硫酸软骨素和硫酸氨基葡萄糖对成人大骨节病的疗效分析

目的 观察硫酸软骨素和硫酸氨基葡萄糖对大骨节病的疗效.方法 2007年7月,在黑龙江省尚志市光辉村按<大骨节病诊断标准>检出患者80例.按病情等级、年龄、性别将80例患者分成治疗组、对照组.每组40人.治疗组给予硫酸软骨素和硫酸氨基葡萄糖治疗,对照组给予安慰剂(等量淀粉).在治疗前及治疗后(第8个月)对患者进行直立体位的膝关节X线拍片,利用刻度放大镜测量X线膝关节腔宽度.结果 对照组治疗前、后的X线膝关节腔宽度分别为(4.30±2.14)、(4.10±2.07)mm,治疗组分别为(4.17±2.15)、(4.16±2.11)mm.药物对X线关节腔宽度没有影响(F=0.50,P>0.05),时间、药物与时间的交互作用对X线关节腔宽度有影响(F值分别为67.66、46.74,P均<0.05).治疗组X线关节腔宽度治疗前低于对照组(P<0.05),治疗后高于对照组(P<0.05);对照组治疗前X线关节腔宽度高于治疗后(P<0.05).结论 硫酸软骨素和硫酸氨基葡萄糖减缓了成人大骨节病患者膝关节间隙继续变窄的进程,对关节软骨起到了保护作用,为成人大骨节病治疗在药物选择和疗效判定上提供了依据.     

2009年山西省饮水高砷区成人颈动脉粥样硬化调查

Objective To investigate the relationship between drinking-water type of endemic arsenicosis and adult carotid artery atherosclerosis. Methods In 2009, 285 participants aged over 40 from drinking-water type of endemic arsenism areas and 293 residents aged over 40 from control areas were investigated in Yingxian county,Shanxi province. Portable-type B mode color ultrasound was used to examine the carotid artery of all participants.The carotid atherosclerosis were diagnosed and graded through the ultrasonograms. Content of water arsenic and hair arsenic of 10 people randomly selected in every villages were detected. Results A total of 5 villages with drinkingwater type of endemic arsenicosis as observation group and 5 villages without drinking-water type of endemic arsenicosis as control group were investigated. The prevalence rates of adult carotid atherosclerosis within observation group were 35.09%(20/57), 55.74%(34/61), 38.46%(20/52), 36.51%(23/63) and 46.15%(24/52), respectively,and standardized prevalence rates were 32.5%, 33.8%, 34.9%, 46.2% and 47.3%, respectively and the prevalence rates of adult carotid atherosclerosis within control group were 18.18%(10/55), 30.77%(16/52), 20.00%(10/50),18.67% (14/75) and 21.31% ( 13/61 ), respectively; the standardize prevalence rates were 22.4%, 17.7%, 10.7%,24.6%, 18.9%, respectively. The standardize prevalence rates were higher in observation group [39.50%(113/285) ]than that in control group[39.50%(113/285), T = 26, P ＜ 0.01 ]. The severity of adult carotid atherosclerosis (composition of 4 - 7 scores ) was compared between observation group [ 17.70%(20/113 )] and control group [ 14.06% (9/64) ], and the difference was insignificant(x2 = 0.26, P ＞ 0.05). Conclusions The prevalence rate of carotid atherosclerosis in drinking-water type of endemic arsenicosis areas is higher than that of the control areas.The study provides evidence that arsenic poisoning can cause atherosclerosis.     

2009年山西省饮水高砷区成人颈动脉粥样硬化调查

目的 探讨饮水型砷中毒与成人颈动脉粥样硬化发生的关系.方法 2009年,在山西省应县,根据<地方性砷中毒病区判定和划分标准>(WS 277-2007),选择东辛寨村、北湛村、大西头村、赤堡村和杏寨村为病区组,选择龙泉村、接马峪村、城下庄村、罗庄村和南丰町村作为对照组,利用彩超对40岁以上的饮水型高砷地区居民285人和对照地区居民293人进行颈动脉粥样硬化检查,并进行诊断、记分.在对年龄构成标准化后,计算动脉粥样硬化的标准化检出率.每个调查村各抽取10人,采用原子荧光法检测水砷和发砷.结果在病区组中,东辛寨村、北湛村、大西头村、赤堡村和杏寨村成人颈动脉粥样硬化检出率分别为35.09%(20/57)、55.74%(34/61)、38.46%(20/52)、36.51%(23/63)、46.15%(24/52);标准化检出率分别为32.5%、33.8%、34.9%、46.2%、47.3%;在对照组,龙泉村、接马峪村、城下庄村、罗庄村和南丰町村成人颈动脉粥样硬化检出率分别为18.18%(10/55)、30.77%(16/52)、20.00%(10/50)、18.67%(14/75)和21.31%(13/61);标准化检出率为22.4%、17.7%、10.7%、24.6%、18.9%.病区组的标准化检出率[39.50%(113/285)]高于对照组[21.70%(64/293),T=26,P＜0.01],病区组成人颈部动脉粥样硬化4～7分的构成[17.70%(20/113)]与对照组[14.06%(9/64)]比较,差异无统计学意义(x2=0.26,P＞0.05).结论山西省饮水型砷中毒病区成人的动脉粥样硬化检出率高于对照区.为进一步证实砷中毒可致动脉粥样硬化症提供了证据.     

我国5省区非大骨节病病区村儿童掌指骨干骺端改变率调查

目的 研究非大骨节病病区村7~12岁儿童干骺端的改变率,为病区村判定消除大骨节病提供依据。方法 在吉林、辽宁、陕西、山西和内蒙古5个大骨节病病区省份随机调查36个非大骨节病病区村。用全数字化多功能X线摄影系统(DR)拍摄每个调查村全部7~12岁儿童右手X线片,并按照《大骨节病诊断》标准(WS/T 207-2010)诊断。结果 在调查的36个村中,只有13个村的儿童右手X线干骺端发生改变,且无骨端改变病例,以村为单位X线干骺端改变率均<3%。结论 建议判定病区村消除大骨节病的标准为7~12岁儿童干骺端改变率<3%。