贵州省燃煤污染型地方性氟中毒病区氟骨症监测结果分析  

Analysis of monitoring results of skeletal fluorosis in coal-burning type endemic fluorosis areas in Guizhou Province

作　　者：高静[1] 李杨[1] 向红[1] 叶红兵[1] 张伯友[1] 王晓明[1] 姚丹成[1] Gao Jing;Li Yang;Xiang Hong;Ye Hongbing;Zhang Boyou;Wang Xiaoming;Yao Dancheng(Department of Epidemiology,Institute of Endemic Disease,Guizhou Center for Disease Control and Prevention,Guiyang 550004,China)

机构地区：[1]贵州省疾病预防控制中心地方病防治研究所流行病科,贵阳550004

出　　处：《中华地方病学杂志》2023年第11期888-892,共5页Chinese Journal of Endemiology

基　　金：中央补助地方公共卫生专项资金地方病防治项目(2019年)。

摘　　要：目的分析贵州省燃煤污染型地方性氟中毒(简称燃煤型氟中毒)病区氟骨症监测结果,评价燃煤型氟中毒综合治理对病区氟骨症的防治效果。方法2009、2014、2019年在国家级监测点贵州省仁怀市、七星关区、大方县、黔西市、普定县、普安县6个县(市、区)开展氟骨症病情监测,在每个县(市、区)的3个固定监测村对25岁以上常住居民进行年龄分层后抽取调查对象,进行氟骨症X线检查。结果2009、2014、2019年氟骨症检出率分别为51.48%(798/1550)、34.88%(308/883)、6.51%(60/922),呈逐年下降趋势(χ^(2)_(趋势)=505.83,P<0.001),2019年较2009年下降了44.97个百分点;氟骨症患者年龄分布以55岁及以上年龄组为主,各年占比依次为53.88%(430/798)、56.49%(174/308)、78.33%(47/60),均高于50%。2009、2014、2019年分别检出轻度氟骨症483、222、21例,中重度氟骨症315、86、39例,不同年份间病情分度比较差异有统计学意义(χ^(2)=32.63,P<0.001);其中,七星关区、黔西市、普定县、普安县氟骨症病情分度比较差异均有统计学意义(χ^(2)=14.56、12.24、35.01、23.35,均P<0.05)。结论贵州省氟骨症检出率逐年降低,防控成效显著;氟骨症患者以55岁及以上年龄组为主,且中重度患者比例增高,应继续做好氟骨症现症患者的监测与治疗管理。Objective To analyze the monitoring results of skeletal fluorosis in coal-burning type endemic fluorosis areas in Guizhou Province,and evaluate the effectiveness of comprehensive treatment of coal-burning type endemic fluorosis in the affected areas.Methods In 2009,2014,and 2019,monitoring of skeletal fluorosis was carried out in six counties(cities,districts)of Renhuai City,Qixingguan District,Dafang County,Qianxi City,Puding County,and Pu'an County in Guizhou Province.Age stratification was conducted in each county(city,district)for permanent residents aged 25 and above,and survey subjects were selected for X-ray examination of skeletal fluorosis.Results The detection rates of skeletal fluorosis in 2009,2014,and 2019 were 51.48%(798/1550),34.88%(308/883),and 6.51%(60/922),respectively,showing a decreasing trend year by year(χ^(2)trend=505.83,P<0.001),decreased by 44.97 percentage points from 2009 to 2019.The age distribution of patients with skeletal fluorosis was mainly in the age group of 55 years and older,with annual proportions of 53.88%(430/798),56.49%(174/308),and 78.33%(47/60),all higher than 50%.In 2009,2014,and 2019,483,222 and 21 cases of mild skeletal fluorosis were detected,and 315,86,and 39 cases of moderate to severe skeletal fluorosis were detected.There was a statistically significant difference in disease grading among different years(χ^(2)=32.63,P<0.001).Among them,there were statistically significant differences in the grading of skeletal fluorosis in Qixingguan District,Qianxi City,Puding County,and Pu'an County(χ^(2)=14.56,12.24,35.01,23.35,P<0.05).Conclusions The detection rate of skeletal fluorosis in Guizhou Province decreases year by year,and the prevention and control effect is significant.Patients with skeletal fluorosis are mainly in the age group of 55 years and older,and the proportion of patients with moderate to severe skeletal fluorosis is increasing.We should continue to monitor and manage the treatment of current patients with skeletal fluorosis.

关 键 词：氟 燃煤 氟骨症 监测 

分 类 号：R599.1[医药卫生—内科学]