内蒙古新巴尔虎左旗饮茶型氟铝联合中毒调查 Tea Type Aluminum Fluoride Poisoning Investigation in Xin Barag Left County in Inner Mongolia

目的：对内蒙古新巴尓虎左旗开展饮茶型氟铝联合中毒病情调查。方法：在无工业污染的内蒙古新巴尔虎左旗乌布尔宝力格苏木锡林贝尔嘎查进行流行病学调查、并对成人进行临床检查、X线摄片、骨密度(BMD)检测；采集砖茶、饮水、奶茶、尿、血液等样品进行检测其含氟量、含铝量，计算人均经砖茶每日摄氟量、摄铝量；血液生化采用日本奥林巴斯AU-400全自动生化分析仪检测，试剂为贝克曼库尔公司提供试剂盒，氟采用离子迭择电极法检测，Al、Ca、采用ICP-AES法检测，CT、ALP、PTH采用ECL法检测。结果：氟斑牙检出率43.20% (35/81)，X线氟骨症检出率24.09% (20/83)，骨密度检测结果为骨量减少和骨质疏松检出率38.82% (33/85)。砖茶、饮水、奶茶、尿、血淸含氟量检测结果分别为(618.2 ± 53.3) mg/kg、(1.03 ± 0.10) mg/L、(3.00 ± 2.59) mg/L、(2.24 ± 0.34) mg/L，(0.074 ± 0.032) mg/L；含铝量分别为(2908.6 ± 225.8) mg/kg、(0.036 ± 2.43) mg/L、(6.34 ± 3.64) mg/L、(2.98 ± 1.47) mg/L，(1.42 ± 1.05) mg/L。其中经砖茶摄入氟9.30 mg/d，摄入铝29.25 mg/d, 血清Ca (2.26 ± 0.21) mmol/L低于正常范围，CT (110.65 ± 26.82)ug/L、ALP (98.47 ± 32.84) u/L位于较高水平。结论：内蒙古新巴尔虎左旗是饮茶型氟铝联合中毒病区。 Objective: This study investigated the condition of tea type aluminum and fluorine joint poisoning in Xin Barag Left county in Inner Mongolia. Methods: Epidemiological investigation was conducted in nonindustrial pollution area of Wborbolog Xilinbuir town which locates in Xin Barag Left county in Inner Mongolia. Clinical examination, X-ray, bone mineral density (BMD) detection were conducted in adults. The fluoride content and aluminum content of brick tea, water, milk tea, urine, blood and other samples were collected. Then we calculated the fluoride content and aluminum content per day of every adult. Blood biochemistry was tested by the Japanese Olympus AU-400 automatic biochemical analyzer; Beckman Kur offered kit; Fluorine is tested by ion selective electrodes; Al, Ca were detected by ICP-AES; CT, ALP, PTH were detected by ECL. Results: The rate of fluorine spot tooth was 43.20% (35/81), X-ray detection rate of skeletal fluorosis was 24.09% (20/83) and Bone mineral density test results were bone loss and osteoporosis rate was 38.82% (33/85). The results of fluorine content detection for brick tea, drinking water, tea with milk, urine, serum were (618.2 ± 53.3) mg/kg, (1.03 ± 0.10) mg/L, (3.00 ± 2.59) mg/L, (2.24 ± 0.34) mg/L, (0.074 ± 0.032) mg/L respectively; Aluminum content for brick tea, drinking water, tea with milk, urine, serum were (2908.6 ± 225.8) mg/kg, (0.036 ± 2.43) mg/L, (6.34 ± 3.64) mg/L, (2.98 ± 1.47) mg/L, (1.42 ± 1.05) mg/L respectively. The fluoride intake through the brick tea was 9.30 mg/d; the aluminum intake through brick tea was 29.25 mg/d; Serum calcium was (2.26 ± 0.21) mmol/L below the normal range. The CT was (110.65 ± 26.82) ug/L and the ALP was (98.47 ± 32.84) u/L, and both of these maintained high level. Conclusion: Xin Barag Left county was the endemic area of tea type aluminum and fluorine joint poisoning in Inner Mongolia.