2008年天津市地方性氟中毒病区成人氟骨症流行病学调查

目的 了解2008年天津市地方性氟中毒病区成人氟骨症的流行现状,为防治工作提供科学依据.方法 2008年4-6月,在天津市氟中毒轻、中、重病区,采用分层抽样方法抽取55个村,检测饮用水水氟,对16岁以上人群进行氟骨症临床检查;在55个病村中按轻、中、重分层抽取20个病村,对患者或疑似患者进行氟骨症X线检查.结果 在轻、中、重病区,水氟几何均值分别为1.35、3.44、5.49 mg/L,临床氟骨症检出率分别为6.4%(385/6016)、6.5%(757/11723)、27.8%(1538/5539).随年龄的增长,氟骨症检出率逐渐增高(r=0.534,P<0.01),临床病情也随年龄增长(H=84.813,P<0.01).轻、中、重病区X线氟骨症检出率分别为36.7%(44/120)、20.6%(33/160)、39.4%(43/109).随年龄的增长,氟骨症X线检出率逐渐增高(r=0.990,P<0.01),X线下病情也随年龄增长(H=25.169,P<0.01).临床、X线氟骨症检出率男女比较差异无统计学意义(X2=0.343、3.532,P均>0.05).结论 天津市氟骨症病区成人氟骨症尚存在一定程度的流行,地方性氟中毒尚未达到完全控制.仍应坚持病区改水以改善病情.

Investigation on the prevalent condition of adult osteofluorosis in the endemic fluorosis areas of Tianjin in 2008

Objective To investigate the prevalence of adult osteofluomsis in the endemic fluomsis areas in Tianjin and to provide scientific foundation for endemic fluorosis.Methods Stratified sampling in 55 villages were selected in 3 areas with slight,moderate and severe fluorosis regions in Tianjin from April to June in 2008.Water fluorine were tested and clinical osteofluorosis examinations were conducted to the population aging 16 and above in the villages.Tweenty villages were selected randomly in the slight,moderate and severe fluorosis regions.X-ray osteofluorosis examination were conducted to patients and suspected patients in these 20 villages.Results The geometric mean fluoride content in the water for the 3 areas were 1.35 mg/L,3.44 mg/L,5.49 mg/L,respectively.The prevalence of osteofluorosis were 36.7%(44/120),20.6%(33/160),39.4%(43/109),respectively.The prevalence of osteofluorosis Was increased gradually(r=0.534,P<0.01)and the symptoms and signs of the disease were more serious(H=84.813,P<0.01).The prevalence of X-ray diagnosis Was increased gradually(r=0.990,P<0.01)and signs of the disease were more severe(H=25.169,P<0.01)with an increase in age.There was no statistical significance of prevalence rate of osteofluorosis between males and females,regardless if it Was a clinical diagnosis(X2=0.343,P>0.05)or an X-ray diagnosis(X2=3.532,P>0.05).Conclusions Adult osteofluorosis to a certain extent is still prevalent in the fluorosis areas in Tianjin.Endemic fluorosis is still rampant.Improving water in fulorosis areas should be mandatory.