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目的探讨燃煤型儿童氟骨症的危险因素。方法以贵州省织金燃煤型氟中毒病区为研究现场,运用成组病例对照研究方法,选择病区7~14岁儿童氟骨症患者65例作为病例组,该地区生活环境、卫生、文化等条件相近的同年龄范围的健康儿童作为对照组,调查居住环境、生活习惯、家庭经济等各种因素,检测总摄氟量、尿氟、血中微量元素、血浆骨形态蛋白2(BMP-2)含量,研究儿童氟骨症的危险因素。结果多因素分析显示家庭人均年收入低、敞灶燃煤方式、烘烤粮食、未封闭储存粮食、少吃肉食、总摄氟量高、尿氟含量高、BMP2含量变化、血钙浓度低可能为氟骨症的危险因素(OR值均大于1,且P值均<0.05);主食大米(少吃煤烘玉米)、炉灶有烟囱则可能为保护因素(OR值均小于1,且P值<0.05)。结论家庭人均年收入低、敞灶烧煤、烘烤粮食及未封闭储存粮食、少吃肉食、总摄氟量高、尿氟高、血钙浓度低、BMP2含量低可能为燃煤型儿童氟骨症的危险因素;主食大米(少吃煤烘玉米)、炉灶有烟囱则可能为保护因素。
Objective To investigate the risk factors of skeletal fluorosis in coal-fired children. Methods Taking woven gold-fired fluorosis area in Guizhou Province as the research site, 65 cases of skeletal fluorosis patients from 7 to 14 years old in the ward were selected as the case-group. The living environment, health, Culture and other similar conditions of the same age range of healthy children as a control group to investigate the living environment, living habits, family economics and other factors, detection of total fluoride, urinary fluoride, blood trace elements, bone morphogenetic protein 2 (BMP -2) content, to study the risk factors of skeletal fluorosis in children. Results Multivariate analysis showed that the per capita annual household income was low, the way of open coal burning, baking food, unsealed food storage, eating less meat, higher fluoride intake, higher urinary fluoride content, changing BMP2 content and lower serum calcium concentration (Odds ratio> 1, P <0.05). The staple food rice (less coal bake corn) and the stove chimney may be protective factors (OR values less than 1, and P value <0.05). Conclusion The per capita annual income of the family is low, with open stove burning coal, baking food and non-closed storage of food, eating less meat, high fluoride intake, high urinary fluoride, low blood calcium concentration and low BMP2 content may be fuel-burning children’s fluorine Risk factors for bone disease; staple rice (less coal bake corn), the stove has a chimney may be a protective factor.