氟骨症X线诊断部位选择性的研究  

X-ray diagnostic site selectivity studies of skeletal fluorosis

作　　者：李亨祥[1] 王学松[1] 陈培忠[1] 高杰[1] 黄菊梅[1] 

机构地区：[1]山东省地方病防治研究所放射室,济南250014

出　　处：《中华地方病学杂志》2013年第5期565-568,共4页Chinese Journal of Endemiology

基　　金：中央补助地方公共卫生专项资金地方病防治项目（2009）;济宁市科技发展计划（2009-56号）;山东省医药卫生科技发展计划（HZ086）

摘　　要：目的对氟骨症前臂和小腿x线征象及其诊断价值进行再研究和认识，为地方性氟中毒（简称地氟病）病区X线普查或检测正确实施易减部位提供科学依据。方法应用自行研制的防护罩、暗室等便携式专用装置配合小型X线机对地氟病病区1440例受检者进行X线摄片，确诊氟骨症384例，并以此为样本，分析对比观察其前臂和小腿肘、膝关节及长骨骨干X线改变时间、X线改变程度、X线改变范围等项内容的差异．评价它们诊断作用的大小，正确作出部位选择。结果前臂肘关节改变先于小腿膝关节，其中骨小梁改变为最早，分别检出197、157例，两者比较差异有统计学意义（X^2=8．385，P〈0．01）。前臂骨干骨间膜骨化比小腿早，多见于I度照片，分别为213例和126例，两者比较差异有统计学意义（X^2=17．626，P〈0．01）。骨间膜骨化演变方向是从前臂桡骨始至尺骨，在向小腿胫骨至腓骨蔓延，并伴随前臂加重而改变；观察多种指标，尤其是骨关节骨小梁改变和长骨骨干骨间膜骨化的表现最为活跃，且前臂比小腿异常敏感、明显。结论在地方性氟中毒病区X线普查或检测中，选择前臂取代小腿摄片是简便、经济、快速、有效的诊断方法。Objective To study the X-ray signs of forearm and leg in skeletal fluorosis and its diagnostic value, aim at finding the easy examination parts. Methods One thousand four hundred and forty subjects were examined using developed shield, darkroom and other portable dedicated device combined with a small X-ray machine. A total of 384 cases were diagnosed skeletal fluorosis. All patients were divided into different groups and the time, degree and range of X-ray to the forearm and calf elbow, knee, and long bone were compared. Results The X-ray change in the forearm elbow was earlier than that of the leg knee, and trabecular bone change was the earliest indicator, 197 cases and 157 cases, respectively, and the difference was statistically significant （X^2 = 28.006, P 〈 0.01 ）. Membrane ossification of forearm backbone was earlier than that of the leg, and most of them were degree I photos, 213 cases and 126 cases respectively. The difference was statistically significant （X^2= 17.626, P 〈 0.01 ）. The direction of the interosseous membrane ossification was from the forearm radius to the ulna, then to the fibula and tibia, and was accompanied by changes in the aggravation of forearm. A variety of indicators were observed, especially the membrane ossification in bone and joint trabecular bone and the long bone was the most active, and the forearm was more sensitive, obviously than that of the calf. Conclusion In the X-ray screening or detection of endemic fluorosis, the forearm radiography is a simple, economical, and effective diagnostic method.

关 键 词：氟骨症 X线 诊断 

分 类 号：R599[医药卫生—内科学]