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目的了解氟中毒与大骨节病混合病区居民骨关节症状、体征,为混合病区氟骨症的诊断和鉴别诊断提供科学依据。方法采用分层整群抽样,在全省氟中毒和大骨节病混合病区中抽取2个屯做为调查点,对病区屯有骨关节症状、体征的居民进行调查;数据用SPSS13.0进行统计处理。结果共调查43例,所有症状中,指关节痛最多,占74.42%,所有体征中,关节增粗最多,占81.40%;所有症状、体征中只有髋关节痛有性别差异(P<0.05);四肢单、双侧关节症状、体征比较,腕、髋、趾痛,肘伸不直、中指触不到同侧肩峰、前臂上举受限、腿伸不直、短指短肢无差异(P>0.05);肘痛,中指经枕后触不到对侧耳廓、中指经背后触不到对侧肩胛下角有差异(P<0.05);肩、膝、踝和指痛,指末节掌曲、指尖触不到掌横纹远侧、关节增粗有极显著差异(P<0.001)。结论在氟中毒与大骨节混合病区,存在多种情况(氟骨症、大骨节病、骨关节炎、其他骨关节疾病、2种及2种以上疾病同时存在),氟骨症的调查、诊断方法都应区别于单纯氟中毒病区,今后还需进一步深入调查研究。
Objective To understand the bone-joint symptoms and signs of residents with mixed fluorosis and Kashin-Beck disease and to provide a scientific basis for the diagnosis and differential diagnosis of skeletal fluorosis in mixed disease area. Methods The stratified cluster sampling was used to select 2 villages in the mixed ward of fluorosis and Kashin-Beck disease in the province as the investigation point to investigate residents with symptoms and signs of osteoarthritis in the area. The data were analyzed by SPSS 13.0 Statistical processing. Results A total of 43 cases were investigated. Among all the symptoms, the most common was arthralgia, accounting for 74.42% of the total. Among all the signs, the joint thickening was the most, accounting for 81.40% of the total. All the symptoms and signs showed gender differences in hip pain (P <0.05). Limbs single, bilateral joint symptoms, signs, wrist, hip, toe pain, elbow extension is not straight, the middle finger can not touch the ipsilateral acromion, forearm lift restricted, leg extension is not straight, short finger short leg no difference ( P> 0.05); elbow pain, the middle finger through the occiput not touch the contralateral ear, the back of the middle finger can not touch the contralateral subscapular angle differences (P <0.05); shoulder, knee, ankle and finger pain, , Fingertips can not touch the distal stripes, joint thickening was significantly different (P <0.001). Conclusion There are many cases (skeletal fluorosis, Kashin-Beck disease, osteoarthritis, other bone and joint diseases, two kinds and two or more kinds of diseases coexist) Diagnostic methods should be different from the simple fluorosis area, the future need further investigation.