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目的研究燃煤型地方性砷中毒患者甲基化能力与中毒症状间的关系。方法对贵州省某燃煤型地方性砷中毒病区进行调查,依据诊断标准确定患者,并将患者分为轻、中、重度3组。取尿样,测定尿中无机砷(iAs)、甲基砷(MMA)、二甲基砷(DMA)水平,计算总砷(tAs)水平,以一甲基化率(FMR)和二甲基化率(SMR)评价砷甲基化代谢能力。结果重度患者组iAs、MMA、DMA及tAs水平均显著高于轻度患者组;iAs、MMA及tAs水平均显著高于中度患者组。重度患者组SMR水平显著低于轻度及中度患者组。SMR与尿中MMA水平呈显著负相关(r=-0.793,P=0.001),与砷中毒症状的轻重程度亦呈显著负相关(r=-0.439,P=0.046)。结论燃煤型地方性砷中毒患者SMR水平与尿中MMA水平显著负相关,重症患者的中毒损伤效应可能是由于患者SMR水平降低而引起MMA水平增高所致。
Objective To study the relationship between methylation status and the symptoms of poisoning in coal-fired endemic arsenism patients. Methods A coal-fired endemic arsenism in Guizhou Province was investigated. According to diagnostic criteria, patients were divided into three groups: light, moderate and severe. Urine samples were taken for determination of urinary arsenic (iAs), methyl arsenic (MMA) and dimethyl arsenic (DMA) levels, total arsenic (tAs) Rate (SMR) to assess arsenic methylation metabolic capacity. Results The levels of iAs, MMA, DMA and tAs in severe patients were significantly higher than those in mild patients. The levels of iAs, MMA and tAs were significantly higher than those in moderate patients. The level of SMR in severe patients was significantly lower than that in mild and moderate patients. There was a significant negative correlation between SMR and urine MMA level (r = -0.793, P = 0.001), and a significant negative correlation with severity of arsenicosis (r = -0.439, P = 0.046). Conclusions There is a significant negative correlation between the level of SMR and the level of MMA in the patients with endemic arsenism of coal combustion. The poisoning effect of severe patients may be due to the increase of MMA caused by the decrease of SMR level.