不同价态形态砷与砷中毒患者病情关系的研究

目的:通过对砷中毒患者血样与尿样进行砷价态形态、肝肾功等指标的检测,初步探索砷不同价态形态与患者病情程度之间的关系。方法:采集150例新疆奎屯农七师、内蒙古呼和浩特市和山西省山阴县等地对照组及患者的血样与尿样,分别检测样品中总砷、As(Ⅲ)(三价无机砷)、DMA(二甲基砷酸盐)、MMA(一甲基砷酸盐)的浓度,以及患者皮肤损害、相关酶和肝肾功的变化;通过统计学分析,了解相互之间的关系。结果:对于重度砷中毒患者,iAsⅢ、MMA和DMA的浓度与GST01(谷胱甘肽硫转移酶)、PNP20(嘌呤核苷磷酸化酶)、PNP51的浓度密切相关;其中MMA与PNP51之间呈正相关,r值为0.72334,P<0.01;iAsⅢ和DMA与PNP51也呈正相关,r值分别为0.57496和0.56569,P<0.05;而iAsⅢ和DMA与GST01之间表现出负相关的关系,r分别为-0.42833和-0.47226,P<0.05;iAsⅢ和DMA与AS3MT(砷甲基转移酶)呈负相关,r分别为-0.50329和-0.65320,P<0.05。iAsⅢ、MMA和DMA含量则表现出与皮肤损害包括色素缺失、色素减少及皮肤角化的弱正相关关系,但相关性较弱,r为0.32389,P<0.05。Logistic有序回归分析结果显示:iAsⅢ、DMA、MMA的回归系数β在α=0.05水平上无统计学意义。结论:砷不同价态形态与患者病情程度相关,主要表现为影响酶的活性。

The study on the relationship between the different valence and speciation of arsenic and arseniasis

Objective:To analyze the relationship between different valences of the arsenic and the degree of the arseniasis by detecting the valences of arsenic and the metabolic enzymes in the blood and urine samples.Methods:Totally 150 samples of the arseniasis patients were collected including control group and arseniasis group which were from the Seventh Agricultural Construction Division of Kuitun city,Xinjiang Autonomous Region,Hohhot city of Inner Mongolia Autonomous Region and Shanyin County of Shanxi province.The concentrations of As(Ⅲ)(trivalent inorganic arsenic),DMA(dimethyl arsenate),MMA(methyl arsenate) in the samples were determined,the degree of skin lesions,changes of relative enzymes were measured.The relation between the data were analysed by statistical analysis.Results:Regarding severe arseniasis patients,the concentrations of iAs Ⅲ,MMA and DMA were closely related to the concentrations of GST01(glutathione S-transferase),PNP20(purine nucleoside phosphorylase) and PNP51.The concentration of MMA was positively related with PNP51(r = 0.723,P<0.01);The concentration of iAs Ⅲ and DMA,iAs Ⅲ were positively related with PNP51(r=0.575 and 0.566 respectively,P<0.05).The concentration of iAs Ⅲ and DMA,iAs Ⅲ were negatively related with GST01(r=-0.428 and-0.472,P<0.05).The concentration of iAsⅢ and DMA,iAsⅢ were negatively related with AS3MT(r=-0.503 and-0.653,P<0.05).There was a weak correlation between contents of iAsⅢ,MMA,DMA and skin lesions including loss of pigment,hypopigmentation and skin keratosis,(r=0.323,P<0.05).Ordinal logistic regression analysis showed no significance of regression coefficient β at α=0.05 level.Conclusion:The degree of arseniasis is related to different valence arsenic in which,the latter mainly affects enzyme activities.