内蒙古鄂温克族牧民砖茶型氟铝联合中毒调查

Investigation on combined toxicosis of fluorine-aluminum in Ewenke Qi Inner Mongolia

目的调查鄂温克族牧民砖茶型氟铝联合中毒病情。方法随机对鄂温克族16-55岁男女均衡62名牧民进行发、血清、尿氟铝水平及血清电解质、生物化学检查，同时检测饮水、牛奶、砖茶、奶茶等氟铝水平，并进行临床检诊和拍摄前臂、骨盆正位X线片，不饮用砖茶的16-55岁男女均衡41名居民为对照组。结果发、血清、尿铝水平牧民组分别为（24．60±9．82）mg／Kg、（0．78±0．25）、（2．84±0．65）mg／L，对照组分别为（12．50±4．55）mg／kg、（0．18±0．11）、（2．09±0．64）mg／L；发、血清、尿氟水平牧民组分别为（1．00±0．52）mg／kg、（0．10±0．10）、（2．74±1．42）mg／L，对照组分别为（1．39±1．34）mg／kg、（0．04±0．03）、（0．87±0．43）mg／L；牧民发、血、尿铝及血、尿氟显著高于对照组（P〈0．01）。牧民组血清AST、LDH、HBDH、ALP显著高于对照组（P〈0．01）。X线摄片牧民组氟骨症检出率50．00％，关节退行性变检出率61．29％，骨间膜骨化33．87％，疏松型改变检出率29．03％，硬化型改变检出率8．06％；对照组氟骨症检出率2．44％，退行性变检出率34．15％，疏松型改变检出率21．95％，骨间膜骨化检出率2．44％，硬化型改变2．44％，X线氟骨症、关节退行性变、骨间膜骨化牧民组均高于对照组（P〈0．01）。结论内蒙古鄂温克族牧民饮茶型氟中毒病情较为严重，其发病机理较为复杂，并导致多组织、器官损伤，可能为砖茶型氟铝联合中毒。

Objective To investigate fluorine - aluminum combined toxicosis from brick tea on the Ewenke people in the Inner Mongolia Autonomous Region. Methods 62 Ewenke herdsmen, 16 to 55 years of age were selected randomly from Hui village, Ewenke County. The contents of F and Al in drinking water, milk, brick tea, milk tea, hair, serum, and urine were analyzed. The dectrolyte and biochemistry marks of serum were determined. The clinical examination and the entopie X - ray photo（forearm and pelvis） were taken. 41 inhabitants from Yimin town dose to Hui village were examined as the control group. Results The AI content in hair, serum and urine of the Ewenke herdsmen were 24.60 ± 9.82 mg/kg, 0.78 ± 0.25 mg/ L, 2.84 ± 0.65 mg/L respectively, and those of the control were 12.50 ± 4.55 mg/kg, 0.18 ± 0.11 mg/L, 2.09 ± 0.64 mg/L respectively. The F content in hair, serum and urine of the Ewenke herdsmen were 1.00 ±0.52 mg/kg, 0. 10 ±0.10 mg/L, 2.74 ± 1.42mg/L respectively, and those of the control were 1.39 ± 1.34 mg/kg, 0.04 ± 0.03 mg/L, 0.87 ±0.43 mg/L respectively. The A1 content in serum, urine and hair, and the F content in serum and urine of the Ewenke herdsmen were significant higher than those of the control （ P 〈 0.01）. The AST,LDH,HBDH,ALP in serum of the Ewenke herdsmen were also significant higher than those of the control（ P 〈0.01）. The prevalence rate of dental fluorosis and bone fluorosis （by X -ray） in the Ewenke herdsmen were 87.01% and 50.00%, and those were 12.20% and 2.44% in control group. The X -rays revealed that herdsmen oceured degeneration of 61.29%, interosscous membrane ossification of 33.87%, osteoporosis of 29.03%, and ostcoselerosis of 8.06% ; while control group only presented degeneration of 34.15%, interosscous membrane ossification of 2.44%, osteoporosis of 21.95%, and osteosderosis of 2.44%. The dental fluorosis, skeletal fluorosis （by X-ray）, arthrosis degeneration and interosscous membrane ossification in Ewenke herdsmen were significant higher than those in the control （ P 〈 0.01 ）. Conclusions The toxicosis from brick tea on the Ewenke herdsmen in the Inner Mongolia Autonomous Region was quite serious and could cause multi - organa＇s damages. Its pathogenesis was complex, and it would be the brick tea type of fluorine - aluminum combined toxicosis in Ewenke Qi, Inner Mongolia.