工业性和地方性氟病骨损伤X线征象的对比

Comparative study of X-ray photographic feature in bone injuries between industrial and endemic fluorosis

目的通过对工业性和地方性氟病患者进行骨骼X线检测,探究两种不同类型骨损伤X线的征象差异及其原因。方法选取湖北省某大型铝厂工业性氟病患者60例和湖北省某地方性氟中毒高发区氟病患者39例,采用问卷调查研究对象的一般情况、既往史及现患疾病情况,采集其生物样本,并对其进行前臂正位X线检测,使用SPSS18.0统计软件对数据进行统计学分析。结果工业性氟病患者的血氟和尿氟均高于地方性氟病患者(P<0.05);工业性氟病患者临床表现较轻,以关节疼痛和僵硬为主,而地方性氟病患者的临床表现相对较重,出现肢体关节活动受限和四肢轻微变形;工业性氟病患者骨骼X线分型以硬化和骨周骨化型为主,疏松软化型较少,地方性氟病患者三种类型均可见,两者之间差异有统计学意义(P<0.01);X线分度上工业性氟病骨损伤主要是早期和轻度,没有重度,而地方性氟病骨损伤相对较重,两种类型差异有统计学意义(P<0.01)。结论两种不同类型的氟病骨损伤X线征象存在一些差异,工业性氟病骨损伤以轻度骨硬化、骨周骨化型为主,地方性氟病骨损伤以混合型多见。

Objective Through the skeleton X-ray detection on industrial and endemic fluorosis patients, to explore the differences and its reasons of X-ray photographic features in two different types of fluorosis. Methods All 60 cases of industrial fluorosis from a large aluminum plant in Hubei province and 39 cases of endemic fluorosis in fluorosis high-risk region of Enshi area in Hubei province were selected as the subjects. The questionnaire was used for investigation of general situation, past his- tory, present illness history, etc. , biological saimples were also taken, meantime, the X-ray examination on the forearms of the patients was made as well. The data was analyzed with SPSS software system, version 18.0 （SPSS Inc, 2003）. Results The results showed that the fluorine levels in blood and urine of industrial fuorosis patients were higher than that of endemic fluo- rosis patients （P 〈 0.05 ） ; the clinical manifestations of industrial fluorosis were lighter mainly were joint pain and stiffness while endemic fluorosis always had heavier manifestations, might appear limb-joints activities limitation and limbs slight deforma- tion. The X-ray examination showed that there mainly were osteosclerosis and peripheral osseous ossification, osteoporosis and osteomalacia were seldom, but three types all could be seen in endemic fluorosis （P 〈 0. 01 ）. As for scale division in X-ray ex- amination, there were only slight or mild degree in industrial fluorosis, no severe could be seen, while endemic fluorosis were severe relatively （P 〈 0.01 ）. Conclusion The results showed that there were some differences in X-ray photographs between two types of fluorosis, the bone injuries in industrial fluorosis mainly were the mild ostcosclerosis and peripheral osseous ossifica- tion types, however, the endemic fluorosis, bone injuries mianly were mixed types.