CAJ | 학술논문

目的了解燃煤污染型地方性氟中毒(地氟病)病区学龄儿童氟斑牙、尿氟及智力水平情况,探讨综合治理对地氟病病区儿童智力发育的影响.方法 2012年,在贵州省毕节市,选择鸭池镇下坝村和千溪乡中屯村(改炉改灶及健康教育综合治理时间超过3年)、海子街镇沙地村和八寨镇毛栗坪村(改良炉灶和健康教育综合治理时间＜1年),以村小学8～12岁学生为调查对象,分别作为治理时间长组、治理时间短组.同时选择毕节市七星关区第八小学学生作为对照组.氟斑牙检查采用Dean法,尿氟测定采用氟离子选择电极法,智商检查采用《瑞文标准推理测验》.结果对照组学龄儿童104人,氟斑牙检出率为0(0/104);治理时间长组298人,氟斑牙检出率为72.5％(216/298);治理时间短组339人,氟斑牙检出率为85.3％ (289/339);治理时间长组、治理时间短组氟斑牙检出率比较差异有统计学意义(x2=15.736,P＜0.01).治理时间长组、治理时间短组儿童尿氟含量[(2.33±0.18)、(3.03±0.16)mg/L]均高于对照组[(1.34±0.64) mg/L,F=306.53,P＜ 0.01].对照组儿童中等以上智商占97.1％(101/104),明显高于治理时间长组[59.4％ (177/298)]和治理时间短组[55.2％ (187/339)],病区经过长时间治理后,低年龄组(8～ 10岁)儿童智力低下的检出率明显降低(x2=7.542,P＜ 0.01).儿童尿氟含量与智力水平具有负相关性(r=-0.553,P＜0.01).结论地氟病病区儿童智力发育较对照组儿童明显迟缓,经过一定时间的综合治理后,低年龄组儿童智力发育迟缓现象有明显改善.
목적 료해연매오염형지방성불중독(지불병)병구학령인동불반아、뇨불급지력수평정황,탐토종합치리대지불병병구인동지력발육적영향.방법 2012년,재귀주성필절시,선택압지진하패촌화천계향중둔촌(개로개조급건강교육종합치리시간초과3년)、해자가진사지촌화팔채진모률평촌(개량로조화건강교육종합치리시간＜1년),이촌소학8～12세학생위조사대상,분별작위치리시간장조、치리시간단조.동시선택필절시칠성관구제팔소학학생작위대조조.불반아검사채용Dean법,뇨불측정채용불리자선택전겁법,지상검사채용《서문표준추리측험》.결과 대조조학령인동104인,불반아검출솔위0(0/104);치리시간장조298인,불반아검출솔위72.5％(216/298);치리시간단조339인,불반아검출솔위85.3％ (289/339);치리시간장조、치리시간단조불반아검출솔비교차이유통계학의의(x2=15.736,P＜0.01).치리시간장조、치리시간단조인동뇨불함량[(2.33±0.18)、(3.03±0.16)mg/L]균고우대조조[(1.34±0.64) mg/L,F=306.53,P＜ 0.01].대조조인동중등이상지상점97.1％(101/104),명현고우치리시간장조[59.4％ (177/298)]화치리시간단조[55.2％ (187/339)],병구경과장시간치리후,저년령조(8～ 10세)인동지력저하적검출솔명현강저(x2=7.542,P＜ 0.01).인동뇨불함량여지력수평구유부상관성(r=-0.553,P＜0.01).결론 지불병병구인동지력발육교대조조인동명현지완,경과일정시간적종합치리후,저년령조인동지력발육지완현상유명현개선.
Objective To investigate the incidence of dental fluorosis,urinary fluoride level and intelligence of children who lived in the coal-burning-borne endemic fluorosis areas and to reveal the effects of comprehensive control measures on intelligence of children in this area.Methods Children aged 8-12 who lived in coal-burning-borne endemic fluorosis areas in Bijie City of Guizhou Province were selected and divided into two groups according to the duration of comprehensive treatments given:long treatment group (Xiaba Village and Zhongtun Village,furnace stovewas changed and comprehensive control measure of health education was carried out for more than 3 years) and short treatment group(Chadi Village and Maoliping Village,stoves were improved and health education time ＜ 1 year).The children who lived in a non-fluorosis area were selected as controls in 2012.Dental fluorosis was diagnosed by the method of Dean; urinary fluoride was analyzed by the method of fluoride-ion selective electrode; and the intelligence quotient (IQ) was measured by Raven's Standard Progressive Matrices Test.Results The number of children surveyed in control group was 104,long treatment group was 298,short treatment group was 339,and the incidence rates of dental fluorosis were 0 (0/104),725％(216/298) and 85.2％ (289/339),respectively,and the incidence rates of dental fluorosis in children lived in the endemic fluorosis areas were significantly increased compared with that of control group; the difference of incidence rates between long treatment group and short treatment group was statistically significantly(x2 =15.736,P ＜ 0.01).Urinary fluoride content were (2.33 ± 0.18) and (3.03 ± 0.16)mg/L,respectively,compared with the control group[(1.34 ± 0.64) mg/L],the values in endemic fluorosis areas were significantly higher(F =306.53,P ＜ 0.01).Above average IQ of children in the control group was 97.1％ (101/104),which was significantly higher than that of long and short treatment groups; after a lengthy treatment,mental retardation detection rate was significantly lower in the low-age group,8-10 year-old ehildren(x2 =7.542,P ＜ 0.01).Urinary fluoride content was negatively correlated with the level of IQ (r =-0.553,P ＜ 0.01).Conclusions The intelligence development of children in coal-burning-borne endemic fluorosis area is significantly delayed.After a certain period of comprehensive treatment,the decreased level of cognition is inhibited and the mental retardation in the low-age group is improved.