王大朋,邹忠兰,张彤,胡昭宇,叶萍,张碧霞,刘桂成,黄晓欣,张爱华
WANG Dapeng,ZOU Zhonglan,ZHANG Tong,HU Zhaoyu,YE Ping,ZHANG Bixia,LIU Guicheng,HUANG Xiaoxin,ZHANG Aihua

• 1:贵州医科大学环境污染与疾病监控教育部重点实验室
• 2:贵州医科大学公共卫生学院卫生毒理学教研室
• 3:中国人民解放军第44医院

摘要(Abstract)：

目的:分析燃煤型砷中毒病区不同程度皮肤损害患者血清C反应蛋白(CRP)及α-L-岩藻糖苷酶(AFU)水平及相关性。方法:符合《地方性砷中毒诊断标准》(WS/T 211-2001)及经临床复查确诊的392例砷中毒患者,根据皮肤损害程度分为轻度砷中毒组(n=174)、中度砷中毒组(n=121)及重度砷中毒组(n=97),另选择离病区12 km以外无燃用高砷煤史、且生活方式相近的健康人群作为对照组(n=103);采用免疫比浊法检测受检者血清CRP水平,CPNP-α-Fucoside速率法检测受检者血清AFU水平,记录各组血清CRP、或AFU水平超标率;采用Pearson检验分析砷中毒患者血清CRP与AFU的相关性。结果:血清CRP水平比较,中度砷中毒组、重度砷中毒组高于对照组及轻度砷中毒组,差异有统计学意义(P <0. 05);血清AFU水平比较,重度砷中毒组高于对照组、轻度砷中毒组及中度砷中毒组,差异有统计学意义(P <0. 05);各砷中毒组患者血清CRP、AFU超标率高于对照组,差异有统计学意义(P <0. 05);且两项指标的超标率随着砷中毒皮肤病变的加重呈逐渐升高趋势;中度砷中毒组、重度砷中毒组患者血清CRP超标率高于轻度砷中毒组,差异有统计学意义(P <0. 05);砷中毒病区人群血清CRP水平与AFU水平之间呈明显正相关(r=0. 210,P <0. 05)。结论:燃煤砷暴露可导致人群血清CRP和AFU水平升高,其升高与砷致皮肤损害程度密切相关。
Objective: To analyze the level and correlation of serum C-reactive protein(CRP) and α-L-fucosidase(AFU) in patients with different degree of skin lesion. Methods: According to the National Principle for Diagnosis of Arsenicosis(WS/T 211-2001),392 cases of arsenism confirmed by clinical reexamination were divided into mild arsenism group(n = 174),moderate arsenism group(n =121) and severe arsenism group(n = 97) according to the degree of skin damage. In addition,healthy people who had no history of burning high arsenic coal and had similar lifestyle were selected as the control group(n = 103) except for 12 km from the disease area. The level of serum CRP was detected by immunoturbidimetric method and the level of serum AFU was detected by CPNP-α-Fucoside rate method. The levels of serum CRP or AFU were recorded in each group. The correlation between serum CRP and AFU was analyzed by Pearson test. Results: The level of serum CRP in moderate arsenism group and severe arsenism group was higher than that in control group and mild arsenism group,and the difference was statistically significant(P < 0. 05). The levels of serum AFU in severe arsenism group were higher than those in control group,mild arsenism group and moderate arsenism group,and the difference was statistically significant(P < 0. 05). The exceeding standard rate of CRP and AFU in patients with arsenic poisoning was higher than that in the control group,and the difference was statistically significant(P < 0. 05). The exceeding standard rate of the two indexes increased gradually with the aggravation of the skin lesion of arsenic poisoning. The rate of serum CRP in patients with moderate arsenism and severe arsenism was higher than that with mild arsenism,and the difference was statistically significant(P < 0. 05). There was a significant positive correlation between serum CRP level and AFU level in arsenism area(r = 0. 210,P < 0. 05). Conclusion: The levels of serum CRP and AFU are increased by arsenic exposure,which is closely related to the degree of skin damage induced by arsenic.

关键词(KeyWords)： 燃煤污染;砷中毒;C反应蛋白;α-L-岩藻糖苷酶;皮肤损害;相关性分析
coal pollution;arsenism;C-reactive protein;α-L-fucosidas;skin lesions;correlation analysis

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金重点资助项目(81430077,81730089)

作者(Author): 王大朋,邹忠兰,张彤,胡昭宇,叶萍,张碧霞,刘桂成,黄晓欣,张爱华
WANG Dapeng,ZOU Zhonglan,ZHANG Tong,HU Zhaoyu,YE Ping,ZHANG Bixia,LIU Guicheng,HUANG Xiaoxin,ZHANG Aihua

DOI: 10.19367/j.cnki.1000-2707.2018.10.008

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