奎屯地方性砷中毒病区长期干预后慢性砷中毒患者的转归

Epidemiologic investigation and patients following study in the endemic arsenism region afer ridding arsenic from drinking water for years

目的 通过慢性砷中毒病区 15年的长期改水干预后 ,对病区进行流行病学调查及慢性砷中毒患者的转归分析。方法 选择干预前井水砷含量为 0 .6mg/ L 和 0 .5 8mg/ L两地区居民进行随访 ,并进行染色体畸变、微核检查 ,同时以水砷含量 0 .0 3 mg/ L地区居民为对照组。结果 经过长期改水干预后两病区患者中改水 2年仍未愈病例总的好转率为 73 .4% ,轻度患者治愈率达 76.4% ,掌跖角化好转率为 85 .2 % ,色素异常好转率为71.2 %。皮肤癌患者 3例。随访患者中 19例死亡者 14例为癌症。部分患者躯干色素及角化皮疹增多。两病区患者染色体畸变、微核与对照组相比差异有显著意义 (P <0 .0 1)。随访中未发现新病例。结论 改水干预 15年患者有了明显好转 ,较彻底解决了砷中毒的病因。

Objective To use epidemiologic investigation and patients following study in the endemic arsenism region after ridding arsenic from drinking water for 15 years.Methods The cases of two areas that the arsenic content in the well water was 0.6 mg/L and 0.58 mg/L before the water reform were chosen to study chromosome aberration ; microkernel ;clinical feature and pathologric lesion.The other was chosen control that the arsenic in well water was 0.03 mg/L.Results After the water reform the patients of two areas 73.4% improved.76.4% the light cases cure. 85.2% skin keratosis of hands and feet improved. 71.2% skin pigmentation of truk improved.Skin cancer are discoverd in 3 patients 14 cases were died of cancer in the 19 pass away patients.Some patients skin pigmentation and keratosis increased in truk.Chromosome aberration and microkernel frequency of patients was higher than control(P<0.01).We don't find a new arsenism patient during the investigation.Conclusions The patients have evident improved after the water reform 15 years. Though the arsenism patients will be caused more influence by arsenic in future we will find more effective scheme.