重庆市燃煤污染型地方性氟中毒重点病区氟骨症流行现状调查分析  

Sampling survey on the prevalence of skeletal fluorosis in the coal-burning-borne fluorosis affected areas of Chongqing

作　　者：何成丹 倪涛 王松林 肖尊练 晏维[3] He Chengdan;Ni Tao;Wang Songlin;Xiao Zunlian;Yan Wei(Wushan County Center for Disease Control and Prevention,Chongqing,Wushan 404700,China;Pengshui County Center for Disease Control and Prevention,Chongqing,Pengshui 409600,China;Chongqing Municipal Center for Disease Control and Prevention,Yuzhong 400042,China)

机构地区：[1]重庆市巫山县疾病预防控制中心,404700 [2]重庆市彭水县疾病预防控制中心,409600 [3]重庆市疾病预防控制中心,渝中400042

出　　处：《中华地方病学杂志》2020年第4期269-272,共4页Chinese Journal of Endemiology

摘　　要：目的掌握重庆市燃煤污染型地方性氟中毒(简称燃煤型氟中毒)重点病区氟骨症流行现状和特征,为制定持续消除燃煤型氟中毒精准化防控策略提供科学依据。方法2018年1-11月,采用分层抽样的方法,在巫山、彭水两个县的历史轻、中、重病区村分别采用单纯随机的方法抽取调查村。每层病区调查村的数量根据病区村实际村数量5%~10%的比例确定。调查常住人口数,对调查村全部25岁以上成人进行氟骨症临床和X线检查,依据《地方性氟骨症诊断标准》(WS 192-2008)进行诊断。对不同病区、性别、年龄(25~、35~、45~、55~、≥65岁)的临床和X线氟骨症检出率进行比较分析。并根据2015年调查人口数据推算重庆市氟骨症患者病例数。结果共调查2个县10个乡镇15个病区村25岁以上成人7768人,临床诊断氟骨症478人,检出率为6.15%;氟骨症临床诊断检出率不同病区类型之间比较差异有统计学意义(χ^2=183.23,P<0.01),不同年龄组之间比较差异有统计学意义(χ^2=406.73,P<0.01),不同性别之间比较差异无统计学意义(χ^2=0.32,P>0.05)。X线检出690人,检出率为8.88%,中重度氟骨症检出率为4.20%(326/7768)。氟骨症X线诊断检出率不同病区类型之间比较差异有统计学意义(χ^2=46.25,P<0.01),不同年龄组之间比较差异有统计学意义(χ^2=384.60,P<0.01),不同性别之间比较差异无统计学意义(χ^2=1.77,P>0.05)。根据不同病区类型估算重庆市燃煤型氟中毒病区氟骨症病例约有临床诊断48770人,X线诊断72630人。结论氟中毒病区程度越重、人群年龄越大,氟骨症检出率越高。在重庆市燃煤型氟中毒病区开展氟骨症流行现状的普查,摸清底数,对扶贫攻坚有重要意义。Objective To master the epidemic status and characteristics of skeletal fluorosis in the coal-burning-borne fluorosis affected areas of Chongqing,and to provide a scientific basis for formulating accurate prevention and control strategy for elimination of coal-burning-borne fluorosis.Methods Stratified sampling method was used to select the villages with mild,moderate and severe coal-burning-borne fluorosis in Wushan and Pengshui,respectively in January-November 2018.The number of villages surveyed in each area was determined by the proportion of 5%to 10%of the actual number of the diseased villages.To investigate the resident population,all the adults over 25 years old in the village were examined for skeletal fluorosis through clinical and X-ray examination,and were diagnosed according to the"Diagnostic Criteria of Endemic Skeletal Fluorosis"(WS 192-2008).The prevalence of skeletal fluorosis in different disease areas,different sexes,different ages(25-,35-,45-,55-,≥65 years old)were compared and analyzed.The number of cases of skeletal fluorosis in Chongqing was calculated according to the 2015 population survey data.Results A total of 7768 adults over 25 years old were investigated in 15 villages of 10 townships in 2 counties,and 478 people were diagnosed clinically as skeletal fluorosis,and the clinical detection rate was 6.15%.There were differences in the clinical diagnosis of skeletal fluorosis among different disease areas(χ^2=183.23,P<0.01).There were significant differences among different age groups(χ^2=406.73,P<0.01).But no difference was found among different sex groups(χ^2=0.32,P>0.05).A total of 690 people were diagnosed as skeletal fluorisis by X-ray,the X-ray detection rate was 8.88%,and moderate and severe skeletal fluorosis detection rate was 4.20%(326/7768).The X-ray diagnosis rates of skeletal fluorosis were different among different disease areas(χ^2=46.25,P<0.01)and different age groups(χ^2=384.60,P<0.01).There was no difference between different sexes groups(χ^2=1.77,P>0.05).Accord

关 键 词：氟 氟骨症 流行现状 

分 类 号：R181[医药卫生—流行病学] R5[医药卫生—公共卫生与预防医学]