摘要
目的了解饮水型地氟病区改水后低氟饮水对氟骨症患者骨密度的影响,为氟骨症患者早期预防和治疗骨质疏松提供科学依据。方法在陕西省大荔县随机选择50~60岁氟骨症患者43例(男20例、女23例),并随机选择在当地生活的健康居民50名(男25名,女25名)作为对照组,采用双能X线吸收法测定腰椎正位1~4椎体、左髋部包括股骨颈、大转子、转子间、髋部总体的骨密度,并比较两组骨密度和骨质疏松检出率的差异;使用多因素Logistic回归分析探讨罹患氟骨症的危险预测因素。结果饮水型地氟病区改水后,50~60岁轻、中度氟骨症患者腰椎和髋部骨密度与当地健康居民相比差异无显著统计学意义(P>0.05),骨质疏松的检出率与对照组相似;多因素Logistic回归分析显示,地氟病区居住时间是罹患氟骨症的独立危险预测因素。结论该县改水降氟工作数十年来成效明显,50~60岁年龄段的轻、中度氟骨症患者的骨密度和骨质疏松的检出率与当地正常人群相仿,提示长年饮用低氟水源对轻、中度氟骨症患者的骨密度有积极作用。
Objective To investigate the effect of low fluoride drinking water on the bone mineral density(BMD)of patients with skeletal fluorosis in endemic fluorosis area associated with drinking water,so as to provide scientific basis for the early prevention and treatment of osteoporosis in patients with fluorosis.Methods Forty-three 50-60-year old patients(male 20,female 23)with skeletal fluorosis were randomly selected in Dali County,Shaanxi Province,and 50 healthy residents(male 25,female 25)living in the local area were randomly selected as the control group.BMD of the lumbar vertebra 1-4,left hip including femoral neck,trochanter,intertrochanter,and total hip was measured using dual energy X-ray absorptiometry.The difference of BMD and detection rate of osteoporosis between the two groups were compared.Multivariate logistic regression analysis was used to explore the risk factors of skeletal fluorosis.Results After the modification of the water,there was no significant difference in BMD of the lumbar vertebrae and hip between the 50-60-year-old patients with skeletal fluorosis and the local healthy residents(P<0.05).The detection rate of osteoporosis in the fluorosis area was similar to that in the control group.Multivariate logistic regression analysis showed that residence time in endemic fluorosis area was an independent risk factor for skeletal fluorosis.Conclusion The improvement of water quality and defluorination in this county have achieved remarkable result in the past decades.BMD and detection rate of osteoporosis in 50-60-year-old patients with mild to moderate skeletal fluorosis are similar to that of normal local people,suggesting that long-term low fluorine water drinking has a positive effect on BMD in early skeletal fluorosis patients.
作者
董向辉
姜宾
吕媛媛
常彦海
王军
孙正明
凌鸣
DONG Xianghui;JIANG Bin;LV Yuanyuan;CHANG Yanhai;WANG Jun;SUN Zhengming;LING Ming(Department of Orthopedics, Shaanxi People’s Hospital, Xi’an 710068;Shaanxi Provincial Key Laboratory of Infection and Immune Diseases, Xi’an 710068;Department of Functional Examination, Shaanxi People’s Hospital, Xi’an 710068;Dali County Maternal and Child Health Hospital, Weinan 715100, China)
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2020年第11期1664-1667,共4页
Chinese Journal of Osteoporosis
基金
陕西省卫生健康科研基金项目(2018E012)
陕西省重点研发计划(2018ZDXM-SF-054)。
关键词
地氟病区
氟骨症
骨密度
骨质疏松
endemic fluorosis area
skeletal fluorosis
bone mineral density
osteoporosis
