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目的研究陕南燃煤型地方性砷中毒病区的高砷石煤暴露人群发砷含量与年龄、性别、病情的关系。方法采集病区高砷暴露居民的发样90份,对照村居民的发样14份。用电感耦合等离子体质谱(ICP-MS)测定发砷。结果陕南砷暴露村居民发砷含量显著高于对照村,同时显著高于砷中毒病情更加严重的贵州省兴仁县长青镇,经比较差异均有统计学意义(P<0.05)。高砷暴露人群内部发砷含量随着年龄增加和砷中毒病情加重而增加,符合慢性砷暴露的特征,男性和女性的发砷差异不显著。41名未出现临床体征的居民发砷含量高达7.83 mg/kg,与轻度、中度中毒患者的发砷含量差异无统计学意义(P>0.05),表明在皮肤损伤症状出现之前,砷已经在人体内蓄积并达到有害程度,可能处于亚临床阶段。结论陕南燃煤型砷中毒病区暴露人群具有高砷蓄积特征;无临床体征的高砷暴露人群可能处于亚临床阶段,提示在地方性砷中毒的诊断标准中,应重视发砷值而不能仅注重临床症状和体征。
Objective To study the relationship between arsenic content and age, sex and disease in high-arsenic stone-exposed coal in endemic arsenism in southern Shaanxi. Methods A total of 90 hair samples from residents with high arsenic exposure and 14 samples from control village residents were collected. Arsenic was determined by inductively coupled plasma mass spectrometry (ICP-MS). Results The arsenic content of villagers in arsenic exposure in southern Shaanxi was significantly higher than that in control village and significantly higher than that of arsenic poisoning in Changqing Town, Xingren County, Guizhou Province (P <0.05). The content of arsenic in the arsenic-exposed group increased with age and arsenic poisoning, which accorded with the characteristics of chronic arsenic exposure. There was no significant difference in the arsenic levels between men and women. There was no significant difference in the levels of arsenic in 41 patients without clinical signs of arsenic (7.83 mg / kg) compared with mild or moderate poisoning (P> 0.05), indicating that arsenic had been found before the symptoms of skin injury Accumulate in the human body and reach harmful levels, may be in the subclinical stage. Conclusion The population exposed to coal-burning arsenism in southern Shaanxi province has the characteristics of high arsenic accumulation. The high arsenic-exposed population without clinical signs may be in the subclinical stage, suggesting that in the diagnostic criteria of endemic arsenism, attention should be paid to the value of arsenic rather than Only focus on clinical symptoms and signs.