍片.饮用水水氟、砖茶氟和尿氟测定采用离子选择电极法(WS/T 89-2006);X线氟骨症诊断依据《地方性氟骨症诊断标准》(WS/T 192-2007),并结合流行病学特征及临床表现.结果 共调查16岁以上成人l 703人,其中藏族、蒙古族、哈萨克族和汉族分别为525、328、305和545人.4个民族日均砖茶水摄入量、饮用水氟含量、茶水氟含量、日均砖茶摄氟量的均值以及尿氟的几何均数分别为2 758.42 ml、0.88 mg/L、2.76 mg/L、8.77 mg、1.75 mg/L.其中藏族、蒙古族、哈萨克族和汉族人群的日均砖茶水摄入量、饮用水氟含量、茶水氟含量、日均砖茶摄氟量、尿氟分别为3 304.58、2 170.42、2 476.34、1583.93 ml,0.27、0.88、1.04、0.35 mg/L,2.91、1.66、3.14、0.93 mg/L,10.17、4.14、9.22、2,66 mg,2,17、1.41、3.37、1.15 mg/L.日均砖茶水摄入量、饮用水氟含量、茶水氟含量、日均砖茶摄氟量、尿氟含量各民族间比较差异均有统计学意义(F值分别为10.639、50.498、25.371、10.800、166.852,P均＜0.05).X线氟骨症总体检出率为27.25％(399/1 464).其中藏族、蒙古族、哈萨克族和汉族的检出率分别为43.55％(179/411)、21.90％(60/274)、33.22％(98/295)和12.81％(62/484);男性氟骨症检出率[30.70％(175/570)]高于女性[25.06％(224/894),x2=5.596,P＜0.05];不同年龄段藏族、蒙古族、汉族氟骨症检出率组间比较差异均具有统计学意义(x2值分别为50.423、8.899、18.676,P均＜0.05).结论 我国饮茶型氟中毒流行程度在不同民族间存在明显差异,藏族人群的氟骨症检出率和病情程度明显重于哈萨克族、蒙古族和汉族,与不同民族之间砖茶氟暴露程度不同有关.在砖茶氟暴露程度相近的情况下,哈萨克族氟骨症检出率和病情程度明显较藏族人群轻,提示在饮茶型氟中毒流行中还有非暴露因素的参与.
目的 探討飲茶型氟中毒地區藏、矇古、哈薩剋、漢4箇民族的氟中毒病情是否存在差異及引起差異的可能原因.方法 在青海省果洛州藏族居住地區、內矇古自治區呼倫貝爾市矇古族居住地區、新疆維吾爾自治區阿勒泰哈薩剋族居住地區各選擇瞭2箇縣,每箇縣分彆選擇人口相對集中的3～4箇病區鄉為調查點.選擇調查點內16歲以上少數民族及漢族人群進行問捲調查,調查內容包括調查對象的一般情況、日均磚茶水攝入量等;併採集調查點的居民傢中飲用水樣,以及調查對象的磚茶水、尿樣進行氟含量測定;使用便攜式數字化X光機(DR)對調查對象的前臂、腰椎及盆骨進行X線拍片.飲用水水氟、磚茶氟和尿氟測定採用離子選擇電極法(WS/T 89-2006);X線氟骨癥診斷依據《地方性氟骨癥診斷標準》(WS/T 192-2007),併結閤流行病學特徵及臨床錶現.結果 共調查16歲以上成人l 703人,其中藏族、矇古族、哈薩剋族和漢族分彆為525、328、305和545人.4箇民族日均磚茶水攝入量、飲用水氟含量、茶水氟含量、日均磚茶攝氟量的均值以及尿氟的幾何均數分彆為2 758.42 ml、0.88 mg/L、2.76 mg/L、8.77 mg、1.75 mg/L.其中藏族、矇古族、哈薩剋族和漢族人群的日均磚茶水攝入量、飲用水氟含量、茶水氟含量、日均磚茶攝氟量、尿氟分彆為3 304.58、2 170.42、2 476.34、1583.93 ml,0.27、0.88、1.04、0.35 mg/L,2.91、1.66、3.14、0.93 mg/L,10.17、4.14、9.22、2,66 mg,2,17、1.41、3.37、1.15 mg/L.