燃煤污染型氟中毒患者氟暴露、骨相损伤程度与骨形成标志物的关系

doi:10.13287/j.1001-9332.201901.026

应用生态学报 ›› 2019, Vol. 30 ›› Issue (1): 43-48.doi: 10.13287/j.1001-9332.201901.026

燃煤污染型氟中毒患者氟暴露、骨相损伤程度与骨形成标志物的关系

汪希兰¹,明娟¹,邱冰²,廖永芳²,廖玉丹¹,魏绍峰¹,涂成龙³,潘雪莉^1,3*

¹贵州医科大学公共卫生学院, 贵阳 550025;
²贵州省骨科医院, 贵阳 550000;
³贵州医科大学环境污染与疾病监控教育部重点实验室, 贵阳 550025

收稿日期:2018-10-10 修回日期:2018-12-01 出版日期:2019-01-20 发布日期:2019-01-20
通讯作者: xuelipan@gmc.edu.cn
作者简介:汪希兰, 女, 1973年生, 高级实验师. 主要从事毒理学研究. E-mail: 593531164@qq.com
基金资助:
本文由国家自然科学基金项目(81660524,81260418)资助

Relationship between fluoride exposure, orthopedic injuries and bone formation markers in patients with coal-burning fluorosis

WANG Xi-lan¹, MING Juan¹, QIU Bing², LIAO Yong-fang², LIAO Yu-dan¹, WEI Shao-feng¹, TU Cheng-long³, PAN Xue-li^1,3*

¹School of Public Health, Guizhou Medical University, Guiyang 550025, China;
²Guizhou Orthopaedics Hospital, Guiyang 550000, China;
³Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China

Received:2018-10-10 Revised:2018-12-01 Online:2019-01-20 Published:2019-01-20
Supported by:
This work was supported by the National Natural Science Foundation of China (81660524,81260418).

摘要/Abstract

摘要： 慢性氟暴露是世界范围内的公共卫生问题之一.为研究燃煤污染型氟中毒患者中氟暴露、骨相损伤程度与骨形成标志物血清碱性磷酸酶(ALP)、骨钙素(BGP)之间的相关关系,以贵州省织金县荷花村(燃煤污染型地方性氟中毒病区)和安顺市张官村(非氟暴露村)为调查点,采集环境样品,采用氟离子选择电极法测定环境介质及食物中的氟含量.在知情同意的原则下,对295例氟暴露和85例非氟暴露调查对象进行氟斑牙、氟骨症诊断;收集其尿液及外周血,测定尿氟(UF)浓度、ALP活性和BGP含量.结果表明: 病区环境中大米、辣椒、玉米、饮水、黏土、菜土、煤以及室内外空气氟含量均明显高于对照区,但较以往报道数据降低;随着尿氟浓度的升高,ALP活性、BGP含量显著升高,氟骨症病情差异有统计学意义,氟斑牙病情差异无统计学意义;氟骨症病情与ALP活性、BGP含量呈正相关.表明燃煤污染型低氟暴露可引起人群的骨相损害,且ALP、BGP可用于评估氟骨症患者骨转换情况,在氟骨症的辅助诊断、疗效评估中有着一定的应用价值.

关键词: 碱性磷酸酶, 氟骨症, 骨钙素, 氟暴露, 氟斑牙

Abstract: Chronic exposure to fluoride is a public health problem worldwide. We explored the relationship between fluoride exposure, orthopedic injuries and bone formation markers alkaline phosphatase (ALP), bone Gla protein (BGP) in participants with coal-burning fluorosis in Hehua Village (coal-burning fluorosis endemic area) in Zhijin County of Guizhou Province and Zhangguan Village (non-fluoride contaminated area) in Anshun City of Guizhou Province. Environmental samples were collected and fluoride contents were examined using a fluoride ion-selective electrode. Dental fluorosis and skeletal fluorosis of 295 participants from Hehua Village and 85 participants from Zhangguan Village were diagnosed with informed consent. Urinary samples and peripheral blood samples were collected from the participants to determine urinary fluoride (UF), ALP acti-vity, and BGP content. The results showed that fluoride contents in rice, pepper, corn, drinking water, clay, vegetable-grown soil, coal and indoor and outdoor air were significantly higher than those in the control area, but lower than the previously reported values. With the increases of UF concentration, the ALP activity and BGP content significantly increased, the severity of skeletal fluorosis was greater, but with no significant changes in dental fluorosis. There was positive correlation between the severity of skeletal fluorosis and ALP activity, BGP content. These results indicated that low fluoride exposure could cause orthopedic injuries. ALP and BGP could be used to eva-luate the bone turnover in patients with skeletal fluorosis, which would be useful in the auxiliary diagnosis and therapeutic evaluation of skeletal fluorosis.

Key words: fluoride exposure, bone Gla protein., alkaline phosphatase, dental fluorosis, skeletal fluorosis

汪希兰,明娟,邱冰,廖永芳,廖玉丹,魏绍峰,涂成龙,潘雪莉. 燃煤污染型氟中毒患者氟暴露、骨相损伤程度与骨形成标志物的关系[J]. 应用生态学报, 2019, 30(1): 43-48.

WANG Xi-lan, MING Juan, QIU Bing, LIAO Yong-fang, LIAO Yu-dan, WEI Shao-feng, TU Cheng-long, PAN Xue-li. Relationship between fluoride exposure, orthopedic injuries and bone formation markers in patients with coal-burning fluorosis[J]. Chinese Journal of Applied Ecology, 2019, 30(1): 43-48.

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燃煤污染型氟中毒患者氟暴露、骨相损伤程度与骨形成标志物的关系

Relationship between fluoride exposure, orthopedic injuries and bone formation markers in patients with coal-burning fluorosis

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