陜南燃煤型砷中毒患者內(nèi)外環(huán)境砷、硒水平及對血清P53、BCL2、NO、MDA的影響

1、陜南燃煤型砷中毒患者內(nèi)外環(huán)境砷、硒水平及對血清P53、BCL2、NO、MDA的影響         11-01-10 15:22:00     編輯：studa20        作者：王宇東，王芝芳，白廣祿，雷艷霞，王立新，范中學(xué)，耿冬，郭雄【摘要】  目的 探討陜南燃煤型砷中毒患者內(nèi)外環(huán)境砷、硒水平及對血清P53、B淋巴細(xì)胞瘤/白血病2(BCL2)、一氧化氮(NO)、丙二醛(MDA)

2、 的影響。方法 采用石墨爐原子吸收法測定煤、水、土、玉米、辣椒、血清、尿、發(fā)中砷、硒含量；采用ELISA法、硝酸還原酶法、TBA法分別測定血清P53、BCL2、NO、MDA水平。結(jié)果 病區(qū)煤、土、玉米、辣椒中砷、硒含量顯著高于非病區(qū)；病例組血清、尿和發(fā)砷、硒含量顯著高于內(nèi)、外對照組；病例組血清BCL2水平顯著高于外對照組，病例組、內(nèi)對照組的血清MDA水平顯著低于外對照組。結(jié)論 陜南燃煤型砷中毒患者內(nèi)、外環(huán)境砷含量增高，外環(huán)境硒含量偏高而內(nèi)環(huán)境硒負(fù)荷適宜， 其血清BCL2水平增高，MDA降低，而P53、NO無顯著變化。 【關(guān)鍵詞】  燃煤型砷中毒；砷；硒；P53；B淋巴細(xì)胞瘤/白血病2

3、；一氧化氮；丙二醛ABSTRACT: Objective  To investigate the levels of arsenic (As) and selenium (Se) in the internal and external environment, and their effects on P53, Bcell lymphoma/leukemia2 (BCL2), nitric oxide (NO) and maleic dialdehyde (MDA) in serum of burningcoaltype arseniasis from south Shaanxi

4、Province. Methods  As and Se contaminations in the external environment (coal, drinking water, soil, corns and pepper) and the internal one (serum, urine and hair) were analyzed using a graphite furnace atomic absorption spectrophotometer. The contents of P53, BCL2, NO and MDA in serum were det

5、ected by ELISA, nitrifying ferment and TBA, respectively. Results  The contents As and Se in coal, soil, corns and pepper from the arseniasisaffected area were significantly higher than those in the nonarseniasisaffected area. Concentrations of As in serum, urine and hair and Se in hair from pa

6、tient group with arsenism were statistically higher than those from the other two groups. BCL2 content in serum from patient group with arsenism was statistically higher than that from the controls in nondiseased areas, while MDA contents in serum from both patients and the control groups in the dis

7、eased areas were significantly lower than those from the controls in nonarsenism areas. Conclusion  As levels in internal and external environment of patients with arsenism were statistically higher than those in the controls both arsenismaffected and nonarsenismaffected area, and Se levels in

8、the external environment were increased while those in the internal were moderate. BCL2 content was raised in the patients with arsenism, but MDA decreased, and P53 and NO had  little changes.KEY WORDS: burningcoaltype arsenism; arsenic; selenium; P53; Bcell lymphoma/leukemia2 (BCL2); nitric ox

9、ide (NO); maleic dialdehyde (MDA)近年來，繼貴州省之后發(fā)現(xiàn)的陜南燃煤污染型砷中毒是地方性砷中毒的一種特殊類型，以皮膚與全身多系統(tǒng)多器官損害為特點。盡管有研究表明陜南燃煤型砷中毒外環(huán)境砷(arsenic, As)、硒(selenium, Se)含量高于非病區(qū)1，但對患者體內(nèi)砷、硒含量及血清P53、B淋巴細(xì)胞瘤/白血病2(Bcell lymphoma/leukemia2, BCL2)、一氧化氮(nitric oxide, NO)、丙二醛(maleic dialdehyde, MDA)水平的影響尚不清楚。本文采用流行病學(xué)調(diào)查方法，檢測陜南燃煤型砷中毒患者血清、尿和發(fā)砷

