2008年黑龙江省饮水型地方性氟中毒病区成人颈动脉粥样硬化病情调查

Survey of adult carotid atherosclerosis in water-related endemic fluorosis areas in Heilongjiang province in 2008

目的 调查黑龙江省饮水型地方性氟中毒（简称地氟病）病区成人颈动脉粥样硬化病情,探讨饮水型氟中毒与颈动脉粥样硬化发生的关系.方法 2008年,在黑龙江省肇州县选取4个饮水含氟量≥1.0 mg/L的自然村作为病区组,在泰来县选取4个饮水含氟量＜1.0 mg/L的自然村作为对照组.用B超对40岁以上居民进行了颈动脉粥样硬化检查,保留超声图片并做记分、诊断、评分.结果病区组4个村（新丰村、太平山村、宝产村和后郑村）共检查266人,颈动脉粥样硬化检出率分别为47.3%（35/74）、63.5%（40/63）、73.3%（33/45）、60.7%（51/84）;对照组4个村（哈拉村、乾兴村、三家村、爱林村）共检查283人,颈动脉粥样硬化检出率分别为32.7%（17/52）、32.9%（24/73）、39.2%（31/79）、30.4%（24/79）,两组间检出率比较,差异有统计学意义（T=26,P＜0.05）;病区村与对照村按年龄标准化后的颈动脉动脉粥样硬化检出率分别为47.3%、63.5%、73.3%、60.7%,34.7%、36.3%、43.0%、41.3%,两组间预期阳性率[57.5%（153/266）、37.8%（107/283）]比较,差异有统计学意义（x2=21.36,P＜0.01）;按年龄标准化的颈动脉粥样硬化病例病变严重程度两组间比较,差异有统计学意义（x2=36.15,P＜0.01）.结论饮水型地氟病病区成人颈动脉粥样硬化的检出率高于对照,病变程度重于对照,高氟与动脉粥样硬化的发生存在一定的关系.

Objective To investigate the disease situation of adult carotid atherosclerosis in water-related endemic fluorosis areas in Heilongjiang province in 2008 so as to explore the relationship between water-related endemic fluorosis and incidence of carotid atherosclerosis disease. Methods A total of 266 participants over the age of 40 from four villages in Zhaozhou county with water fluoride ≥ 1.0 mg/L in a fluorosis area and 283 residents over the age of 40 from four villages in Tailai county with water fluoride 〈 1.0 mg/L in a nonfluorosis area were investigated. A portable-type B mode color ultrasound was used to examine the left carotid artery of all participants.The carotid atherosclerosis was diagnosed and graded through the ultrasonograms. Results The prevalence rates of carotid atherosclerosis in the 4 fluorosis villages（Xinfeng, Taipingshan, Baochan and Houzheng villages） were 47.3% （35/74）, 63.5%（40/63）, 73.3%（33/45） and 60.7%（51/84）, respectively, and in the 4 nonfluorosis villages（Hala,Qianxing, Sanjia and Ailin villages） were 32.7% （17/52）, 32.9% （24/73）, 39.2% （31/79） and 30.4% （24/79）,respectively. The prevalence rates of carotid atherosclerosis in every villages standardized by age were 47.3% ,63.5%,73.3% ,60.7% and 34.7% ,36.3% ,43.0% ,41.3%, respectively. Statistic method used was Wilcoxon two sample test and the differences were significant（T = 26, P 〈 0.05 ）. Total carotid atherosclerosis positive rate standardized by age in the 4 fluorosis villages was significantly higher than that in the 4 nonfluorosis villages[57.5%（153/266） ,37.8% （107/283）, x2 = 21.36, P 〈 0.01 ]. After standardized by age, the severity of carotid atherosclerosis was significantly different between fluorosis villages and nonfluorosis villages （x2 = 36.15, P 〈 0.01 ）. Conclusion The prevalence rate of carotid atherosclerosis in endemic fluorosis area is higher than that in nonfluorosis area.