燃煤污染型氟中毒病区儿童智力调查及法医学意义  

Investigation of children's intelligence in coal-burning fluorosis areas and the significance of Forensic Medicine

作　　者：骆艳[1] 马荣荣 刘子龙[3] 官志忠[4] 楼迪栋 郑丹[1] Luo Yan;Ma Rongrong;Liu Zilong;Guan Zhizhong;Lou Didong;Zheng Dan(Maternal and Child Health Hospital of Guiyang Province,Guizhou Guiyang 550000;Sanquan College Of Xinxiang Medical College,Henan Xingxiang 453000;Tongji Medical College,Huazhong University of Science and Technology,Hubei Wuhan 430003;Key Laboratory of endemic diseases and minority diseases Ministry of Education ,Guizhou Guiyang 550004;Department of Legal Medicine in Guizhou Medical University,Guizhou Guiyang 550004)

机构地区：[1]贵阳市妇幼保健院,贵州贵阳550000 [2]新乡医学院三全学院,河南新乡453000 [3]华中科技大学同济医学院法医学系,湖北武汉430003 [4]贵州医科大学地方病与少数民族疾病教育部重点实验室,贵州贵阳550000 [5]贵州医科大学法医学院法医病理学教研室,贵州贵阳550004

出　　处：《中国法医学杂志》2018年第6期590-593,共4页Chinese Journal of Forensic Medicine

基　　金：国家自然科学基金(81460483)

摘　　要：目的探讨燃煤污染型氟中毒病区8～12岁儿童智力水平及其与染氟量之间的关系,为慢性氟中毒致中枢神经损伤的相关研究提供人群数据资料,为氟病区人群智力残疾鉴定提供修正参考值。方法采用《中国修订韦氏学龄期儿童智力量表(WISC-CR)》测试99名8～12岁小学生(包括氟斑牙组55人,对照组44人)的智力水平,比较氟斑牙组与对照组儿童智力水平差异,并对染氟儿童智力水平与染氟量之间的相关性进行分析。结果氟斑牙组的言语智商(85.64±16.53)、操作智商(94.87±12.73)、总智商(88.51±12.77)均低于对照组(言语智商94.34±16.04、操作智商99.23±12.44、总智商96.64±11.70),其中,两组的言语智商和总智商差异有统计学意义(P=0.002,P=0.01)。氟斑牙组与对照组的言语智商中各项分测验均显著低于对照组,差异有统计学意义(P<0.05)。操作智商中各项分测验除积木测验和译码检测外,差异有统计学意义(P<0.05)。结论燃煤污染型氟中毒儿童可出现智力损害,对言语智力的损伤较为明显;对患儿进行智力残疾鉴定时,应考虑修正智力评测的结果。Objective To explore the relationship between intelligence level and fluorine exposure in children aged 8~12 years in coal-burning endemic fluorosis areas, and to provide data for the study of central nervous system injury caused by fluorosis, and also to provide a revised reference for the identification of mental disability in the population of the fluorosis area. Method Use "Chinese Wechsler Intelligence Scale for children(WISC-CR)" to test the intelligence of 99 students aged 8~12 years(including dental fluorosis group 55, control group 44)then compare the children’s intelligence level between the dental fluorosis group and control group, the correlation between children’s intelligence level and fluoride were analyzed. Result Dental fluorosis group’s verbal IQ(85.64±16.53), operation IQ(94.87±12.73) and total IQ(88.51±12.77) were all lower than the control group(verbal IQ(94.34±16.04), operation IQ(99.23± 12.44), total IQ(96.64 ±11.70), there was statistically significant difference on verbal IQ and total IQ between the two groups(P =0.002, P =0.01). Dental fluorosis group and control group in the verbal IQ subtest were significantly lower than the control group, the difference was statistically significant(P<0.05). In the operation IQ, the differences were statistically significant(P<0.05) except for the block test and the decode test. Conclusion Children with chronic fluorosis can suffer from intelligence damage, which is more obvious in verbal intelligence. We should consider the results of intelligence evaluation when we identify intellectual disability.

关 键 词：法医临床学 儿童氟中毒 智商 智力量表 

分 类 号：DF795.2[医药卫生—法医学]