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目的探讨低浓度饮水型砷暴露人群皮肤损伤的影响因素。方法在山西省大同市,选择85名地方性砷中毒(简称地砷病)病区(水砷含量为14.41~90.34μg/L)某村饮水年限20年以上本地居民,无传染性、遗传性等疾病,无放射线和理化致病因素接触史者为调查对象。按照皮肤损伤程度将调查对象分为无皮肤损伤组(即正常组)、轻度皮肤损伤组(简称轻度皮损组)、中度皮肤损伤组(简称中度皮损组)和重度皮肤损伤组(简称重度皮损组)。原子荧光光谱法测定研究对象体内尿砷水平,ELISA试剂盒测定其血清8-OHdG的含量。结果不同皮损组的尿砷和血清8-OHdG分布差异均有统计学意义(P<0.05)。重度皮损组的尿砷含量高于正常组和轻度皮损组(P<0.05);轻度、中度和重度皮损组的血清8-OHdG含量均高于正常组(P<0.05),且重度皮损组的血清8-OHdG含量高于轻度和中度皮损组(P<0.05)。Logistic回归分析显示,年龄和血清8-OHdG是砷暴露人群皮肤损伤的主要危险因素(OR=9.87,P<0.05;OR=6.08,P<0.05)。结论砷暴露所致的皮肤损伤可能与暴露时间和氧化损伤关系密切。
Objective To study the influencing factors of skin damage in low-concentration drinking-water arsenic-exposed people. Methods In Datong, Shanxi Province, 85 endemic arsenism (Arsenicosis) endemic areas (arsenic content of 14.41-90.34μg / L) were selected in this study. The drinking water of a certain village was more than 20 years old and was not contagious and hereditary And other diseases, no radiation and physical and chemical factors exposure history as the survey. According to the degree of skin injury, the subjects were divided into three groups: non-skin injury group (normal group), mild skin injury group (mild lesion group), moderate skin lesion group (moderate lesion group) and severe skin lesion group Group (referred to as severe skin lesions group). Urinary arsenic levels were determined by atomic fluorescence spectrometry and serum levels of 8-OHdG were measured by ELISA kit. Results There were significant differences in urinary arsenic and serum 8-OHdG distribution between different lesions (P <0.05). Urinary arsenic levels in patients with severe skin lesions were significantly higher than those in normal controls and mild lesions (P <0.05). Serum levels of 8-OHdG in mild, moderate and severe lesions were significantly higher than those in normal controls (P <0.05) , And the level of serum 8-OHdG in patients with severe skin lesions was higher than that in mild and moderate lesions (P <0.05). Logistic regression analysis showed that age and serum 8-OHdG were the main risk factors of skin damage in arsenic-exposed people (OR = 9.87, P <0.05; OR = 6.08, P <0.05). Conclusion The skin damage caused by arsenic exposure may be closely related to the exposure time and oxidative damage.