云南弥渡县饮水型地方性砷中毒流行病学调查分析  

An epidemiological investigation of endemic arseniasis via drinking water in Midu County of Yunnan Province

作　　者：叶枫[1] 张浩伟[1] 郭玉熹[1] 王红云[2] 陈白云 罗华 鲁林 白仙玉 皋玉明 王安伟[1] 黄文丽[1] 

机构地区：[1]云南省地方病防治所,云南大理671000 [2]昆明医学院第一附属医院,云南昆明650000 [3]大理州疾控中心,云南大理671000 [4]弥渡县疾控中心,云南弥渡675600

出　　处：《国外医学（医学地理分册）》2013年第2期113-117,共5页Foreign Medical Sciences：Section of Medgeography

摘　　要：目的了解弥渡县砷中毒病情及其危害程度。方法对弥渡县饮用水砷含量超过0.15 mg/L的弥城镇谷芹村委会高芹和高孟营2个村进行地砷病病情调查,砷中毒待诊患者(待诊组)和非饮用高砷水正常对照人群(对照组)发砷、尿砷、水砷含量检测,砷中毒病例排查,与地砷病患病有关的影响因素等。结果共调查成人458人,专家组进一步就诊159人,其中皮肤病患者95人、砷中毒待诊49人、其他15人。待诊组尿砷、发砷、水砷含量中位数分别为173.1μg/L、2.9 mg/kg、0.44 mg/L;对照组尿砷、发砷、水砷含量中位数分别为22.6μg/L、0.6 mg/kg、0.0 mg/L。经秩和检验,两组人群发砷、尿砷、水砷含量差别有统计学意义,待诊组高于对照组。其中待诊组中有29例在非暴露部位存在类似砷中毒轻微皮肤改变为主,且发砷、尿砷含量中位数分别为3.5 mg/kg、237.0μg/L,水砷超标率为96.6%。将29例病例与其他20例待诊病例发砷、尿砷、水砷含量进行秩和检验,两组人群发砷、尿砷、水砷含量差别有统计学意义,29例(疑似砷中毒组)高于其他待诊病例(非中毒组)。结论弥渡县高砷水源分布较广,且水砷含量较高,当弥渡县高芹和高孟营2个村为饮水型地方性砷中毒潜在病区。应在2个村继续开展监测,开展更细致更深入的调查研究。Objective To investigate the basic characteristics of arseniasis in Midu County. Methods The basic characteristics of arseniasis, dermatonosis history of subjects, and other factors were investigated in the Gaoqin and Gaomcngying villages, where the concentrations of arsenic in drinking water were more than 0.15 mg/L. More- over, drinking water arsenic, hair and urine arsenic concentrations were determined. All subjects were divided into two groups （case and control groups） according to arsenic concentrations in drinking water. Results A total of 458 adult subjects were enrolled in the study. Of these, 159 attended physical examination, 95 were diagnosed as derma- tonosis and 49 as suspected arseniasis. The median urine, hair and drinking water arsenic in the case group were 173.1 μg/L, 2.9mg/kg and 0.44 mg/L, respectively. The median urine, hair and drinking water arsenic in the con- trol group was 22.6 μg/L, 0.6mg/kg and 0.0 mg/L, respectively. There were statistically significant differences in hair, urine and drinking water arsenic between the two groups according to non-parameter test. Furthermore, 29suspected arseniasis subjects had concurrent atypical cutaneous hyperpigmentation or depigmentation. The median u- rine and hair arsenic in these 29 subjects were 3.5 mg/L and 237.0 μg/kg, respectively. Meanwhile, the proportion of drinking water arsenic not less than standard in the arsenic exposure district was 96.6%. There were statistic sig- nificant differences in hair, urine and drinking water arsenic between the 29 subjects and other 20 suspected arsenia- sis. All these indexes in the 29 subjects were higher than those of other suspected arseniasis cases. Conclusions The two villages may be the potential endemic areas of arsenic disease resulted from drinking water. Therefore, careful investigation should be taken into account.

关 键 词：饮水型砷中毒 病情调查 潜在病区 云南弥渡 

分 类 号：R599[医药卫生—内科学]