地方性氟中毒临床与X线表现及两种方法诊断分度结果比较  

Clinical and x-ray manifestation of endemic fluorosis and to compared to the diagnostic results for both the methods

作　　者：黄长青[1] 杨凤山[1] 倪凤伟[1] 

机构地区：[1]吉林省地方病第一防治研究所,白城137000

出　　处：《中国地方病防治》2007年第6期431-433,共3页Chinese Journal of Control of Endemic Diseases

摘　　要：目的进一步了解地方性氟中毒临床与X线表现、特点及2种方法诊断氟中毒结果的差异,为临床诊断提供参考。方法(1)对112名高氟区居民进行临床症状询问和体征检查,统计各种症状、体征检出率,依据其表现进行临床诊断与分度。(2)拍摄全身骨和关节X线照片,统计各部位阳性征象检出率,按照现行标准进行X线诊断与分度,(3)比较临床与X线2种方法诊断、分度结果及差别。结果地方性氟中毒的临床表现分为(1)一般中毒症状如头痛、头迷,肢体抽麻和消化道症状;(2)骨关节疼痛症状如腰、膝、髋、肘、肩、颈等大关节持续性休息痛;(3)骨关节运动功能障碍体征,包括颈部、上肢、下肢和脊柱。在全身骨关节X线照片中,骨盆、前臂、小腿阳性征象检出率最高。临床和X线方法检出率分别为85.7%和83.0%,2种方法诊断结果的差别无显著性(P>0.05)。但是,2种方法在轻度和中度的判定上的差别有显著性(P<0.01)。临床分度与X线分度的符合率为41.96%。结论地方性氟中毒主要表现为一般中毒症状,多关节持续性休息痛和肢体运动功能障碍。骨盆、前臂、小腿是氟中毒X线阳性征象的易感部位。尽管临床与X线2种方法在其严重程度的判定上有交叉性,但总的诊断结果一致。Objective To further understand clinical and x - ray manifestation and characteristic of endemic fluorosis and difference of diagnostic results of the both methods of clinical and x - ray for the diseases. Methods （1）112 patients with endemic fluorosis were examined to clinical symptom and signs of bone and joint. The rate of every symptom and signs,the diagnostic results according to the manifestation of fluorosis were statistical. （2） X - ray photographs of whole skeletal were taken for 112 the patient, the positive x- ray signs were investigated. （3）The diagnostic result and difference both methods of clinical and x - ray were compared. Results The clinical manifestation of endemic fluorosis as follows： （1）general poisoning symptom such as headache, dizzy, twitch, apathetic of limbs and symptom of alimentary canal; （2） painful symptom of bone and joints such as waist, knee, hip joint, elbow, shoulder and neck etc ; （3） signs of move about limited in neck, upper limbs, lower limbs and spinal. The positive rate of x - ray sign of pelvis, forearm and shank was highest in photographs of whole skeletal, The diagnostic rate of clinical method were 85.7% and x -ray method were 85.3% which difference of both methods was not significant（ P 〉 0.05 }. But the difference the diagnostic result of both methods of clinical and x - ray were statistical significant for mild and moderate degree fluorosis （ P 〈 0.01 ）. The tall with rate was 41.96% clinical dinvided and x - ray divided degree. Conclusions Clinical manifestation of endemic fluorosis consists of general poisoning symptom ; pain of many bigger joint and signs of to limited of move about in limbs and trunk. The total diagnostic results was shows no difference of both clinical and x - ray methods although it has difference in divided to serious degree.

关 键 词：地方病 氟中毒 临床 X线 骨 关节 

分 类 号：R599.9[医药卫生—内科学]