过量氟致骨相损伤的早期诊断指标分析

目的探讨过量氟致骨相损伤早期监测和诊断的参考指标。方法将48只Wistar大鼠随机分为四组各12只。染氟低、中、高剂量组分别饮用氟化钠浓度为50、100、150mg／L的自来水，对照组饮用普通自来水。8周后麻醉处死大鼠取切牙及股骨，HE染色观察切牙成釉细胞和骨组织形态学改变；放射免疫法测定血清骨钙素（OC）水平；生化法测定血清碱性磷酸酶（ALP）活性；氟离子选择电极法测定血氟浓度。结果各染毒组切牙成釉细胞排列不规则呈多层，高柱状细胞结构变矮或消失，少量细胞发生扭曲，随氟浓度增加以上病理学改变加重；骨组织出现骨小梁增多，排列致密等骨硬化性表现，骨骺板增厚，增殖层软骨细胞排列紊乱，随浓度增加以上病理学改变加重；血氟含量显著高于对照组（P〈0．05），且随饮用水氯化钠浓度浓度增加而增加（F=11．234，P〈0．01）。中、高剂量组血清OC水平显著高于对照组（P〈0．01），亦呈浓度依赖性（F=3．801，P〈0．05）。各染毒组ALP活性均呈上升趋势，呈浓度依赖性；但低、中剂量组与对照组比较无统计学差异；高剂量组明显高于低、中剂量组（F=5．759，P〈0．01）。结论血清氟、ALP和OC水平可作为氟致骨相损伤早期诊断的参考指标。

Early diagnostic indexes of skeleton damage caused by excessive fluoride

Objective To investigate the early monitoring and diagnostic indexes of skeleton damage caused by excessive fluoride. Methods A total of 48 Wistar rats were randomly divided into four groups that included the control group （distilled water）, low-dose group （NaF, 50mg/L）, medium-dose group （ NaF, 100mg/L） and high-dose group （ NaF, 150mg/L）. After 8 weeks, the rats were executed to obtain the incisor teeth and femurs （anesthesia）. HE staining technique was used to observe the changes of dental fluorosis and bone fluorosis. Radioimmunoassay was employed to detect the levels of osteocalcin （OC）. The biochemical technique was used to detect the activity of serum alkaline phosphatase （ALP）. The concentrations of serum fluorine of each group were analyzed with fluoride ion selective electrode method. Results The ameloblasts were disarranged in multi- layer, the columnar cells were getting shorter or disappeared, and a few cells were distorted. HE staining indicated that the tra- becular bone increased and the epiphyseal plate was thicker in fluoride-treated groups as compared with that of the control group. The hypertrophic chondrocytes accumulated and arranged disordered in fluoride-treated rats. The fluorine contents in the fluoride groups were significantly higher than that of the control group （P 〈0. 05）, and increased with the increase of concentration （F = 11. 234, P 〈0. 01 ）. The levels of OC in the medium and high-dose groups were significantly higher than that of the control group （ P 〈 0. 01 ）, and in a concentration dependent manner （ F = 3.801, P 〈 0.05）. The activity of ALP in the fluoride-treated groups increased and in a concentration dependent manner, and it increased significantly in the high-dose group than that of the low and medium-dose groups （F=5.759, P〈0.01）. Condusion The serum fluoride, ALP and OC levels can be used as the early di- agnostic indexes of skeleton damage caused by excessive fluoride.