不同含氟量低氟砖茶预防饮茶型氟中毒效果评价

目的对不同含氟量低氟砖茶预防饮茶型氟中毒效果进行评价。方法选择内蒙古自治区克什克腾旗达来诺日镇罕达罕嘎查、哈达英格嘎查居民分别为饮用含氟量(204.5±10.2)、(308.2±15.4)mg/kg低氟青砖茶预防试验点,选择伊金霍洛旗苏布尔嘎苏木苏布尔嘎嘎查居民为饮用含氟量(115.8±38.4)mg/kg、四子王旗吉生太镇南号一组和南号二组居民为分别饮用(200.6±20.5)mg/kg、(301.9±28.4)mg/kg低氟普洱砖茶预防试验点。开展预防试验前,用Dean法检查20～70岁成人氟斑牙,临床和X线法检查氟骨症,并根据《地方性氟骨症诊断标准》(WS192-2008)进行氟骨症诊断。用便携双能X线机检查预防试验前、预防试验24个月后成人骨密度,用氟离子选择电极法检测预防试验点饮用水、砖茶、砖茶饮料、居民尿含氟量,计算居民日经砖茶饮料摄氟量。结果预防试验点氟斑牙检出率54.84%～79.63%;临床氟骨症检出率50.91%～65.69%;X线氟骨症检出率44.30%～65.17%,X线重度氟骨症检出率2.27%～8.86%,预防试验点均为地方性氟中毒重病区。成人骨密度0.451～0.508,骨量减少和骨质疏松检出率38.6%～62.5%。饮水含氟量均≤1.0 mg/L;砖茶含氟量805.6～918.5 mg/kg;预防试验前砖茶饮料含氟量罕达罕嘎查(2.16±1.12)mg/L、哈达英格嘎查(2.82±1.38)mg/L、苏布尔嘎嘎查(1.61±0.74)mg/L、南号一组(3.95±1.22)mg/L,南号二组(3.56±1.39)mg/L;成人尿含氟量罕达罕嘎查(2.78±1.57)mg/L、哈达英格嘎查(2.96±1.80)mg/L,苏布尔嘎嘎查(1.53±0.70)mg/L,南号一组(2.82±1.47)mg/L,南号二组(2.76±1.79)mg/L;经砖茶饮料摄氟量罕达罕嘎查(8.12±5.84)mg/d,哈达英格嘎查(6.42±5.04)mg/d,苏布尔嘎嘎查(3.95±2.42)mg/d,南号一组(8.31±4.49)mg/d,南号二组(6.66±4.73)mg/d。预防试验后24个月骨密度罕达罕嘎查0.527±0.083,显著高于预防试验前(t=3.65,P<0.01),哈达英格嘎查0.443±0.131、苏布尔嘎嘎查0.471±0.110、南号一组0.446±0.118、南号二组0.444±0.099,与预防试验前比较差异均不显著;砖茶饮料含氟量罕达罕嘎查(1.18±0.45)mg/L、哈达英格嘎查(1.60±0.85)mg/L、苏布尔嘎嘎查(0.62±0.29)mg/L、南号一组(1.16±0.35)mg/L、南号二组(1.60±0.71)mg/L,均显著低于预防试验前(P<0.05),苏布尔嘎嘎查显著低于其他预防试验点(P<0.01),罕达罕嘎查显著低于哈达英格嘎查(P<0.05),南号一组显著低于南号二组(P<0.05),苏布尔嘎嘎查、罕达罕嘎查、南号一组符合小型集中式供水国家标准(GB5749-2006氟化物<1.2 mg/L);尿含氟量罕达罕嘎查(2.35±1.04)mg/L、南号一组(2.12±0.96)mg/L显著低于预防试验前(P<0.05),哈达英格嘎查(2.81±1.00)mg/L、苏布尔嘎嘎查(1.47±0.69)mg/L、南号二组(2.48±1.17)mg/L低于预防试验前,但差异均无显著性;经砖茶饮料日摄氟量罕达罕嘎查(2.99±1.71)mg/d、哈达英格嘎查(3.66±2.22)mg/d、苏布尔嘎嘎查(1.75±1.26)mg/d、南号一组(3.08±1.56)mg/d、南号二组(3.52±2.42)mg/d均显著低于预防试验前(P<0.05),苏布尔嘎嘎查显著低于其他预防试验点(P<0.01),苏布尔嘎嘎查、罕达罕嘎查、南号一组经砖茶饮料日摄氟量在国家卫生标准允许限量内(WS/T 87-1996允许限量3.5 mg/d)。结论饮用低氟砖茶可有效预防饮茶型氟中毒,含氟量≤(204.5±10.2)mg/kg低氟砖茶预防效果更为显著。

Effect evaluation of different fluorine contents of low-fluoride brick-tea prevents fluorosis

