CAJ | 학술논문

目的研究不同水砷含量暴露与人群心电图改变的关系,探讨砷对心血管系统的影响.方法 2008-2013年,根据饮水型地方性砷中毒的历史监测资料,在山西省和内蒙古自治区选择15个村作为调查点,选择年龄≥20岁、饮水≥10年的当地常住居民作为调查对象,按照饮水砷含量分为对照组(＜0.01 mg/L)、低水砷组(0.01～＜0.05 mg/L)、中水砷组(0.05～＜0.10 mg/L)以及高水砷组(≥0.10 mg/L).采集调查对象家中的饮用水,应用氢化物原子荧光法检测水砷,并描记12导联心电图,比较不同水砷暴露人群的心电图改变.结果共对1 341人进行心电图检查,异常率为11.56％(155/1 341),其中,对照组、低、中、高水砷组分别为5.7％(9/158)、12.85％(59/459)、12.02％(28/233)、12.02％(59/491).对照组的心电图异常率均低于低、中、高水砷组(x2值分别为6.141、4.391、5.090,P均＜0.05).心电图改变以心律失常和ST-T改变为主.对照组的各种心律失常异常率[0(0/158)]均低于低、中、高水砷组[4.58％(21/459)、3.86％(9/233)、3.46％(17/491);x2值分别为7.483、6.247、5.618,P均＜0.05].4组人群右心室扩大、心肌缺血心电图异常率组间比较差异均有统计学意义(x2值分别为9.525、9.848,P均＜0.05).结论饮水型砷中毒病区居民心电图异常改变以心律失常和ST-T改变为主.水砷含量≥0.01 mg/L即可明显引起心电图异常率的增加,饮水砷对心脏组织有一定的影响.
목적 연구불동수신함량폭로여인군심전도개변적관계,탐토신대심혈관계통적영향.방법 2008-2013년,근거음수형지방성신중독적역사감측자료,재산서성화내몽고자치구선택15개촌작위조사점,선택년령≥20세、음수≥10년적당지상주거민작위조사대상,안조음수신함량분위대조조(＜0.01 mg/L)、저수신조(0.01～＜0.05 mg/L)、중수신조(0.05～＜0.10 mg/L)이급고수신조(≥0.10 mg/L).채집조사대상가중적음용수,응용경화물원자형광법검측수신,병묘기12도련심전도,비교불동수신폭로인군적심전도개변.결과 공대1 341인진행심전도검사,이상솔위11.56％(155/1 341),기중,대조조、저、중、고수신조분별위5.7％(9/158)、12.85％(59/459)、12.02％(28/233)、12.02％(59/491).대조조적심전도이상솔균저우저、중、고수신조(x2치분별위6.141、4.391、5.090,P균＜0.05).심전도개변이심률실상화ST-T개변위주.대조조적각충심률실상이상솔[0(0/158)]균저우저、중、고수신조[4.58％(21/459)、3.86％(9/233)、3.46％(17/491);x2치분별위7.483、6.247、5.618,P균＜0.05].4조인군우심실확대、심기결혈심전도이상솔조간비교차이균유통계학의의(x2치분별위9.525、9.848,P균＜0.05).결론 음수형신중독병구거민심전도이상개변이심률실상화ST-T개변위주.수신함량≥0.01 mg/L즉가명현인기심전도이상솔적증가,음수신대심장조직유일정적영향.
Objective Through studying the relationship between different concentrations of arsenic in drinking water and ECG changes,to investigate the effects of arsenic on human cardiovascular system.Methods During 2008-2013,people that over 20 years old and over 10 years of drinking arsenic water were investigated in 15 villages of Shanxi Province and Inner Mongolia according to the historical data of endemic arsenic poisoning through drinking water,who were divided into control group (＜ 0.01 mg/L),low arsenic group (0.01-＜ 0.05 mg/L),medium arsenic group (0.05-＜ 0.10 mg/L) and high arsenic group (≥0.10 mg/L) according to the concentration of water arsenic.Arsenic concentrations in drinking water samples were detected by the method of hydride generation atomic fluorescence spectrometry.ECG-site inspections were finished to record 12-lead ECG.The effect of different concentrations of arsenic in drinking water on ECG was studied.Results ECG of 1341 people were surveyed,and abnormal rate was 11.56％ (155/1 341),including abnormal rate of control group,low arsenic group,medium arsenic group and high arsenic group which was 5.7％ (9/158),12.85％ (59/459),12.02％ (28/233),and 12.02％ (59/491),respectively.The abnormal rate of control group was lower than that of low arsenic group,medium arsenic group and high arsenic group (x2 =6.141,4.391,5.090,all P ＜ 0.05).ECG changes were characterized by cardiac arrhythmias and ST-T changes.A variety of arrhythmias abnormal rate of control group [0(0/158)] was lower than that of low arsenic group,medium arsenic group and high arsenic group [4.58％ (21/459),3.86％ (9/233),3.46％ (17/491); x2 =7.483,6.247,5.618,all P ＜ 0.05].In addition,there were significant differences among the four groups in the rates of right ventricular enlargement and myocardial ischemia (x2 =9.525,9.848,all P ＜ 0.05).Conclusions ECG changes of the residents in the areas of water-borne-endemic arsenic poisoning are characterized by cardiac arrhythmias and ST-T changes.Water arsenic concentration exceeding 0.01 mg/L could significantly increase the ECG abnormal rate,indicating that arsenic in drinking water has a certain effect on heart tissue.