燃煤污染型地方性氟中毒病区儿童智商与尿氟的关系

Relationship between intelligence quotient and urinary fluoride of children in coal-burning-borne endemic fluorosis area

目的探讨贵州省燃煤污染型地方性氟中毒病区梭戛苗族彝族回族乡(简称梭戛乡)儿童智力水平与尿氟之间的关系。方法2019年4月,在梭戛乡的3所学校选择173名10~13岁儿童作为调查对象,按照是否有氟斑牙,将儿童分为病例组(n=104)和对照组(n=69)。采集调查对象中段尿样,采用离子选择电极法检测尿氟;采用联合型瑞文测试农村版(CRT-RC2)进行儿童智商(IQ)测试。采用线性回归分析观察尿氟与IQ之间的关联,结果以回归系数(β)和95%置信区间(CI)表示。结果病例组尿氟高于对照组[(2.14±1.78)比(1.53±0.98)mg/L],IQ值低于对照组[(92.33±11.68)比(100.38±11.87)分],差异均有统计学意义(t=2.58、4.41,P均<0.05)。病例组尿氟(X)与IQ(Y)的线性回归方程为Y=96.99-2.86X,尿氟每增加1 mg/L,IQ下降2.86分(β=-2.86,95%CI:-5.48~-0.24)。结论长期处于燃煤污染的氟环境可能会对儿童的智力产生损害,儿童IQ随尿氟的增加而下降。

Objective To explore the relationship between children's intelligence and urinary fluoride in Suojia Township of Miao,Yi and Hui Nationalities(referred to as Suojia Township),a coal-burning-borne endemic fluorosis area in Guizhou Province.Methods In April 2019,173 children aged 10 to 13 years old were selected from three schools in Suojia Township.According to whether they had dental fluorosis,the children were divided into case group(n=104)and control group(n=69).Middle segment urine samples of the children were collected and urinary fluoride level was determined by the method of ion-selective electrode.Combined Raven's Test-the Rural in China(CRT-RC2)was used for children's intelligence quotient(IQ)test.Linear regression analysis was used to observe the association between urinary fluoride and IQ,and the results were expressed by regression coefficient(β)and 95%confidence interval(CI).Results Urinary fluoride level of case group was higher than that of control group[(2.14±1.78)vs(1.53±0.98)mg/L],and IQ was lower than that of control group[(92.33±11.68)vs(100.38±11.87)points],and the differences were statistically significant(t=2.58,4.41,P<0.05).The linear regression equation of urinary fluoride(X)and IQ(Y)of case group was Y=96.99-2.86X.For every 1 mg/L increase in urinary fluoride level,IQ decreased by 2.86 points(β=-2.86,95%CI:-5.48--0.24).Conclusion Long-term exposure to fluoride pollution from coal burning may damage children's intelligence,and children's IQ decreases with increase of fluoride level in urine.