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目的 探讨慢性砷中毒患者自觉症状、皮肤色素异常及过度角化的影响因素。方法 选择山西大同地区山阴县黑疙瘩乡大营村进行调查问卷及体检 ,结果进行单因素及多因素Logistic逐步回归分析。 结果 单因素分析提示 ,年龄、迁入时间、饮含砷井水时间、吸烟、饮茶等与自觉症状、色素异常及皮肤角化显著相关 ,水果是保护因素。多因素Logistic逐步回归分析结果表明 ,年龄、迁入时间是自觉症状的主要危险因素 ;年龄是色素异常的主要危险因素 ,水果摄入是保护因素 ;年龄、迁入时间、饮含砷井水时间是皮肤过度角化的主要危险因素 ,水果摄入是保护因素。结论 自觉症状及皮肤改变主要与砷的摄入及蓄积量有关。砷中毒病区地理环境背景也是影响皮肤改变的因素之一。水果等抗氧化物质的摄入可能起保护作用。
Objective To explore the influencing factors of patients with chronic arsenic poisoning symptoms, abnormal skin pigmentation and hyperkeratosis. Methods A questionnaire and physical examination were conducted in Daying Village, Hajudao Township, Sanyin County, Datong, Shanxi. The results were analyzed by single factor and Logistic stepwise regression analysis. Results Univariate analysis showed that age, immigration time, drinking water containing arsenic well time, smoking, drinking tea and other symptoms, abnormalities of pigmentation and skin keratosis were significantly related to the protection of fruits. Multivariate Logistic stepwise regression analysis showed that age and immigration time were the main risk factors of subjective symptoms. Age was the main risk factor of pigmentation and fruit intake was the protective factor. Age, immigration time, Is the main risk factors for skin hyperkeratosis, fruit intake is a protective factor. Conclusion Conscious symptoms and skin changes are mainly related to arsenic uptake and volume accumulation. Arsenic poisoning ward geographical environment background is also one of the factors that affect the skin changes. Antioxidants such as fruit intake may play a protective role.