低浓度饮水型砷暴露人群皮肤损伤的影响因素分析

Analysis on the influencing factors of skin lesion among the population exposed to low concentration arsenic in drinking water

目的探讨低浓度饮水型砷暴露人群皮肤损伤的影响因素。方法在山西省大同市，选择85名地方性砷中毒（简称地砷病）病区（水砷含量为14．41～90．34μg／L）某村饮水年限20年以上本地居民，无传染性、遗传性等疾病，无放射线和理化致病因素接触史者为调查对象。按照皮肤损伤程度将调查对象分为无皮肤损伤组（即正常组）、轻度皮肤损伤组（简称轻度皮损组）、中度皮肤损伤组（简称中度皮损组）和重度皮肤损伤组（简称重度皮损组）。原子荧光光谱法测定研究对象体内尿砷水平，ELISA试剂盒测定其血清8-OHdG的含量。结果不同皮损组的尿砷和血清8-OHdG分布差异均有统计学意义（P〈0．05）。重度皮损组的尿砷含量高于正常组和轻度皮损组（P〈0．05）；轻度、中度和重度皮损组的血清8-OHdG含量均高于正常组（P〈0．05），且重度皮损组的血清8-OHdG含量高于轻度和中度皮损组（P〈0．05）。Logistic回归分析显示，年龄和血清8-OHdG是砷暴露人群皮肤损伤的主要危险因素（OR=9．87，P〈0．05；OR=6．08，P〈0．05）。结论砷暴露所致的皮肤损伤可能与暴露时间和氧化损伤关系密切。

Objective To explore the influencing factors of skin lesion in people exposed to low concentration arsenic in drinking water. Methods A total of 85 people were selected from arsenic exposure area in Datong city,Shanxi province （the arsenic content in drinking water was 14.41-90.34 μg/L） as the research subjects （the people living in the arsenic exposure area and drinking local water for more than twenty years consecutively）. All of the candidates had neither infectious nor genetic diseases nor contacted radiation or physicochemic factors which may cause disease. The study subjects were divided into four groups., none skin lesion group （normal group）, mild skin lesion group, moderate skin lesion group） and severe skin lesion group, based on the degree of skin lesion. Urine arsenic concentration was detected by Hydride Generation Atomic Absorption Spectroscopy. Serum 8-hydroxy-2＇-deoxyguanosine （8-OHdG） level was analyzed by the Enzyme-linked Immunosorbent Assay （ELISA） kit. Results There were significant differences in urine arsenic and serum 8-OHdG levels among groups（ P 〈0.05）. The concentration of urine arsenic in severe skin lesion group was significantly higher than that in normal and mild skin lesion groups（ P 〈0.05）. The content of serum 8-OHdG in mild, moderate and severe skin lesion groups were obviously higher than that in normal group（ P 〈0.05） ,and the content of serum 8-OHdG in severe skin lesion group was markedly higher than that in mild and moderate skin lesion groups（ P 〈0.05）. Logistic regression analysis showed that age and serum 8-OHdG were major risk factors for skin lesion that caused by arsenic exposure. （ OR was 9.87, P 〈0.05 and OR was 6.08, P 〈0.05）. Conclusion Skin lesion caused by arsenic exposure may has a close correlation with exposure time and oxidative damage.