改水前后内蒙古饮水型砷中毒病区人群砷暴露临床特点分析  

Clinical characteristics of drinking-water type endemic arsenism in population lived in the diseased areas before and after water improvement in Inner Mongolia

作　　者：郭志伟 武克恭 宋炜 杨卫红[3] 韩晓红[4] 李艳红 夏雅娟 

机构地区：[1]内蒙古地方病防治研究中心,呼和浩特010031 [2]内蒙古杭锦后旗疾病预防控制中心 [3]山东省德州市疾病预防控制中心 [4]内蒙古乌兰察布市疾病预防控制中心

出　　处：《中华地方病学杂志》2015年第11期813-815,共3页Chinese Journal of Endemiology

摘　　要：目的了解改水前后内蒙古饮水型砷中毒病区人群砷暴露临床特点，评估饮水型砷中毒自然发展对人体的影响及人为干预效果。方法在内蒙古饮水型砷中毒病区，选择巴彦淖尔市杭锦后旗的4个村作为调查点，分别在2004（改水前）、2010（完成改水）、2014（改水后）年，对调查点居民的皮肤损害情况进行跟踪随访，同时测量其血压和心率。砷中毒皮肤损害分度依据《地方性砷中毒诊断标准》（WS／T211-2001）。结果2004、2010、2014年分别调查病区居民229、122、161人。2004年砷暴露人群皮肤损害临床分度主要为正常和可疑，分别占调查人数的61．6％（141／229）和22．7％（52／229）。2010年，人群皮肤损害临床分度可疑占31．1％（38／122），轻度及以上者占48．4％（59／122），与2004年比较，差异有统计学意义（χ2=68．53，P〈0．01）。2014年正常和可疑者分别占46．6％（75／161）和39．8％（64／161），与2010年比较，差异有统计学意义（χ2=45．22，P〈0．01）。2010年对91例2004年体检过的居民进行复检，其中皮肤损伤减轻12例，占13．2％（12／91），加重52例，占57．1％（52／91）。2014年对47例2010年体检过的居民进行复检，其中皮肤损伤减轻25例，占53．2％（25／47），加重9例，占19．1％（9／47）。两阶段皮肤损伤转变比较差异有统计学意义（χ2=28．66，P〈0．05）。2004、2010、2014年砷暴露人群的收缩压和舒张压分别为（132．19±21．21）、（126．99±18．32）、（147．69±22．65），（84．88±14．13）、（76．52±10．08）、（84．39±13．89）mmHg，与2004年相比，2010年收缩压和舒张压均降低（P均〈0．05）；与2010年比较，2014年收缩压和舒张压均升高（P均〈0．01）。2004、2010、2014年砷暴露人群的心率分别为（76．05±12．56）、（78．86±11．69）、（82．05±11．26）次／分。与2004Objectives To analyze the clinical characteristics of drinking-water type endemic arsenism in population lived in the diseased areas before and after water improvement in Inner Mongolia, so as to assess the natural development and the effects of human intervention measures. Methods Residents of four villages lived in Mangjinhouqi Bayinnaoer city Inner Mongolia were followed-up and their skin lesions were examined in 2004 （before water improvemen0, 2010 （complete water improvement）, 2014 （after water improvement）. Meanwhile, blood pressure and heart rate of the subjects were measured. The arsenic poisoning skin damage indexing was in accordance with endemic arsenic poisoning diagnostic criteria （WS/T 211-2001）. Results Totally, 229, 122, 161 people were investigation in 2004, 2010, 2014, respectively. The clinical grading of arsenic exposed population were mainly normal and suspicious cases in 2004, accounting for 61.6% （141/229） and 22.7% （52/229）, respectively. The clinical grading of normal, suspicious, mild and severe cases were 20.5% （25/122）, 31.1% （38/122） and 48.4% （59/ 122）, respectively, in 2010, which were significantly different compared with those of 2004 （χ2 = 68.53, P 〈 0.01）. The clinical grading percentages of normal and suspicious of the subjects in 2014 were 46.6% （75/161） and 39.8% （64/161）, respectively, which were significantly different compared with those of 2010 （χ2 = 45.22, P 〈 0.01）. Meanwhile, 91 subjects examined in 2004 were re-examined in 2010 and 47 subjects examined in 2010 were re- examined in 2014. Totally, 12 cases were migitation, accounting for 13.2% （12/91）, 52 cases were aggravation, accounting for 57.1% （52/91） in 2010, and 25 cases were migitation, accounting for 53.2% （25/47）, 9 cases were aggravation, accounting for 19.1% （9/47） in 2014. The differences of skin lesion transition between these two periods were significant （χ2 = 28.66, P 〈 0.05）. In addition, the systolic pressures and diastolic

关 键 词：砷中毒 饮水 结果评价 

分 类 号：R599.1[医药卫生—内科学]