日均磚茶水攝入量、飲用水氟含量、茶水氟含量、日均磚茶攝氟量、尿氟含量各民族間比較差異均有統計學意義(F值分彆為10.639、50.498、25.371、10.800、166.852,P均＜0.05).X線氟骨癥總體檢齣率為27.25％(399/1 464).其中藏族、矇古族、哈薩剋族和漢族的檢齣率分彆為43.55％(179/411)、21.90％(60/274)、33.22％(98/295)和12.81％(62/484);男性氟骨癥檢齣率[30.70％(175/570)]高于女性[25.06％(224/894),x2=5.596,P＜0.05];不同年齡段藏族、矇古族、漢族氟骨癥檢齣率組間比較差異均具有統計學意義(x2值分彆為50.423、8.899、18.676,P均＜0.05).結論 我國飲茶型氟中毒流行程度在不同民族間存在明顯差異,藏族人群的氟骨癥檢齣率和病情程度明顯重于哈薩剋族、矇古族和漢族,與不同民族之間磚茶氟暴露程度不同有關.在磚茶氟暴露程度相近的情況下,哈薩剋族氟骨癥檢齣率和病情程度明顯較藏族人群輕,提示在飲茶型氟中毒流行中還有非暴露因素的參與.
목적 탐토음다형불중독지구장、몽고、합살극、한4개민족적불중독병정시부존재차이급인기차이적가능원인.방법 재청해성과락주장족거주지구、내몽고자치구호륜패이시몽고족거주지구、신강유오이자치구아륵태합살극족거주지구각선택료2개현,매개현분별선택인구상대집중적3～4개병구향위조사점.선택조사점내16세이상소수민족급한족인군진행문권조사,조사내용포괄조사대상적일반정황、일균전다수섭입량등;병채집조사점적거민가중음용수양,이급조사대상적전다수、뇨양진행불함량측정;사용편휴식수자화X광궤(DR)대조사대상적전비、요추급분골진행X선박편.음용수수불、전다불화뇨불측정채용리자선택전겁법(WS/T 89-2006);X선불골증진단의거《지방성불골증진단표준》(WS/T 192-2007),병결합류행병학특정급림상표현.결과 공조사16세이상성인l 703인,기중장족、몽고족、합살극족화한족분별위525、328、305화545인.4개민족일균전다수섭입량、음용수불함량、다수불함량、일균전다섭불량적균치이급뇨불적궤하균수분별위2 758.42 ml、0.88 mg/L、2.76 mg/L、8.77 mg、1.75 mg/L.기중장족、몽고족、합살극족화한족인군적일균전다수섭입량、음용수불함량、다수불함량、일균전다섭불량、뇨불분별위3 304.58、2 170.42、2 476.34、1583.93 ml,0.27、0.88、1.04、0.35 mg/L,2.91、1.66、3.14、0.93 mg/L,10.17、4.14、9.22、2,66 mg,2,17、1.41、3.37、1.15 mg/L.일균전다수섭입량、음용수불함량、다수불함량、일균전다섭불량、뇨불함량각민족간비교차이균유통계학의의(F치분별위10.639、50.498、25.371、10.800、166.852,P균＜0.05).X선불골증총체검출솔위27.25％(399/1 464).기중장족、몽고족、합살극족화한족적검출솔분별위43.55％(179/411)、21.90％(60/274)、33.22％(98/295)화12.81％(62/484);남성불골증검출솔[30.70％(175/570)]고우녀성[25.06％(224/894),x2=5.596,P＜0.05];불동년령단장족、몽고족、한족불골증검출솔조간비교차이균구유통계학의의(x2치분별위50.423、8.899、18.676,P균＜0.05).결론 아국음다형불중독류행정도재불동민족간존재명현차이,장족인군적불골증검출솔화병정정도명현중우합살극족、몽고족화한족,여불동민족지간전다불폭로정도불동유관.재전다불폭로정도상근적정황하,합살극족불골증검출솔화병정정도명현교장족인군경,제시재음다형불중독류행중환유비폭로인소적삼여.
