饮茶型氟中毒病区藏族和哈萨克族人群尿氟和尿pH水平差异

Differences of urinary fluoride and pH level between Tibetan and Kazakh in drinking-brick-tea-borne fluorosis areas

目的探讨饮茶型氟中毒病区尿氟、尿pH在藏族和哈萨克族之间的差异。方法根据饮茶型氟中毒历史资料，在青海省果洛州玛沁县、达日县选择6个藏族聚集村，在新疆阿勒泰地区的阿勒泰市、哈巴河县选择5个哈萨克族聚集村作为调查点。调查生活于当地的16岁以上人群，采集砖茶水水样，检测氟含量．并计算日均砖茶氟摄入量；采集即时尿液样本，检测尿氟含量，并测定尿液pH值；对全部调查对象进行前臂、小腿和骨盆x线摄片，根据《地方性氟中毒诊断标准》（WS192—2008）进行氟骨症诊断。结果本次共计调查445例16岁以上成人，其中藏族224例，哈萨克族221例。藏族日均砖茶氟摄入量的中位数为7-33mg，与哈萨克族（6．55mg）相似。哈萨克族人群尿氟几何均值（3．29mg／L）高于藏族（2．26mg／C，Z=6．26，P〈0．05）。藏族人群尿液pH中位数（5．5）高于哈萨克族（5．1，Z=7．00，P〈0．05）。藏族人群X线氟骨症检出率（45．33％，102／224）高于哈萨克族（30.32％，67／221，χ2=10．94，P〈0．05）。在藏族非氟骨症人群中，尿氟与尿pH呈负相关关系（r=-0．24，P〈0．05）。结论藏族和哈萨克族人群之间尿氟水平和尿pH水平存在差异。

Objective To study the differences of urinary fluoride, pH level between Tibetan and Kazakh in drinking-brick-tea-borne fluorosis areas. Methods Based on historical data, people from six villages in Qinghai （Maqin County and Dari County） and five villages in Sinkiang （Altay City and Habahe County）, who were 16 years and older, born and grew up in those villages, were enrolled in the study. All participants were surveyed, and their tea water samples were collected and fluoride concentration was tested, and average daily intake of fluoride was calculated. Fluoride concentration of spot urine was tested. In the meantime, urinary pH was tested. All participants were diagnosed by X-ray （forearm, shank and pelvic） by the standard of ＂Diagnosis standard for Endemic Fluorosis＂ （WS 192-2008）. Results A total of 445 people who were over 16 years old were surveyed, 224 were Tibetan and 221 were Kazakh. The median of average daily intake of fluoride of Tibetan was 7.33 rag, which was similar with that of Kazakh （6.55 rag）. The geometric mean of urinary fluoride of Tibetan was 2.26 mg/L, which was lower than that of Kazakh which was 3.29 mg/L （Z = 6.26, P 〈 0.05）. The median of urinary pH was 5.5 in Tibetan, which was higher than that of Kazakh which was 5.1 （Z = 7.00, P 〈 0.05）. The prevalence of skeletal fluorosis diagnosed by X-ray ,was higher in Tibetan （45.33%, 102/224） than that of Kazakh （30.32%, 67/221, χ2 = 10.94, P 〈 0.05）. There was a negative correlation between urinary fluoride and urinary pH in non-skeletal fluorosis of Tibetan （r = - 0.24, P 〈 0.05）. Conclusion There are differences of urinary fluoride level and urinary pH between kazakh and Tibetan.