2000—2009年内蒙古呼伦贝尔市新巴尔虎右旗地方性氟中毒监测结果分析

Analysis of endemic fluorosis of Xinbaerhuyouqi in Hulunbeir city of Inner Mongolia in 2000 - 2009

目的了解内蒙古呼伦贝尔市新巴尔虎右旗饮水型氟中毒改水后病情动态及发展趋势，为制订防治对策提供科学依据。方法2000—2009年在内蒙古呼伦贝尔市新巴尔虎右旗选择阿墩础鲁和克尔伦2个已改水苏木作为监测点，集中式供水采集水源水1份、末梢水3份，分散式供水按东、西、南、北、中5个方位各采集1份水样，检测水氟：检查全部在校8—12岁儿童氟斑牙患病情况；从2002年开始，每年采集30名8～12岁儿童即时尿样（5个年龄组，每个年龄组6份尿样），不足30人全部采集，检测尿氟。氟斑牙诊断采用Dean法；水氟检测采用氟离子选择电极法（WS／T106—1999）；尿氟检测采用尿中氟化物的测定离子选择电极法（WS／T89—1996）。结果2000—2009年阿墩础鲁苏木和克尔伦苏木水氟均值分别在1．79～4．35mg／L和1-38。3．18mg／L；8～12岁儿童氟斑牙检出率分别在45．24％（19／42）-89．78％（123／137）和40．00％（28／70）～74．47％（70／94）：8～12岁儿童尿氟中位数分别在2-30～4．15mg／L和2．73—4．55mg／L。结论新巴尔虎右旗改水10年儿童氟斑牙检出率居高不下，地方性氟中毒病情仍然比较严重，今后必须采取有效防治措施，控制氟中毒的发生。

Objective To investigate the dynamics and development trends of drinking water type of endemic fluorosis after water improvement in Xinbaerhuyouqi of Hulunbeir city, Inner Mongolia and to provide a scientific evidence for the development of countermeasures. Methods We mainly selected Adunchulusumu and Kerlunsumu in Xinbaerhuyouqi of Hulunbeir city as the two monitoring points after water improvement in 2000 - 2009. Of these, 1 sample of centralized water supply source water and 3 samples of tap water and 5 samples of non- centralized water supply source water according to water well locations of east, west, south, north and center were collected and the levels of water fluoride were tested; the prevalence of dental fluorosis of school children aged 8 to 12 were examined; from 2002 onwards, the urine samples of 30 children aged 8 to 12（five age groups, six urine samples for each age group） were collected, and all urine samples were collected in the case of less than 30, and urine fluoride was tested. Dental fluorosis was diagnosed using Dean method; water fluoride was tested using fluoride ion selective electrode （WS/T 106-1999）; urinary fluoride was tested by determination of fluoride in urine using ion-selective electrode（WS/T 89-1996）. Results In 2000 - 2009, the mean levels of fluorine in drinking water in Adunchulusumu and Kerlunsumu were 1.79 - 4.35 mg/L and 1.38 - 3.18 mg/L, respectively; the detection rate of dental fluorosis of children aged 8 to 12 were 45.24% （19/42） - 89.78% （123/137） and 40.00% （28/70） - 74.47% （70/94）, respectively; the median urinary fluoride of them were 2.30 - 4.15 mg/L and 2.73 - 4.55 mg/L, respectively. Conclusions The detection rate of children＇ s dental fluorosis remains high in Xinbaerhuyouqi during the past 10 years after changing water. The endemic fluorosis remains a serious disease. Effective prevention and control measures must be taken to control the occurrence of fluorosis in the future.