Objective To evaluate the effect of different fluorine contents of low-fluoride brick-tea prevents fluorosis.Method The residents from Handahangacha and Hadayinggegacha of Keshiketongqi dalainuori town of the Inner Mongolia Autonomous Region who drunk low fluoride green brick tea which contains fluoride(204.5±10.2)mg/kg,(308.2±15.4) mg /kg respectively were selected as prevention testing points,residents of Yijinhuoluoqi Subuergasumu subuergagacha drunk fluoride content (115.8±38.4) mg /kg,residents of Siziwangqi jishengtaiTown,two groups drunk fluoride content(200.6±20.5) mg /kg,(301.9±28.4) mg /kg low fluorine Pu’er brick tea as prevention test points.Before carrying out preventive test Dean method was used to check the 20 to 70 years old adults’ dental fluorosis,clinical and radiographic examination were used to examine skeletal fluorosis,and according to the"Endemic Skeletal Fluorosis Diagnosis Standard"(WS192-2008) to conduct diagnosis of fluorosis of bone.Portable dual energy X-ray machine was used to check adults’ bone mineral density before prevention test and 24 months after test,fluorine content level of water,brick tea,tea beverage,residents’ urinary was detected by fluoride ion by selective electrode method to calculate residents’ fluoride ingestion from tea beverage every day.Results Detection rate of dental fluorosis in prevention test points was from 54.84% to79.63%;Detection rate of clinical fluorine bone disease was from 50.91% to 65.69%;Detection rate of X-ray fluorine bone disease was from 44.30% to 65.17%,Detection rate of severe X-ray fluorine bone was from 2.27% to 8.86%.Prevention test points were severe endemic fluorosis areas.Adults’ bone mineral density was from 0.451 to 0.508,detection rate of osteopenia and osteoporosis was from 38.6% to 62.5%.Fluoride content in drinking water were less than or equal to 1.0 mg / L;Fluoride content of brick tea was from 805.6 to 918.5mg /kg;Before test: fluorine content in tea drinks of Handahangacha test point was(2.16±1.12) mg /L,Hadayinggegacha was(2.82±1.38) mg /L,Subergagacha was(1.61±0.74) mg /L,Nanhaoyizu was(3.95±1.22) mg /L,Nanhaoerzu was(3.56±1.39) mg /L;Adult urine fluorine content in Handahangacha was(2.78±1.57) mg /L,Hadayinggegacha was(2.96±1.80) mg /L,Subuergagacha was 1.53±0.70) mg /L,Nanhaoyizu was(2.82±1.47) mg /L,Nanhaoerzu was(2.76±1.79) mg /L;Intake of fluoride from the brick tea beverage in Handahangacha was(8.12±5.84) mg /d,Hadayinggegacha was(6.42±5.04) mg /d,Subergagacha was(3.95±2.42) mg /d,Nanhaoyizu was(8.31±4.49) mg /d,Nanhaoerzu was(6.66±4.73) mg /d.24 months after prevention test: bone mineral density in Handahangacha is 0.527±0.083,significantly higher than that of prevention test(t = 3.65,P<0.01),Hadayinggegacha was 0.443±0.131,Subuergagacha is 0.471±0.110,Nanhaoyizu was 0.446±0.118,Nanhaoerzu was 0.444±0.099,and there were no significant differences in the fluoride content of brick tea beverage before the prevention test;Handahangacha was(1.18±0.45)mg/L,Hadayinggegacha was(1.60±0.85) mg /L,Subuergagacha was(0.62±0.29) mg /L,Nanhaoyizu was(1.16±0.35) mg /L,Nanhaoerzu was(1.60±0.71) mg /L,which were significantly lower than those before prevention test(P< 0.05),Subuergagacha was significantly lower than the other prevention test points(P< 0.01),Handahangacha was significantly lower than Hadayinggegacha(P< 0.05),Nanhaoyizu was significantly lower than Nanhaoerzu(P< 0.05),Subuergagacha,Handahangacha,Nanhaoyizu met small Centralized Water Supply National Standard(GB5749-2006 fluoride <1.2 mg / L);Urinary fluoride content in Handahangacha was(2.35±1.04) mg /L,Nanhaoyizu was(2.12±0.96) mg /L,which were significantly lower than those of prevention test(P< 0.05),and Hadayinggegacha was(2.81±1.00) mg /L,Subuergagacha was(1.47±0.69) mg /L,Nanhaoerzu was(2.48±1.17) mg /L,lower than the prevention test before,but there were no significant differences between them;Daily fluoride intake from the brick tea beverages in Handahangacha was(2.99±1.71) mg /d,Hadayinggegacha was(3.66±2.22) mg /d,Subuergagacha was(1.75±1.26) mg /d,Nanhaoyizu was(3.08±1.56) mg /d,Nanhaoerzu was(3.52±2.42) mg /d,which were significantly lower than those the prevention test before(P< 0.05),Subuergagacha was significantly lower than the other prevention test points(P<0.01),daily fluoride intake of tea beverages in Subuergagacha,Handahangacha,Nanhaoyizu was within national health standards allow limitation(WS / T 87-1996 allows 3.5mg /d).Conclusion Low fluorine brick tea can effectively prevent brick tea fluorosis,prevention effect of fluoride content is less than or equal to(204.5±10.2) mg /kg of low fluorine brick tea is more obvious.