关中地区地方性氟骨症发病的水氟含量的临界值调查

选择了九个各只有一眼饮用水井和饮用35年以上历史的自然村,对其世居群众通过临床体检、水氟含量检测、X线片多部位摄片、尿氟含量化验等检查,以X线片的四肢骨间膜和近端骨皮质处有无幼芽破土状、玫瑰刺样、花边样骨化物、骨纹增粗和骨质密度增高作为早期氟骨症的综合诊断指征,探讨了地方性氟骨症发生的水氟含量的临界值(或國值)。结果发现水氟含量在2.56ppm的焦家村,有2例疑似氟骨症患者有早期指征,占该村摄片人数的10.52％,在3.71ppm的小坡村和上鲁村分别发现3例和7例,诊断为早期氟骨症,各占X线摄片人数的16.67％和31.81％。据此认为,在陕西省关中地区,凡水氟含量在3.0ppm以上的患区,可列入立即改水防治的范畴,3.0ppm以下的病区可稍为缓后进行。

ENDEMIC SKELETAL FLUOROSIS IN GUANZHONG SHANXI: AN INVESTIGATION ON FLUORIDE LEVEL IN DRINKING WATER AND THE PATHOGENESIS OF SKELETAL FLUOROSIS

Nine natural villages were selected which had only one well each and their inhabitants drink well water for more than 35 years, and the resident population for successive generations were studied by clinical examination, determination of fluoride level in well water, roentgenography of various positions, and evaluation of urinary fluoride excretion for the association of fluoride level in drinking water with the pathogenesis of endemic skeletal fluorosis. The presence of bud-, thornand lace-like ossifications,coarse osseous striation and increased osseous density in interosseous membranes of the extremities and proximal osseous cortex was used as radiologica-lly diagnostic criteria for early skeletal fluorosis,and the threshold was investigated of fluoride level in drinking water over which skeletal fluorosis develops. In the village of Jiaojia where the fluoride content in well water was 2.56 ppm, there were found 2 cases of suspected early skeletal fluorosis, accounting for 10.52% of the number of persons radiographed in the community. In villages of Xiaopo and Shanglu in which the fluoride content in water was 3.71 ppm, three patients in the former and seven in the latter were diagnosed as having early skeletal fluorosis,accounting for 16.67% and 31.81% of the number of persons radiographed in the communities, respectively.It follows that in Guanzhong district of Shanxi province, areas with water fluoride content over 3.0ppm be classified as those requiring immediate control programmes of changing the water.