Objective To investigate the differences of fluorosis of Tibetans,Mongolians,Kazakhs and Han in drinking tea type fluorosis areas.Methods In Guoluo Autonomous Prefecture of Qinghai Province,Hulunbuir City of Inner Mongolia Autonomous Region and Altay Prefecture of Xinjiang Autonomous Region,two counties were selected in each province respectively,and 3-4 diseased townships were selected from each county.People 16 years and older of Tibetans,Mongolians,Kazakhs and Han were examined.A questionnaire survey of endemic fluorosis was conducted,the survey contents included general characteristics,average daily brick tea intake; drinking water,brick tea and urine were collected and used for analysis; forearm,lumbar spine and pelvis of subjects were examined by Portable DR.Water fluoride,brick tea fluorine and urinary fluoride were detected by ion selective electrode (WS/T 89-2006).X-ray diagnosis of skeletal fluorosis was based on "Endemic Skeletal Fluorosis Diagnostic Criteria" (WS/T 192-2007),and epidemiological and clinical descriptive information were combined.Results The total number of respondents was 1 703.The numbers of respondents in Tibetan,Mongolian,Kazak and Han were 525,328,305 and 545,respectively.In the four ethnic,average daily brick tea intake,fluoride content in drinking water,fluoride content in brick tea,average daily fluoride intake of brick tea,urinary fluoride content were 2 758.42 ml,0.88 mg/L,2.76 mg/L,8.77 mg and 1.75 mg/L.Average daily brick tea intake,fluoride contents in drinking water,fluoride contents in brick tea,average daily fluoride intake of brick tea,urinary fluoride contents in Tibetan,Mongolian,Kazak and Han were 3 304.58,2 170.42,2 476.34,1 583.93 ml,0.27,0.88,1.04,0.35 mg/L,2.91,1.66,3.14,0.93 mg/L,10.17,4.14,9.22,2.66 mg,2.17,1.41,3.37,1.15 mg/L.The differences of average daily brick tea intake,fluoride content in drinking water,fluoride content in brick tea,average daily fluoride intake of brick tea and urinary fluoride content between groups were statistically significant(F =10.639,50.498,25.371,10.800,166.852,all P ＜ 0.05).The average detectable rate of X-ray skeletal fluorosis was 27.25％(399/1 464).The X-ray detectable rate of skeletal fluorosis of Tibetan,Mongolian,Kazak and Han were 43.55％ (179/411),21.90％ (60/274),3.22％ (98/295) and 12.81％ (62/484),respectively.The detectable rate of skeletal fluorosis of males [30.70％(175/570)] was higher than that of females[(25.06％ (224/894),x2 =5.596,P ＜ 0.05].The differences of detectable rate of skeletal fluorosis was statistically significant in different age groups of Tibetan,Mongolian and Han(x2 =50.423,8.899,18.676,all P ＜ 0.05).Conclusions Significant differences of tea type fluorosis prevalence are found in different ethnic population.Compared with Mongolian,Kazak and Han,the detectable rate of skeletal fluorosis is higher and the condition of skeletal fluorosis is more serious in Tibetan,which is associated with higher fluoride exposures through brick tea.However,the skeletal fluorosis detectable rate of Kazakh is significantly lower than that of the Tibetan population but both have similar level of fluoride exposure.It is demonstrated that non-exposure factors may be involved in the mechanism of tea type fluorosis.
