内蒙古自治区托克托县饮水型地方性砷中毒病区居民病情调查结果分析  

Survey results of residents in a drinking water-borne endemic arsenism area in Togtoh County Inner Mongolia

作　　者：李海玲 刘建平[2] 崔娜 郭志伟 李艳红 杨晨 夏雅娟 Li Hailing;Liu Jianping;Cui Na;Guo Zhiwei;Li Yanhong;Yang Chen;Xia Yajuan(Department of Public Health,Inner Mongolia Medical University,Hohhot 010050,China;Baoto Central Hospital,Baotou 014000,China;Inner Mongolia Autonomous Regional Comprehensive Center for Disease Control and Prevention,Hohhot 010031,China)

机构地区：[1]内蒙古医科大学公共卫生学院,呼和浩特010050 [2]包头市中心医院,014000 [3]内蒙古自治区综合疾病预防控制中心,呼和浩特010031

出　　处：《中华地方病学杂志》2020年第1期33-37,共5页Chinese Journal of Endemiology

基　　金：国家自然科学基金(81360414、41230749);内蒙古医科大学科技百万工程项目(YKD2016 KJBWD21)。

摘　　要：目的调查内蒙古自治区托克托县饮水型地方性砷中毒病区居民患病情况。方法选择内蒙古自治区托克托县饮水型地方性砷中毒病区刺猬沟村为调查点,采用横断面调查方法,以常住居民(居住年限≥20年)85人作为砷暴露组,以同期非砷中毒病区和林格尔县兰家夭村58人作为对照组,了解调查对象的一般情况,检测并比较分析两组人群水砷、尿砷、血糖、血脂、血压、肝功能、肾功能、心电图及腹部B超检查结果。砷暴露组按是否出现砷中毒皮肤病变分为患病组和未患病组,分析人群一般情况及血压变化。结果砷暴露组与对照组人群性别构成、年龄、吸烟、饮酒以及服用维生素和钙片等情况均衡可比,差异无统计学意义(P均>0.05)。砷暴露组水砷含量[中位数(四分位数间距)]为163.34(35.34)μg/L、尿砷含量[中位数(四分位数间距)]为269.72(152.54)μg/L;对照组水砷含量为2.96(5.62)μg/L、尿砷含量为24.21(28.63)μg/L。砷暴露组与对照组血糖、血脂比较差异无统计学意义(χ2=0.865、0.886,P均>0.05);砷暴露组肝功能异常、肾功能异常、窦性心律失常、脂肪肝检出率高于对照组(χ2=4.654、4.355、4.725、12.423,P均<0.05);对照组血压异常检出率高于砷暴露组(χ2=16.289,P<0.01)。砷暴露组出现皮肤病变24例(28.24%),未出现皮肤病变61例(71.76%)。其中患病组14例(58.33%,14/24)吸烟,吸烟比例高于未患病组(31.15%,19/61,χ2=5.360,P<0.05);12例(50.00%,12/24)高血压,高血压比例高于未患病组(26.23%,16/61,χ2=4.406,P<0.05)。结论长期砷暴露可损害人群肝肾功能,增加发生心律失常和脂肪肝的危险。吸烟可能为饮水型地方性砷中毒病区居民发生皮肤病变的危险因素。Objective To investigate the prevalence of residents in a drinking water-borne endemic arsenism area in Togtoh County Inner Mongolia.Methods In a drinking water-borne endemic arsenism area(Togtoh County of Inner Mongolia),eighty-five permanent residents(residence time≥20 years)of Hedgehog Valley were selected as exposure group.In the same period,58 people from a non-arsenism area(Lanjiayao of Helingeer County)were selected as the control group.The general situation of the respondents was investigated,and water arsenic,urine arsenic,blood glucose,blood lipids,blood pressure,liver function,renal function,electrocardiogram and abdominal B-ultrasound were analyzed in both groups.The exposure group was divided into the disease group and the non-disease group according to whether arsenic poisoning skin lesions occurred,and the general conditions and blood pressure changes in the two groups were analyzed.Results In the exposure group and control group,there were no significant differences among the indicators such as sex,age,smoking,drinking and taking vitamin or calcium tablet(P>0.05).Arsenic concentration[Median(interquartile range)]in drinking water of the exposure group was 163.34(35.34)μg/L,and in urine was 269.72(152.54)μg/L.Arsenic concentration in drinking water of the control group was 2.96(5.62)μg/L,and in urine was 24.21(28.63)μg/L.There were no statistical differences in blood glucose,blood lipids between the exposure group and control group(χ2=0.865,0.886,P>0.05);but liver function,renal function,sinus arrhythmia and fatty liver were significantly different statistically(χ2=4.654,4.355,4.725,12.423,P<0.05);the detection rate of abnormal blood pressure in control group was higher than that of the exposure group(χ2=16.289,P<0.01).Skin lesions occurred in 24 patients(28.24%)in the exposure group and no skin lesions in 61 patients(71.76%).In disease group,14 cases(58.33%,14/24)smoked,the proportion of smoking was higher than that of cases in non-disease group(31.15%,19/61,χ2=5.360,P<0.05);and the prev

关 键 词：砷中毒 肝功能 肾功能 

分 类 号：R5[医药卫生—内科学]