CAJ | 학술논문

目的探讨不同民族饮茶型氟中毒人群茶水氟暴露程度与尿氟水平之间关系.方法选择青海省果洛州玛沁县、达日县和新疆阿勒泰地区的阿勒泰市、哈巴河县饮茶型氟中毒病区为调查点.其中,在青海省的调查点抽取6个藏族聚集村,在新疆阿勒泰地区则抽取5个哈萨克族聚集村.对生活于当地的16岁以上人群进行问卷调查,并采集其饮用的茶水样,依据《砖茶含氟量》(GB 19965-2005)检测砖茶水氟含量,计算日均茶氟摄入量;同时采集调查对象的即时尿液样本,采用《尿中氟化物的测定离子选择电极法》(WS/T89-1996)检测尿氟含量;对全部调查对象进行数字化X线摄片,拍摄部位为前臂、小腿和骨盆,根据《地方性氟骨症诊断标准》(WS 192-2008)进行氟骨症诊断.同时采用Spearman法对不同性别、年龄氟暴露程度与尿氟水平进行相关性分析.结果共调查445名16岁以上成人,其中藏族224人、哈萨克族221人.藏族日均茶氟摄入量中位数为9.93 mg,哈萨克族为9.57 mg.藏族尿氟几何均数为2.26 mg/L,哈萨克族为3.29 mg/L.氟骨症总检出率为37.98％(169/445),其中藏族为45.54％(102/224),哈萨克族为30.32％(67/221).民族、性别及氟中毒病情不同的人群总的日均茶氟摄入量与尿氟水平呈正相关(r=0.23,P＜ 0.01).进一步分层分析,藏族男性40～49岁氟骨症人群与50 ～ 59岁非氟骨症人群日均茶氟摄入量与尿氟水平呈正相关(r=0.81、0.58,P均＜0.05),藏族女性60 ～ 69岁氟骨症人群日均茶氟摄入量与尿氟水平呈正相关(r=0.56,P＜0.05);哈萨克族男、女性50～59岁非氟骨症人群日茶氟摄入量与尿氟水平呈正相关(r=0.57、0.61,P均＜0.05).结论在青海省和新疆阿勒泰地区,人群尿氟水平与砖茶氟暴露程度呈正相关关系.
목적 탐토불동민족음다형불중독인군다수불폭로정도여뇨불수평지간관계.방법 선택청해성과락주마심현、체일현화신강아륵태지구적아륵태시、합파하현음다형불중독병구위조사점.기중,재청해성적조사점추취6개장족취집촌,재신강아륵태지구칙추취5개합살극족취집촌.대생활우당지적16세이상인군진행문권조사,병채집기음용적다수양,의거《전다함불량》(GB 19965-2005)검측전다수불함량,계산일균다불섭입량;동시채집조사대상적즉시뇨액양본,채용《뇨중불화물적측정리자선택전겁법》(WS/T89-1996)검측뇨불함량;대전부조사대상진행수자화X선섭편,박섭부위위전비、소퇴화골분,근거《지방성불골증진단표준》(WS 192-2008)진행불골증진단.동시채용Spearman법대불동성별、년령불폭로정도여뇨불수평진행상관성분석.결과 공조사445명16세이상성인,기중장족224인、합살극족221인.장족일균다불섭입량중위수위9.93 mg,합살극족위9.57 mg.장족뇨불궤하균수위2.26 mg/L,합살극족위3.29 mg/L.불골증총검출솔위37.98％(169/445),기중장족위45.54％(102/224),합살극족위30.32％(67/221).민족、성별급불중독병정불동적인군총적일균다불섭입량여뇨불수평정정상관(r=0.23,P＜ 0.01).진일보분층분석,장족남성40～49세불골증인군여50 ～ 59세비불골증인군일균다불섭입량여뇨불수평정정상관(r=0.81、0.58,P균＜0.05),장족녀성60 ～ 69세불골증인군일균다불섭입량여뇨불수평정정상관(r=0.56,P＜0.05);합살극족남、녀성50～59세비불골증인군일다불섭입량여뇨불수평정정상관(r=0.57、0.61,P균＜0.05).결론 재청해성화신강아륵태지구,인군뇨불수평여전다불폭로정도정정상관관계.
Objective To explore the correlation between urinary fluoride level and brick tea fluoride load.Methods Maqin County and Dari County in Qinghai,Altay City and Habahe County in Sinkiang were selected,six brick-tea-borne fluorosis villages from Qinghai,and five brick-tea-borne fluorosis villages from Sinkiang were surveyed.People over 16 years old borne and grew up in those villages,were all included in the study.All of the participants were carried on question investigation,their tea water samples were collected and the fluoride concentration was tested by "the Standard of Brick Tea Fluorine Content" (GB 19965-2005),and the intaking of fluoride per day was calculated.Meanwhile,the fluoride concentration of spot urine was tested by the ion selective electrode method (WS/T 89-1996).All of the participants were diagnosed by X-ray on forearm,shank and pelvic,then the skeletal fluorosis was diagnosed by "the Standard of Radiologic Diagnosis of Skeletal Fluorosis" (WS 192-2008).Results A total of 445 people over 16 years old were surveyed,224 were Tibetan and 221 were Kazakh.The median of intaking of fluoride per day of Tibetan was 9.93 mg and Kazakh was 9.57 mg.The geometric mean of urinary fluoride of Tibetan was 2.26 mg/L and Kazakh was 3.29 mg/L.The prevalence rates of skeletal fluorosis were 37.98％ (169/445),45.54％ (102/224) in Tibetan,and 30.32％ (67/221) in Kazakh.There was positive correlation between urinary fluoride level and intaking of fluoride per day in different sex,race and fluorosis state (r =0.23,P ＜ 0.01).Stratification analysis had shown that there was positive correlation in some stratification in Tibetan (male in Tibetan:40-49 years,skeletal fluorosis population;50-59 years,non-skeletal fluorosis population;female:50-59 years,skeletal fluorosis population;r =0.81,0.58,0.56,all P ＜ 0.05).Meanwhile,there was also positive correlation in the non-skeletal fluorosis population of 50-59 years in Kazakh (r =0.57,0.61,all P ＜ 0.05).Conclusion There is a positive relationship between the urine fluorine level and brick tea fluorine load in general.