摘要目的 了解饮茶型氟中毒对人体的危害,为制订有效防治措施提供科学依据.方法 2008年,选择西藏拉萨市的7个县作为调查县,每个县抽取4个乡(其中城关区2个乡)、每个乡抽取2个行政村作为调查村.调查监测村所有8～ 12岁学生氟斑牙患病情况,氟斑牙诊断采用Dean法,同时采集尿样,尿氟测定采用尿中氟的离子选择电极法(WS/T 30-1996),依据《人群尿氟正常值》(WS/T 256-2005)进行评价.对监测村18周岁以上人群,按～25、～35、～45、～ 55和56～分为5个年龄段,每个年龄段抽取不少于10人,进行临床氟骨症检查,诊断采用地方性氟骨症诊断标准(WS 192-2007).每个调查点采集居民饮用水,以及所有调查对象日常饮用的砖茶水进行水氟测定,水氟测定采用离子选择电极法.结果 ①儿童氟斑牙:共对723名8～12岁儿童进行氟斑牙检查,检出氟斑牙患者91例,检出率为12.58％,氟斑牙指数为0.34；②成人氟斑牙:共对2626名成人进行氟斑牙检查,检出氟斑牙患者998例,检出率为38.00％,氟斑牙指数为0.71；③成人临床氟骨症:共对2626名成人进行了临床氟骨症检查,检出Ⅱ度以上患者15人,检出率为0.57％；④儿童尿氟:共采集测定儿童尿样700份,尿氟几何均数为1.97 mg/L,范围为0.01 ～ 17.56 mg/L;⑤成人尿氟:共检测成人尿样2626份,尿氟几何均数为2.16 mg/L,范围为0.01～-56.87 mg/L;⑥水氟:共检测水样52份,其中有15份水样的水氟含量范围超标；⑦茶氟:各县共检测2000份茶水样品,茶水氟中位数为2.38 mg/L,范围为0.03～56.87 mg/L.结论 氟斑牙、氟骨症、尿氟增高与调查点饮用茶水氟含量有直接关系.

abstractsObjective To understand the harm of drinking-tea borne endemic flnorosis on human body and to provide a scientific basis for the formulation of effective control measures.Methods Seven counties in Lhasa of Tibet were selected as monitoring counties in 2008.Four townships in each county were selected(including 2 villages in Chengguan county),and 2 administrative villages in each township were selected as monitoring villages.By using Dean method,dental fluorosis of every child aged 8 - 12 in the monitoring villages was examined.At the same time,urine samples were randomly collected in each age group in the above-mentioned villages.The content of fluoride in urine was determined by F-ion selective electrode (WS/T 30-1996) and evaluated according to “The Normal Concentration of Uriary Fluride of Population” (WS/T 256-2005).Over 18 years old in the monitoring counties were divided into five age group as - 25,- 35,- 45,- 55 and 56 -,at least 10 ment were randomly selected in each age group to be examined clinical skeletal fluorosis,and the diagnosis was based on the endemic skeletal fluorosis standard(WS 192-2007 ).At the same time,adult dental fluorosis diagnosis and urinary fluoride examination were done.Drinking water samples in each survey point were collected and water fluoride was determination by ion selective electrode method.Results ①Dental fluorosis:a total of 723 children aged 8 to 12 were examined,91 cases of dental fluorosis were detected,and detection rate was 12.58％,dental fluorosis index was 0.34; ②adult dental fluorosis:a total of 2626 adults were examined,998 cases of dental fluorosis were detected,and detection rate was 38.00％,dental fluorosis index was 0.71; ③Adult clinical skeletal fluorosis:a total of 2626 adults were examined,15 degree Ⅱ clinical skeletal fluorosis patients were detected,and the detection rate was 0.57％ ; ④Child urine fluoride:a total of 700 child urine samples were collected.The geometric mean was 1.97 mg/L,ranged 0.01 to 17.56 rng/L; ⑤Adult urine fluoride:a total of 2626 adults were examined,geometric mean 2.16 mg/L,ranged 0.01 to 56.87 mg/L; ⑥Water fluoride:52 water samples were tested in survey sites,and fluoride content of 15 water samples exceeded the standard; ⑦Tea fluorine content:2000 tea samples were tested; median tea fluoride was 2.38 mg/L,ranged from 0.03 to 56.87 mg/L.Conclusions Fluorosis is serious in Lhasa,which is directly related to drinking brick tea,it is recommended that to drink brick tea with lowfluoride,and discard bad living habits.