摘要
目的调查陕西南部大巴山区燃煤型氟、砷中毒叠加流行的分布规律,为控制陕南燃煤型氟、砷中毒提供科学依据。方法选择陕西省南部大巴山区紫阳县蒿坪镇,依据国家标准"流行性氟骨症诊断的临床分类(GB 16396-1996)"卫生部"氟牙症的临床诊断指南(WS/T208-2001)"、"慢性砷中毒诊断指南(WS/T211-2001)"检查全镇27 713例,对氟骨症、氟斑牙和砷中毒皮肤损伤进行严重程度分级。以全部居民的数据为标准采用标化发病比(SIR)方法进行性别差异分析,以卡方分析方法进行年龄趋势、症状严重程度趋势以及燃煤型氟、砷中毒关系的分析。结果陕南紫阳县蒿坪镇地方性氟中毒患病率为56.7%,砷中毒患病率为0.12%;氟砷中毒叠加患病者全体居民中的患病率为6.7%,其中占氟中毒患病的11.85%;随着氟中毒症状严重程度的减轻,氟、砷中毒患者出现的砷中毒症状体征检出率逐渐下降,以中、重症者为明显。结论长期暴露于燃煤污染的高氟高砷环境的人群可发生氟、砷中毒叠加的临床症状和体征,其中在严重氟中毒患者中叠加砷中毒者,出现中、重度皮肤损伤症状最为显著。
Objective To investigate the distribution of overlapping endemia of fluorosis-arseniasis cases from indoor combustion of local high fluorine-content solid mineral fuel in endemic area of Southern Shaanxi Province. Methods By referring to the national standards ＂Clinical Classification of the Diagnosis for Endemic Skeletal Flu-orosis （GB 16396-1996）＂, and the ＂Clinical Diagnostic Guidelines for Dental Fluorosis （WS/T208-2001）＂ as well as the ＂Diagnostic Guidelines for Arseniasis （WS/T211-2001）＂ formulated by the Ministry of Health, 27 713 inhabit-ants in Haoping township of Ziyang County, Daba mountainous areas in Southern Shaanxi were tested to classify their severity gradation in the perspective of skeletal fluorosis, dental fluorosis, skin injuries caused by arsenics. The gender difference analysis was conducted by the method of SIR using the data of the entire resident population in this township as standards. The age trend, severity trend and fluorosis-arseniasis association analyses were conducted by the method of chi-square analysis. Results The prevalence of fluorosis was represented 56.7 %. Arseniasis symp-toms were also diagnosed in 11.85 % of the diagnosed fluorosis patients. The co-morbidity cases represented 6.7 % of the entire resident population. No significant gender difference was seen in the prevalence of overlapping fluorosis-arseniasis with the three different symptom severities. The significant age trends＇of prevalence of dual morbidity of fluorosis-arseniasis were observed. The significant symptom severity trends were presented in every age group. The prevalence of overlapping fluorosis-arseniasis was significantly associated to the fluorosis symptom severity in the flu-orosis patients. Oonclusion This township was a fluorosis endemic area and was accompanied with endemic of ar-seniasis. The fluorosis patients with more severe symptoms had higher risk of suffering from arseniasis, especially in that with more severe dermal symptoms.
出处
《国外医学（医学地理分册）》
CAS
2012年第3期176-180,共5页
Foreign Medical Sciences：Section of Medgeography
关键词
氟中毒
砷中毒
叠加
陕南
燃煤
overlapping fluorosi-arseniasis
endemia
indoor combustion
coal
