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[目的]研究贵州省燃煤型氟中毒病区8~14岁儿童血清钙、磷变化与年龄及氟斑牙程度的关系,探讨不同年龄段儿童血清钙、磷受氟中毒影响的情况。[方法]采用现况调查对486例(氟病区366例,对照区120例)8~14岁儿童进行氟斑牙和尿氟调查;之后按年龄分层抽取190例儿童进行血清钙、磷浓度测定;根据Tanner分期标准按年龄合并为3个年龄段(8~10岁为青春前期,11~12岁为青春早期,13~14岁为青春中期),分析不同年龄段氟病区与对照区儿童血清钙、磷差异;同时分析氟病区儿童不同氟斑牙程度下血清钙、磷变化。[结果]氟病区儿童氟斑牙患病率及尿氟浓度均高于对照区(χ2氟斑牙=265.130,P=0.000;Z尿氟=-7.716,P=0.000)。与对照区相比,氟病区儿童除青春中期组血磷浓度无明显变化外,其余年龄段血磷浓度均较低(Z青春前期=-2.080,P=0.037;Z青春早期=-3.889,P=0.000)、血钙浓度较高(Z青春前期=-4.022,P=0.000;Z青春早期=-3.289,P=0.001;Z青春中期=-3.952,P=0.000)。三个年龄段间,氟病区儿童血磷、血钙浓度的变化差异均无统计学意义(HP=0.560,P=0.756;HCa=0.296,P=0.863)。不同氟斑牙程度下儿童血清钙、磷无明显规律性变化,仅极轻度和轻度间血磷浓度差异有统计学意义(H=-24.207,P=0.015)。除氟斑牙程度与年龄存在正相关外(r=0.336,P<0.01),其余指标间均无具统计学意义的相关关系。[结论]氟可致低龄、低中毒程度儿童出现血清钙、磷浓度非进展性改变。
[Objective] To investigate the relationship between serum calcium and phosphorus and age and dental fluorosis in children aged 8 to 14 years old in Guizhou province with fluorosis-type fluorosis, and to explore the effect of fluoride poisoning on serum calcium and phosphorus in children of different ages. [Methods] Investigation of dental fluorosis and urinary fluoride in 486 children (366 cases of fluorosis and 120 cases of control) from 8 to 14 years old were carried out according to the current situation investigation. Then 190 children were stratified by age to carry out serum calcium and phosphorus According to the Tanner staging criteria, the patients were divided into three age groups by age (8 to 10 years old in early adolescence, 11 to 12 years old in early adolescence and 13 to 14 years in mid adolescence) The differences of serum calcium and phosphorus in children with fluorosis were analyzed simultaneously. [Results] The prevalence of dental fluorosis and urinary fluoride in children with fluorosis were higher than those in the control group (χ2 dental fluorosis = 265.130, P = 0.000; Z urine fluoride = -7.716, P = 0.000). Compared with the control group, there were no significant changes in serum phosphorus levels in children with FFA except the mid-adolescent group (P = 0.038, P = 0.037; Z = -3.889, P = P = 0.000), and higher serum calcium concentrations (Z = -4.022, P = 0.000; Z, early = -3.289, P = 0.001; Z, mid-adolescence = -3.952, P = 0.000). There were no significant differences in serum phosphorus and serum calcium concentrations between children of three age groups (HP = 0.560, P = 0.756; HCa = 0.296, P = 0.863). There was no obvious regularity of serum calcium and phosphorus in children with different dental fluorosis. There was significant difference in serum phosphorus and phosphorus between the two groups (H = -24.207, P = 0.015). Except for the positive correlation between dental fluorosis and age (r = 0.336, P <0.01), there was no statistically significant correlation between the other indexes. [Conclusion] The non-progressing changes of serum calcium and phosphorus concentrations in children with younger or lower poisoning caused by fluoride can be observed.