综合治理后燃煤污染型地方性氟中毒病区人群血脂水平改变  

Changes of serum lipids in coal-burning-borne endemic fluorosis areas after implementation of comprehensive control measures

作　　者：廖薇[1] 官志忠[1] 刘燕斐[1] 徐仕清 吴昌学 李毅 肖雁 邓婕 欧阳凯 周乘忠 谢猛[3] 于燕妮[1] 单可人 

机构地区：[1]贵阳医学院病理学教研室,550004 [2]分子生物学重点实验室 [3]毕节市疾病预防控制中心

出　　处：《中华地方病学杂志》2013年第1期42-45,共4页Chinese Journal of Endemiology

基　　金：国际科技合作项目（2010DFB30530）;科技部支撑计划课题（2011BAz03220）;国家自然科学基金（81160335）;贵州省科技厅项目（黔科合外G912011]7014g-）;贵阳医学院创新基金（S201104）

摘　　要：目的检查经综合治理后的燃煤污染型地方性氟中毒（地氟病）病区人群血脂改变（包括总胆固醇、甘油三酯和高密度脂蛋白），寻找经综合防治措施后病区人群病情好转的健康判别指标。方法2011年，在贵州省毕节市选择燃煤污染型地氟病病区人群，按综合治理时间长短和病情轻重分为4个组，轻病区＋治理短组（98例）、轻病区＋治理长组（70例）、重病区＋治理短组（61例）、重病区＋治理长组（164例）；在贵阳市选择非地氟病病区人群（125例）作为对照组。两组人群空腹采血，采用酶联免疫吸附试验（ELISA）法测定血清中总胆固醇、甘油三酯和高密度脂蛋白含量。结果轻病区＋治理短组、轻病区＋治理长组、重病区＋治理短组、重病区＋治理长组人群血清总胆固醇水平[（5．75±3；16）、（5．56±2．86）、（7．25±3．84）、（6．51±3．48）mmo]／L]、甘油三酯水平[（2．56±1．45）、（2．98±1．50）、（3．20±1．65）、（2．94±1．49）mmol／L]均高于对照组[（3．97±1．80）、（1．25±0．97）mmol／L，P均〈0．05]，而高密度脂蛋白水平[（0．724-0．40）、（0．964-0．60）、（0．46±0．27）、（0．81±0．43）mmol／L]明显低于对照组[（1．15士0．67）mmol／L，P均〈0．05]；在综合治理时间较长的地氟病轻、重病区人群，仅高密度脂蛋白水平较综合治理时间较短的氟中毒轻、重病区人群明显改善（P均〈0．05）。结论通过综合治理，地氟病病区人群血清中高密度脂蛋白的水平明显增高，其机制可能与综合治理后减弱氟对心血管的损伤有关，但对血清总胆固醇和甘油三酯水平无明显影响，人体血清中高密度脂蛋白水平可考虑为评估综合治理后病区人群血脂水平改善的指标。Objective To detect the level of serum high-density lipoprotein, total cholesterol and triglycerides in coal-burning-borne endemic fluorosis areas in Guizhou and to look for health improvement index after implementation of comprehensive control measures. Methods People in coal-burning-borne endemic fluorosis areas in Bijie city of Guizhou were selected and divided into four groups according to the duration of comprehensive treatments and the severity of fluorosis： moderate illness district ＋ short treatment group（98 cases）, moderate illness district ＋ long treatment group（70 cases）, serious illness district ＋ short treatment group（61 cases）, serious illness district ＋ long treatment group （ 164 cases） ; in addition, the people in Guiyang were selected as non-fluorosis controls in 2011. Fasting blood samples were collected for detection of serum high-density lipoprotein, total cholesterol and triglycerides using enzyme linked immunosorbent assay（ELISA） method. Results As compared to controls[（3.97±1.80）, （1.25 ±0.97）, （1.15 ± 0.67） mmol/L], the levels of total cholesterol[ （5.75±3.16）, （5.56±2.86）, （7.25±3.84）, （6.51 ±3.48）mmol/L] and triglycerides[（2.56 ± 1.45）, （2.98 ±1.50）, （3.20 ± 1.65）, （294 ± 1.49）mmol/L] were significantly increased（all P 〈 0.05）, whereas the amount of high-density lipoprotein [（0.72 ±0.40）, （0.96 ±0.60）, （0.46 ± 0.27）, （0.81 ± 0.43）mmol/L] were significantly declined（all P 〈 0.05） in all fluorosis groups. In these two fluorosis groups with long period of comprehensive treatment, only the declined high-density lipoprotein was not so lower than those in the fluorosis groups with short period of treatment（all P 〈 0.05）. Conclusions Certain period of comprehensive prevention treatment can obviously increase the declined contents of high-density lipoprotein in serum of population living in coal-burning-borne endemic fluorosis areas, and the mechanism might be weakened damag

关 键 词：氟化物中毒 血清 高密度脂蛋白 总胆固醇 甘油三酯 

分 类 号：R599[医药卫生—内科学]