饮水型砷暴露人群砷甲基化代谢水平与皮肤损伤关系的研究  

The study on relationship between arsenic methylation metabolism and skin lesions of population exposed to arsenic through drinking water

作　　者：郭志伟 夏雅娟 李艳红 崔娜 刘一君 韦炳干[3] 孔畅 杨林生[3] 虞江萍[3] Guo Zhiwei;Xia Yajuan;Li Yanhong;Cui Na;Liu Yijun;Wei Binggan;Kong Chang;Yang Linsheng;Yu Jiangping(Business Management Department,the Inner Mongolia Autonomous Region Comprehensive Center for Disease Control and Prevention,Hohhot 010031,China;Institute of Endemic Disease and Chronic Disease Control,the Inner Mongolia Autonomous Region Comprehensive Center for Disease Control and Prevention,Hohhot 010031,China;Key Laboratory of Land Surface Pattern and Simulation,Institute of Geographic Sciences and Natural Resources Research,Chinese Academy of Sciences,Beijing 100101,China)

机构地区：[1]内蒙古综合疾病预防控制中心业务处,呼和浩特010031 [2]内蒙古综合疾病预防控制中心地慢所,呼和浩特010031 [3]中国科学院地理科学与资源研究所陆地表层格局与模拟院重点实验室,北京100101

出　　处：《中华地方病学杂志》2020年第1期38-41,共4页Chinese Journal of Endemiology

基　　金：国家自然科学基金(81360414、41230749);内蒙古自治区卫生计生科研计划项目(201702045)。

摘　　要：目的探讨砷暴露致不同程度皮肤损伤人群尿砷代谢产物水平。方法采用整群抽样方法,以内蒙古自治区巴彦淖尔市饮水型砷中毒病区不同程度皮肤损伤居民为研究对象。依据《地方性砷中毒诊断标准》(WS/T 211-2001),将研究对象按皮肤损伤程度分为正常、可疑、轻度、中度及以上4个临床分度。采集任意1次中段尿样,采用电感耦合等离子质谱仪(ICP-MS)检测不同临床分度人群尿中各形态砷代谢产物水平。结果共纳入522人,其中男性309人、女性213人;年龄为(39.11±12.38)岁,范围为11~65岁。正常、可疑、轻度、中度及以上各有337、80、31、74人,不同临床分度人群尿中无机砷(iAs,中位数:15.46、37.16、104.46、163.06μg/L)、一甲基胂(MMA,中位数:15.95、33.27、82.80、123.84μg/L)、二甲基胂(DMA,中位数:78.16、147.86、301.28、371.30μg/L)、总砷(tAs,中位数:113.90、220.94、501.25、684.46μg/L)、无机砷百分比(iAs%,中位数:15.66%、15.53%、21.67%、21.65%)、一甲基胂百分比(MMA%,中位数:13.51%、15.40%、17.14%、16.43%)、二甲基胂百分比(DMA%,中位数:70.37%、67.98%、63.25%、61.23%)、一甲基化率(PMI,中位数:0.84、0.84、0.78、0.78)、二甲基化率(SMI,中位数:0.84、0.81、0.79、0.79)、一甲基胂与二甲基胂比值(MMA/DMA,中位数:0.20、0.23、0.27、0.27)比较,差异有统计学意义(H=97.98、96.44、85.50、95.08、38.58、29.94、51.98、38.58、43.20、43.20,P均<0.01)。与正常人群比较,可疑、轻度、中度及以上人群iAs、MMA、DMA、tAs、MMA%、MMA/DMA水平明显升高,SMI水平明显降低(P均<0.017);与正常人群比较,轻度、中度及以上人群iAs%水平明显升高,DMA%、PMI水平明显降低(P均<0.017)。结论不同程度皮肤损伤砷暴露人群尿砷代谢产物水平不同,呈剂量效应关系。Objective To investigate the levels of urinary arsenic metabolites in arsenic-exposed people with different degrees of skin lesions.Methods A cluster sampling method was used to select people with different degrees of skin lesions in the drinking water arsenic poisoning area of Bayannaoer City,Inner Mongolia Autonomous Region.According to the"Standard of Diagnosis for Endemic Arsenism"(WS/T 211-2001),the research subjects were divided into four clinical grading:normal,suspicious,mild,moderate and above on the basis of the degrees of skin lesions.Urine samples from any 1 middle section were collected,and the levels of urinary arsenic metabolites of different forms in different clinically graded people were detected by inductively coupled plasma mass spectrometry(ICP-MS).Results A total of 522 people were included,including 309 males and 213 females;the age was(39.11±12.38)years old,ranging from 11 to 65 years old.There were 337,80,31,74 people in normal,suspicious,mild,moderate and above clinical grading,the levels of inorganic arsenic(iAs,medians:15.46,37.16,104.46,163.06μg/L),monomethylarsonic acid(MMA,medians:15.95,33.27,82.80,123.84μg/L),dimethylarsenic acid(DMA,medians:78.16,147.86,301.28,371.30μg/L),total arsenic(tAs,medians:113.90,220.94,501.25,684.46μg/L),iAs percentage(iAs%,medians:15.66%,15.53%,21.67%,21.65%),MMA percentage(MMA%,medians:13.51%,15.40%,17.14%,16.43%),DMA percentage(DMA%,medians:70.37%,67.98%,63.25%,61.23%),monomethylation rate(PMI,medians:0.84,0.84,0.78,0.78),dimethylation rate(SMI,medians:0.84,0.81,0.79,0.79),and ratio of MMA to DMA(MMA/DMA,medians:0.20,0.23,0.27,0.27)were compared in different clinically graded people,the differences were statistically significant(H=97.98,96.44,85.50,95.08,38.58,29.94,51.98,38.58,43.20,43.20,P<0.01).Compared with normal people,iAs,MMA,DMA,tAs,MMA%,and MMA/DMA levels significantly increased,and SMI level significantly decreased in suspicious,mild,moderate and above people(P<0.017);compared with normal people,iAs%level significantly increased,and DMA%

关 键 词：砷中毒 甲基化 代谢产物学 皮肤损伤 

分 类 号：R5[医药卫生—内科学]