必需微量元素与燃煤污染型砷中毒关系探讨

Relationship between coal burning type of arsenic poisoning and essential trace elements

目的 探讨硒、锌、铜、铁、钴、铬、钼7种必需微量元素与燃煤污染型砷中毒的关系.方法 以贵州省兴仁县交乐乡燃煤污染型砷中毒病区为调查点,采用分层抽样方法选择砷暴露者（包括病区非病人及轻、中、重度患者）139例为暴露组;同时选择距病区约13 km的非砷污染村村民34例为对照组.采用电感耦合等离子体发射光谱（ICP-OES）法测定病区和对照区燃煤、土壤、大米、玉米和辣椒以及暴露组和对照组头发、血液和尿液中砷、硒、锌、铜、铁、钴、铬及钼元素水平.结果 病区燃煤、土壤、玉米和辣椒中含砷量分别为4.894、146.551、0.522、1.440 mg/kg,分别高于对照区的1.980、50.167、0.296、0.948 mg/kg（P＜0.05或＜0.01）;病区土壤中含硒量为5.038 mg/kg,低于对照区的8.948 mg/kg（P＜0.05）;病区土壤中含铜、铁、铬量及玉米中含铁量分别为44.114、5731.500、98.323、89.996 mg/kg,分别高于对照区的13.473、1298.430、36.839、57.391 mg/kg（P均＜0.05）.暴露组发砷和尿砷分别为1.985 mg/kg和149.593 μg/g Cr,分别高于对照组的0.670 mg/kg和49.853μg/g Cr（P均＜0.01）;暴露组发硒为1.706 mg/kg,低于对照组的2.405 mg/kg（P＜0.01）;暴露组发铁、发铬、血铜及血铜/锌比值分别为88.295、8.933 mg/kg、1.053 mg/L和0.074,分别高于对照组的47.970、4.099 mg/kg、0.934 mg/L和0.065（P＜0.01或＜0.05）.发硒与病情发展呈负相关（r=-0.414,P＜0.01）;发铁、发铬和血铜/锌比值与病情发展呈正相关（r值分别为0.271、0.261和0.250,P均＜0.01）.结论 病区环境高砷同时存在低硒、高铜、高铁和高铬现象.暴露组发硒偏低,发铁、发铬、血铜和血铜/锌比值偏高,与环境中元素水平变化趋势一致,且与病情发生发展有一定联系.

Objective To investigate the effects of essential trace elements selenium, zinc, copper, iron,cobalt, chromium and molybdenum upon arsenic poisoning caused by coal-burning. Methods Stratified random sampling method was used to conduct epidemiological investigation on 139 arsenic exposed residents（including nonpatient, light, moderate and severe patients） in an area polluted by coal-burning arsenic in Xingren county of Guizhou province as exposure group. Control group included 34 residents who lived about 13 km away from the endemic area of arsenic contamination. Inductively coupled plasma-optical emission spectrometry （ICP-OES） was used to analyze arsenic, selenium, zinc, copper, iron, cobalt, chromium and molybdenum in coal, soil, rice,corn, chilli, hair, blood and urine. Results Arsenic content in coal, soil, corn and chilli of polluted area were 4.894,146.551,0.522,1.440 mg/kg, respectively. These arsenic content were significantly higher than those in control area which were 1.980,50.167,0.296,0.948 mg/kg, respectively（P 〈 0.05 or 〈 0.01） . The content of selenium in soil of the diseased area（5.038 mg/kg） was significantly lower than that in soil of control area（8.948 mg/kg, P 〈0.05）. The content of copper, iron, chromium in soil and iron in corn were 44.114,5731.500,98.323,89.996 mg/kg, respectively. These elements content were significantly higher than those in control area which were 13.473,1298.430,36.839,57.391 mg/kg, respectively （all P 〈 0.05） . Hair and urine arsenic levels were 1.985mg/kg and 149.593 μg/g Cr in exposed group, respectively. These arsenic levels were significantly higher than those in control group which were 0.670 mg/kg and 49.853 μg/g Cr, respectively（all P 〈 0.01） . Hair selenium level in exposed group（1.706 mg/kg） was significantly lower than that in control group（2.405 mg/kg, P 〈 0.01）. Hair levels of iron and chromium, blood level of eopper and the ratio between copper and zinc in exposed group were 88.295,8.933 mg/kg, 1.053 mg/L and 0.074, respectively. These element levels and elements ratio were significantly higher than those in control group which were 47.970,4.099 mg/kg, 0.934 mg/L and 0.065, respectively（P 〈 0.01 or 〈 0.05）. Hair selenium level was negatively correlated with the progression of arsenism（r = - 0.414, P 〈 0.01） .Hair levels of iron and chromium, the ratio between copper and zinc in blood were positively correlated with the progression of arsenism（r = 0.271,0.261,0.250, all P 〈 0.01） . Conclusions Low selenium, high copper, high iron and high chromium coexists in arsenic polluted area. In exposed group, hair selenium is low, hair iron and chromium, blood copper and ratio between copper and zinc are high. These element changes with environment trend.These element changes are associated with the occurrence and development of the disease caused by coal-burning.