燃煤污染型地方性氟中毒患者血锌含量的变化及意义

目的 探讨微量元素锌(Zn)与燃煤污染型地方性氟中毒(燃煤型氟中毒)的关系,为Zn在该病防治中的作用提供科学依据.方法 儿童样本:采取分层抽样方法,分别在巫山县笃坪乡和奉节县兴隆镇各抽取50例氟斑牙和100例健康对照；成人样本:在巫山县笃坪乡现存的氟骨症患者中抽取30例氟骨症,在同乡抽取60例健康对照.抽取研究对象空腹静脉血并测定血Zn含量,收集尿液并检测尿氟.Wilcoxon秩和检验对比分析病例和对照血Zn、尿氟含量的差异以及两县之间病例与病例、对照与对照血Zn、尿氟含量的差异；Pearson线性相关/Spearman秩相关检验血Zn含量与尿氟含量的相关性.结果 巫山和奉节两县儿童尿氟平均含量均为病例组高于对照组(P均＜0.01),血Zn平均含量则均为病例组低于对照组(P均＜0.01)；巫山县儿童病例组和对照组血Zn含量分别低于奉节县儿童病例组和对照组血Zn含量(P均＜0.05),巫山县儿童病例组尿氟含量低于奉节县(P＜0.05).巫山县成人尿氟平均含量病例组高于对照组,血Zn含量病例组低于对照组(P均＜0.01).相关分析显示,儿童和成人的血Zn含量与尿氟含量均具有微弱的正相关关系(P＜0.05,P＜0.01).结论 氟中毒患者体内普遍缺Zn,提示缺Zn可能是患该病的危险因素.

Changes of blood zinc content in patients with coal-burning endemic fluorosis and its implication

Objective To assess the association of zinc (Zn) with coal-burning endemic fluorosis (coal-burning fluorosis), so as to provide an evidence for the role of Zn in preventing coal-burning fluorosis. Methods Fifty children with dental fluorosis and 100 healthy controls were selected from Wushan County by stratified sampling, and the same number of children and controls were also selected from Fengjie County. Thirty adults were selected from skeletal fluorosis patients in Duping Township of Wushan County, and 60 healthy controls were selected in the same township. Fasting blood samples were collected from all the participants for Zn determination. Urine samples were collected to examine urine fluoride content. Wilcoxon rank sum test was used to analyze the differences in Zn and fluoride contents between cases and controls and between the two counties. The association between blood Zn and urine fluoride was examined by Pearson linear correlation/Spearman rank correlation. Results The average urine fluoride contents were significantly higher in the child fluorosis cases than in the controls from both counties (P<0.01); and the average blood Zn contents were significantly lower in the fluorosis cases than in the controls from both counties (P<0.01). Moreover, the child cases and controls from Wushan County had significantly lower average blood Zn contents compared with those from Fengjie County (P<0.05); the child fluorosis cases in Wushan County had a significantly lower urine fluoride content compared with those from Fengjie County (P<0.05). The average urine fluoride content of skeletal fluorosis adults from Wushan County was significantly higher than that of controls, and the average blood Zn content was significantly lower than that of controls (P<0.01). In addition, Pearson linear correlation/Spearman rank correlation showed a weak positive relationship between blood Zn and urine fluoride in both children and adults (P<0.05, P<0.01). Conclusion It is indicated that patients with fluorosis are generally Zn deficient, suggesting Zn deficiency might be a risk factor for fluorosis.