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目的 观察氟蓄积人群血清褪黑素(MT)、五羟色胺(5-HT)、黄嘌呤氧化酶(XOD)、谷胱甘肽过氧化酶(GSH-Px)、降钙素(CT)含量的变化,探讨氟对这5项指标的影响.方法 在青海省玉树州选择长期有饮砖茶习惯且有临床氟中毒表现的人群,年龄为16～ 65岁,按10岁为1个年龄段分为16～、26～、36～、46～、56～组,每组50人,男女各半.采集尿样,测定尿氟含量;并进行X线氟骨症检查;各采集静脉血,检测血清中MT、5-HT、XOD、GSH-Px和CT的含量.尿氟测定采用《尿中氟的离子选择电极测定方法》(WS/T 30-1996);氟骨症诊断依据《地方性氟骨症诊断标准》(WS 192-2008);MT、5-HT、XOD、GSH-Px和CT的测定采用双抗体夹心酶联免疫吸附法.结果 共对250人进行X线检查,X线氟骨症检出率为73.6％(184/250),其中轻度氟骨症88例,占35.2％;中度氟骨症72例,占28.8％;重度氟骨症24例,占9.6％;共检测250份尿样,尿氟几何均数为2.13mg/L,范围为0.20 ～ 12.04 mg/L;其中X线氟骨症为阴性人群尿氟含量为1.71 mg/L,范围为0.26～ 4.78mg/L;轻度人群尿氟含量为1.83 mg/L,范围为0.20～10.00 mg/L;中度尿氟含量为2.29 mg/L,范围为0.29～8.31 mg/L;重度尿氟含量为3.46 mg/L,范围为0.51 ～ 12.04 mg/L.随着病情加重,尿氟呈现逐渐升高的趋势(H=22.412,P＜0.05);共对250份血清样进行MT、5-HT、XOD、GSH-Px和CT测定,血清含量均值分别为(21.80±12.48) ng/L、(362.62±86.70) ng/L、(2 619.83±903.90)ng/L、(51.46±14.13)pmol/L、(762.91±238.18)ng/L.MT和GSH-Px随病情加重,分泌呈现逐渐减少的趋势(F=197.413、8.949,P均＜0.05).16～、26～、36～、46～、56～岁氟骨症人群血清MT分别为(36.96±3.45)、(29.02±3.59)、(24.20±1.92)、(10.23±5.56)、(5.89±4.12)ng/L,随着年龄增大MT和GSH-Px分泌减少(F=580.021、2.456,P均＜0.05).结论 氟蓄积人群血清MT和GSH-Px随病情加重和年龄增大而分泌减少,但其分泌减少是氟蓄积起主导作用还是年龄起主导作用有待进一步观察.“,”Objective To observe the content changes of melatonin (MT),semtonin (5-HT),xanthine oxidase (XOD),glutathione over peroxidase (GSH-Px) and calcitionin (CT) in the fluorosis accumulation human serum.Methods Patients with a habit of long-term drinking brick tea and clinically diagnosed skeletal fluorosis were selected in,aged 16 ～ 65 years,and grouped according to 10-year-old of 16-,26-,36-,46-,56-years old,each group had 50 people,half males and half females,urine samples were collected for determination of urinary fluoride content;and portable X-ray DR was used to take X-ray photographs;at the same time,their venous blood was collected to detect the content of serum MT,5-HT,XOD,GSH-Px and CT.Fluoride content of urine was determined by “Fluoride Ion Selective Electrode in Urine” (WS/T 30-1996);X-ray diagnosis of skeletal fluorosis was based on “Diagnostic Criteria for Endemic Skeletal Fluorosis” (WS 192-2008);MT,5-HT,XOD,GSH-Px and CT were determined with enzyme-linked immunosorbent assay (ELISA).Results Totally 250 patients were checked skeletal fluorosis by X-ray,the prevalence rate of skeletal fluorosis was 73.6％ (184/250),of which 88 cases were degree Ⅰ skeletal fluorosis,accounting for 35.2％;72 cases were degree Ⅱ skeletal fluorosis,accounting for 28.8％;and 24 cases were degree Ⅲ skeletal fluorosis,accounting for 9.6％.Totally 250 urine samples were detected fluoride content,the mean was 2.13 (0.20-12.04) mg/L;of which the urine fluoride content of control group was 1.71 (0.26-4.78) mg/L;that of degree Ⅰ was 1.83 (0.20-10.00) mg/L,that of degree Ⅱ was 2.29 (0.29-8.31) mg/L;that of degree Ⅲ was 3.46 (0.51-12.04) mg/L,as the illness aggravated,there was a tendency of increased urinary fluoride (H =22.412,P ＜ 0.05).The mean of MT,5-HT,XOD,GSH-Px and CT in 250 serum samples was (21.80 ± 12.48) ng/L,(362.62 ± 86.70) ng/L,(2 619.83 ± 903.90) ng/L,(51.46 ± 14.13) pmol/L and (762.91 ± 238.18) ng/L.There was a decreasing trends of MT and GSH-Px secretion (F =197.413,8.949,all P ＜ 0.05) with aggravation of the disease.MT in the age groups of 16-,26-,36-,46-,56-was (36.96 ± 3.45),(29.02 ± 3.59),(24.20 ± 1.92),(10.23 ± 5.56) and (5.89 ± 4.12) ng/L,respectively.MT and GSH-Px secretion declined with age (F =580.021,2.456,P ＜0.05).Conclusion The serum levels of MT and GSH-Px have increased with the severity of the disease and older of age,which needs to be further studied.