山西省临猗县饮水型地方性氟中毒与尿氟关系的研究

目的 了解山西省临猗县饮水型地方性氟中毒的患病情况,探讨氟中毒与尿氟之间的关系,为当地饮水型地方性氟中毒的防治提供依据.方法 2006年在临猗县饮水型地方性氟中毒重、中病区和非病区各选取1个村作为调查点,采用Dean法和离子选择电极法对当地居民进行氟斑牙和尿氟检查,对病区30岁及以上成年人进行前臂正位X线(包括肘与腕)拍片,进行氟骨症患病情况调查.结果 3个地区人群氟斑牙检出率明显不同(X~2=410.945,P<0.01),其中,中病区、重病区氟斑牙检出率分别为92.34%(253/274)、90.09%(291/323),明显高于非病区[23.27%(64/275),X~2值分别为274.927、268.287,P均<0.01].重病区氟骨症检出率[59.75%(141/236)]明显高于中病区[24.76%(52/210),X~2=183.578,P<0.01].3个地区人群尿氟水平差异有统计学意义(H=411.197,P<0.01),其中重病区为(4.69±0.17)mg/L、中病区为(4.86±0.13)ms/L、非病区为(1.75±0.04)mg/L;而氟骨症患病程度与人群尿氟之间呈直线相关关系(r=0.508,P<0.01).结论 山西省临猗县饮水型地方性氟中毒病区氟斑牙、氟骨症患病情况严重,氟骨症患病程度与尿氟水平相关.

Study on relationship between drinking water endemic fluorosis and urine fluorine in Linyi county, Shanxi province

Objective To investigate the prevalence for endemic fluorosis of drinking water type and to discuss the relationship between endemic fluorosis and urinary fluorine in Linyi county, Shanxi province. Methods In 2006, three counties were selected as heavy, medium and control areas according to the distributing feature of the disease. The dental fluorosis in each spots was examined by Dean method. The levels of urinary fluorine were determined by fluorine selective ion electrode. The skeletal fluorosis of adults were examined by X-ray. Results There was evident differences of dental fluorosis and skeletal fluoresis among the heavy and the medium endemic fluorosis and control areas(X~2 = 410.945, P < 0.01 ), the prevalence of dental fluoresis in the medium area and the heavy area were 92.34% (253/274), 90.09% ( 291/323), significantly higher than in the control area[23.27% (64/275), X~2 = 274.927,268.287, all P < 0.01]. The heavy area had the highest rate of the skeletal fluorosis rate [59.75% (141/236) ], the medium area had the middle-level of the skeletal fluorosis rate[24.76%(52/210), X~2 = 183.578, P< 0.01]. Urine fluorine contents in both beavy[ (4.69 ± 0.17)mg/L] and medium areal (4.86 ± 0.13)mg/L] were higher than that in the control areas[ (1.75 ± 0.04)mg/L, H = 411.197, P< 0.01], and there was linear relevance between the different degree of skeletal fluorosis and urine fluorine contents (r = 0.508, P < 0.01). Conclusions The local fluoresis condition of Linyi county in Shanxi province was serious. The degree of skeletal fluorosis is associated with the fluoride content in urine.