广西医学

目的探讨湖北省恩施土家族苗族自治州（简称恩施州）环境硒水平与老年性白内障的相关性。方法参考《恩施土壤全硒含量分布的研究》，将恩施州分为富硒环境区(土壤硒含量≥1.28 mg/kg) 和缺硒环境区(土壤硒含量＜1.28 mg/kg) 。选取健康体检的600例老年人为研究对象，其中来源于富硒环境区及缺硒环境区的老年人各300例。记录研究对象的老年性白内障患病情况，检测研究对象的血硒含量、发硒含量、血清谷胱甘肽过氧化物酶（GSH-Px）活性和血清硒蛋白P1（SEPP1）水平。采集富硒环境区及缺硒环境区的居民饮用水和原产土豆样本各100份，检测居民饮用水和土豆的硒含量。结果600例老年人中，老年性白内障患者244例（40.67%），白内障老年人血硒、发硒含量均低于非白内障老年人（均P＜0.05)。富硒环境区老年人的血硒含量、发硒含量、血清GSH-Px活性和血清SEPP1水平均高于缺硒环境区老年人，老年性白内障发生率低于缺硒环境区老年人（均P＜0.05)。富硒环境区的居民饮用水及土豆硒含量均高于缺硒环境区（均P＜0.05）。血硒含量、发硒含量与老年性白内障发生率均呈负相关(均P＜0.05)。结论湖北省恩施州环境硒水平与老年性白内障的发生具有相关性，环境硒水平越高，老年人的老年性白内障发生率越低。

ObjectiveTo investigate the correlation between selenium level of environments in Enshi Tujia and Miao Autonomous Prefecture (hereinafter referred to as Enshi Prefecture), Hubei Province and senile cataract. MethodsReferring to the A Study of the Distribution of Soil Total Selenium Content in Enshi Prefecture, Enshi prefecture was divided into selenium-rich environmental area (soil selenium content≥1.28 mg/kg) and selenium-deficient environmental area (soil selenium content＜1.28 mg/kg). A total of 600 elderly people who underwent healthy check-up were selected as the research subjects, therein there were 300 elderly people from the selenium-rich environmental area and 300 elderly people from selenium-deficient environmental area. The morbidity of senile cataract was recorded in research subjects, and the contents of blood selenium, hair selenium, as well as serum glutathione peroxidase (GSH-Px) activity, serum selenoprotein P, plasma, 1 (SEPP1) level were detected in research subjects. A total of 100 samples of drinking water for residents and 100 raw potatoes samples were collected from the selenium-rich environmental area and selenium-deficient environmental area, and the selenium contents of drinking water for residents and potatoes were detected. ResultsAmong the 600 elderly people, there were 244 (40.67%) cases with senile cataract, and the contents of blood selenium and hair selenium in the elderly with cataract were lower than those in the elderly with non-cataract (all P＜0.05). Blood selenium and hair selenium contents, and serum GSH-Px activity, serum SEPP1 level in the elderly from the selenium-rich environmental area were higher than those in the elderly from the selenium-deficient environmental area, and the incidence rate of senile cataract was lower than that in the elderly from the selenium-deficient environmental area (all P＜0.05). The selenium contents of drinking water for residents and potatoes in the selenium-rich environmental area were higher than those in the selenium-deficient environmental area (all P＜0.05). Blood selenium content, hair selenium content negatively correlated with the incidence rate of senile cataract (all P＜0.05). ConclusionThere is a correlation between selenium level of environments in Enshi Prefecture, Hubei Province and the occurrence of senile cataract. The higher the environmental selenium level is, the lower the incidence rate of senile cataract in the elderly is.