2012年陕西省停止硒盐防治措施2个月后大骨节病病区人群发硒含量变化的监测

Changes of selenium content in hair samples of people in Kaschin-Beck disease areas two months after stopping selenium salt in Shaanxi Province in 2012

目的比较停止硒盐防治措施2个月后，陕西省大骨节病病区与非病区人群发硒含量变化，为大骨节病防治工作提供决策依据。方法2012年9月选取陕西省永寿县、榆阳区、麟游县和南郑县4个大骨节病重病县（区），每个县（区）按东、西、南、北四个方位选取4个病区村作为监测点。同时选取与监测县（区）相邻，环境、居民生产生活条件、生活方式相近的米脂、岐山、武功和城固4个县（区）作为农村非病区。每个县（区）按东、西、南、北四个方位选取4个村作为监测点。并增加西安市莲湖区作为城市非病区，在东、西、南、北四个方位选取4个社区作为监测点。在每个监测点抽取7～12岁儿童8名（性别均衡）、16岁以上成人8名（性别均衡），进行发硒含量测定。样本采用湿消化法处理，应用2，3-二氨基萘荧光法进行发硒含量测定。结果共收集4个大骨节病病区县（区）人群发硒样本256份，4个农村非病区县（区）人群发硒样本256份，1个城市非病区县（区）人群发硒样本64份。病区及非病区发硒含量均值均≥0．25mg／kg。病区、农村非病区及城市非病区人群发硒含量比较[（0．40±0．23）、O．42±0．28）、（0．37±0．38）mg／kg]，三者差异无统计学意义（F=0．045，P〉0．05）。病区人群发硒含量〈0．20mg／kg的有37人，占14．45％；0．20～〈0．25mg／kg的有28人，占10．94％；0．25～〈0．50mg／kg的有127人，占49．61％；≥0．50mg／kg有64人，占25．00％。非病区人群发硒含量〈0．20mg／kg的有67人，占20．94％；0．20-〈0．25mg／kg的有28人，占8．75％；0．25～〈0．50mg／kg的有143人，占44．69％：≥0．50mg／kg的有82人，占25．63％。病区、农村非病区、城市非病区7～12岁儿童和成人发硒含量比较[儿童分别为（0．45±0．29）、（0．47±0．31）、（0．33±0．12）mg／kg；成人分别为（0．41±0．25）、（0．37±0．25）、（O．g0±0．49）mg／kg]，差异均无统计学意义（F=0．007、0．024，P均〉0．05）。病区、农村非病区、城市非病区男性和女性发硒含量比较[男性分别为（O．43±0．23）、（0．43±0．26）、（0．40±0．51）mg／kg；女性分别为（0．38±0．22）、（0．41±0．31）、（0．34±0．18）mg／kg]，差异均无统计学意义（F=0．872、3．589，P均〉0．05）。结论2012年停止硒盐防治措施2个月后，陕西省大骨节病病区与非病区人群发硒含量均超过人体发硒健康阈值，病区居民发硒水平未有显著下降。本次监测距离停供硒盐时间较近，继续开展病区居民硒水平监测十分必要。

Objective To compare selenium content in hair samples of people in Kaschin-Beck disease （KBD） areas and non KBD areas two months after stopping selenium salt in Shaanxi Province, to provide a scientific basis for KBD control and prevention. Methods In September 2012, four historical KBD areas were selected, including Yongshou, Yuyang, Linyou and Nanzheng, four villages were selected as monitoring sites according to the four directions as east, west, south and north in each county. Meanwhile, four non KBD areas were selected, including Wugong, Mizhi, Qishan and Chenggu, which adjacent to the survey counties and were similar to the survey counties in environment and production and living conditions. Four villages were selected as monitoring sites according to the four directions as east, west, south and north in each county. Lianhu District in Xi＇an city was selected as a urban non KBD area. Four communities were selected in the east, west, south and north as the monitoring sites. In each monitoring point, hair samples of 8 children aged 7 - 12 years old （gender balanced） and 8 adults over the age of 16 （gender balanced） were selected to determine the hair selenium. Samples were disposed by wet digestion method, the selenium content was determined by 2,3-diaminonaphthalene fluorescence method. Results A total of 256 hair samples were collected in the four KBD counties, 256 hair samples in four non KBD counties, 64 hair samples in one urban district. The average of hair selenium in each monitoring point was I〉0.25 mg/kg. Compared the hair selenium content in KBD areas, rural non KBD areas, and urban non KBD areas [（0.40 ± 0.23）, （0.42 ±0.28）, （0.37 ±0.38） mg/kg], the differences were not statistically significant （F = 0.045, P 〉 0.05）. In KBD areas, the hair selenium content of 37 people was 〈 0.20 mg/kg, accounting for 14.45%; 28 people was 0.20 - 〈 0.25 mg/kg, accounting for 10.94%; 127 people was 0.25 - 〈 0.50 mg/kg, accounting for 49.61%; 64 people was i〉 0.50 mg/kg, accounting for 25.00%. In non KBD areas, the hair selenium content of 67 people was 〈 0.20 mg/kg, accounting for 20.94%, 28 people was 0.20 - 〈 0.25 mg/kg, accounting for 8.75%; 143 people was 0.25 - 〈 0.50 mg/kg, accounting 44.69%; 82 people was 〉10.50 mg/kg, accounting for 25.63%. Compared the hair selenium content of children aged 7 - 12 and adults in KBD areas, rural non KBD areas, and urban non KBD areas [children： （0.45 ± 0.29）, （0.47±0.31）, （0.33 ± 0.12） mg/kg; adults： （0.41 ± 0.25）, （0.37 ± 0.25）, （0.40 ± 0.49） mg/kg], the differences were not statistically significant （F = 0.007, 0.024, all P 〉 0.05）. Compared the hair selenium content in different gender in KBD areas, rural non KBD areas, and urban non KBD areas [maile： （0.43 ± 0.23）, （0.43 ±0.26）, （0.40 ± 0.51） mg/kg; female： （0.38 ± 0.22）, （0.41 ±0.31）, （0.34 ± 0.18） mg/kg], the differences were not statistically significant （F = 0.872, 3.589, all P 〉 0.05）. Conclusion Two months after stopping to supply selenium salt in 2012 in Shaanxi Province, the hair selenium content of residents in KBD areas has not dropped significantly. Since this survey is carried out only 2 months after taking the measure, it is necessary to continue to monitor the selenium level in KBD areas.