贵州省燃煤型氟中毒病区8～14岁儿童血清钙、磷变化  

Variations of Serum Calcium and Phosphorus in 8-14 Year-Old Children in the Coal-Burning Fluorosis Area in Guizhou Province

作　　者：金庭旭[1] 吴延莉 韦艳[1] 谢春[1] 张华[1] 

机构地区：[1]贵州医科大学公共卫生学院环境卫生学教研室,贵州550025

出　　处：《环境与职业医学》2015年第8期731-734,共4页Journal of Environmental and Occupational Medicine

基　　金：科技部国家科技支撑计划课题(编号:2013BAI05B03);国家自然科学基金(编号:81360412)

摘　　要：[目的]研究贵州省燃煤型氟中毒病区8~14岁儿童血清钙、磷变化与年龄及氟斑牙程度的关系,探讨不同年龄段儿童血清钙、磷受氟中毒影响的情况。[方法]采用现况调查对486例（氟病区366例,对照区120例）8~14岁儿童进行氟斑牙和尿氟调查;之后按年龄分层抽取190例儿童进行血清钙、磷浓度测定;根据Tanner分期标准按年龄合并为3个年龄段（8~10岁为青春前期,11~12岁为青春早期,13~14岁为青春中期）,分析不同年龄段氟病区与对照区儿童血清钙、磷差异;同时分析氟病区儿童不同氟斑牙程度下血清钙、磷变化。[结果]氟病区儿童氟斑牙患病率及尿氟浓度均高于对照区（χ2氟斑牙=265.130,P=0.000;Z尿氟=-7.716,P=0.000）。与对照区相比,氟病区儿童除青春中期组血磷浓度无明显变化外,余年龄段血磷浓度均较低（Z青春前期=-2.080,P=0.037;Z青春早期=-3.889,P=0.000）、血钙浓度较高（Z青春前期=-4.022,P=0.000;Z青春早期=-3.289,P=0.001;Z青春中期=-3.952,P=0.000）。三个年龄段间,氟病区儿童血磷、血钙浓度的变化差异均无统计学意义（HP=0.560,P=0.756;HCa=0.296,P=0.863）。不同氟斑牙程度下儿童血清钙、磷无明显规律性变化,仅极轻度和轻度间血磷浓度差异有统计学意义（H=-24.207,P=0.015）。除氟斑牙程度与年龄存在正相关外（r=0.336,P〈0.01）,其余指标间均无具统计学意义的相关关系。[结论]氟可致低龄、低中毒程度儿童出现血清钙、磷浓度非进展性改变。[ Objective ] To investigate the relevance of age and dental fluorosis with serum calcium （Ca） and phosphorus （P） in children at 8-14 years of age in a coal-burning fluorosis （CBF） area of Guizhou Province, and discuss the levels of serum Ca and P affected by fluorosis in children across different age groups. [ Methods ] A cross-sectional study was conducted to investigate the prevalence of dental fluorosis in 486 children （n=366 for CBF area, n=120 for control area） between 8 and 14 years of age. Then 190 children were selected by age stratified sampling to determine the concentrations of serum Ca and P. According to the Tanner stage criteria, the cases were merged into three age groups （preadolescence, 8 to 10 years; early adolescence, 11-12years; middle adolescence, 13-14 years） to analyze the difference of serum Ca and P in children of the CBF area and the control area across selected age groups. Variations of serum Ca and P were also analyzed among the children with different stages of dental fluorosis. [ Results ] The dental fluorosis prevalence rates and the urine fluoride concentrations of children in the CBF area were both higher than those of the control group （χ2dental fluorosis=265.130, P=0.000; Zurinaryf luoosis=--7.716, P=0.000）. Increased serum Ca level （Zpreadolescence =-4.022, P=0.000; Zearly adolescence =-3.289, P=0.001; Zmiddle adolescence =--3.952, P=0.000） and declined serum P level （Zpreadolescence =--2.080, P=0.037; Zearly adolescence =--3.889, P=0.000） were found across all age groups compared with corresponding control groups, and only the serum P level in the middle adolescence group was not statistically different. Among the three age groups, there showed no statistical differences in both serum P and Ca levels of children in the CBF area （Hp=0.560, P=0.756; Hca=0.296, P=0.863）. There were no differences among the children with different stages of dental fluorosis, except the serum P levels between children with very mild and mild dental fluorosis �

关 键 词：燃煤型氟中毒 儿童 氟斑牙 钙 磷 

分 类 号：R124[医药卫生—环境卫生学]