10、、硒及對血清P53、BCL2、NO和MDA水平的影響，以探討陜南燃煤型砷中毒的發(fā)病機制，為提高防治水平提供科學(xué)依據(jù)。1  材料與方法1.1  調(diào)查對象與分組  調(diào)查陜西省安康市漢濱區(qū)燃煤型砷中毒病區(qū)198例居民，按照地方性砷中毒診斷標(biāo)準(zhǔn)(WS/T 2112001)診斷砷中毒患者60例，隨機抽取30例為病例組，抽取病區(qū)29例正常者為內(nèi)對照組。調(diào)查西安市長安區(qū)五臺鄉(xiāng)非砷中毒病區(qū)118例居民，隨機抽取29例為外對照組。病例組男18例，女12例，平均年齡(65.77±10.26)歲；內(nèi)對照組男14例，女15例，平均年齡(42.00±17.26)歲；外對

11、照組男13例，女16例，平均年齡(44.03±13.72)歲，三組性別均衡但年齡有差異。1.2  樣品采集與處理  采集調(diào)查對象家中的煤、玉米、辣椒、發(fā)樣和其耕田土置信封內(nèi)密封保存；采集飲用水樣及尿樣置專用塑料瓶內(nèi)，采集靜脈血離心取血清存于離心管中，保存于-30冰箱。1.3  實驗方法  煤、水、土、玉米、辣椒、血清、尿、發(fā)中砷、硒含量均采用石墨爐原子吸收法測定，砷標(biāo)準(zhǔn)液由日本和光純藥工業(yè)株式會社提供，硒標(biāo)準(zhǔn)液由北京國家標(biāo)準(zhǔn)物質(zhì)研究中心提供，石墨爐原子吸收分光光度計為日立公司18080型。NO、MDA試劑盒購自南京建成生物工程研究所，采用772

12、光電比色計測定。P53、BCL2檢測試劑盒產(chǎn)自美國R&D公司，采用德國FLUOstar OPTIMA高通量多功能微板測試系統(tǒng)測定。1.4  數(shù)據(jù)處理  所有數(shù)據(jù)采用SPSS 13.0 軟件分析。因數(shù)據(jù)呈偏態(tài)分布，采用中位數(shù)(median, M)及四分位數(shù)間距(quartile range, QR)表示，取對數(shù)值后進行t檢驗或方差分析，因三組間年齡分布有差異，采用協(xié)方差法分析相關(guān)性指標(biāo)，顯著性標(biāo)準(zhǔn)為P<0.05。2  結(jié)果2.1  病區(qū)與非病區(qū)煤、水、土、玉米、辣椒中砷、硒含量的比較  病區(qū)中的石煤(表1)、土、玉米、辣椒砷、硒含量

13、均顯著高于非病區(qū)，病區(qū)水中硒含量顯著高于非病區(qū)(表2、3)。表1  病區(qū)與非病區(qū)燃煤中砷、硒含量的比較（略）Table 1  The comparison of As and Se concentrations in coal between the diseased and nondiseased areas*P<0.01 vs. nondiseased area2.2  病例組與內(nèi)、外對照組血清、尿、發(fā)中砷、硒水平的比較  病例組血清、尿、發(fā)砷水平顯著高于內(nèi)、外對照組；與外對照組比較，內(nèi)對照組尿砷水平無顯著性差異，血清砷水平顯著降低，但發(fā)砷水平

14、顯著增高(表4)。病例組尿硒水平顯著高于內(nèi)、外對照組，但三組間血清、發(fā)硒水平無顯著性差異(表5)。表2  病區(qū)與非病區(qū)水、土、玉米、辣椒中砷含量的比較（略）Table 2  The comparison of As concentrations in drinking water, dissolved soil, corns and pepper between the diseased and nondiseased areas*P<0.05 vs. nondiseased area表3  病區(qū)與非病區(qū)水、土、玉米、辣椒中硒含量的比較（略）Table 3&

15、#160; The comparison of Se concentrations in drinking water, dissolved soil, corns and pepper between the diseased and nondiseased areas*P<0.05 vs. nondiseased area表4  病例組及對照組血清、尿、發(fā)中砷水平的比較（略）Table 4  The comparison of As concentrations in serum, urine and hair among three groups*P<0.05 vs. IC; P<0.05 vs. EC; As: arsenism; IC: internal control; EC: external control表5  病例組及對照組血清、尿、發(fā)中硒含量的比較（略）Table 5  The comparison of Se concentrations in seru