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[目的]探讨氟暴露人群血清中基质金属蛋白酶(MMP-2、MMP-9、MMP-13)活性变化与氟斑牙的关系。[方法]选择贵州省清镇市流长乡燃煤型氟中毒病区191例氟暴露者为调查对象,根据人群尿氟实际检测结果范围,将病区氟暴露者分为4组:<1.2mg/gC(r95例)、1.2mg/gCr～(43例)、1.8mg/gCr～(24例)和2.4mg/gCr～(29例);为了解其与氟斑牙程度的关系,根据氟斑牙临床分类诊断标准将氟暴露人群分为正常组(34例)、可疑+极轻组(37例)、轻度组(33例)、中度组(56例)、重度组(31例)。采用氟离子电极法测定氟暴露人群尿氟含量,酶联免疫吸附法(ELISA)检测血清样本中MMP-2、MMP-9、MMP-13的活性。[结果]①随着氟暴露人群尿氟水平增高,MMP-2、MMP-9、MMP-13的活性逐渐增高,其中尿氟1.2mg/gCr～、1.8mg/gCr～和2.4mg/gCr～组的MMP-2、MMP-9、MMP-13活性与<1.2mg/gCr组比较,差异有统计学意义(P<0.05);尿氟2.4mg/gCr～组与1.2mg/gCr～组比较,差异有统计学意义(P<0.05)。尿氟2.4mg/gCr～组MMP-2和MMP-9的活性与1.8mg/gCr～组比较,差异有统计学意义(P<0.05)。②随着氟暴露人群氟斑牙程度的加重,MMP-2、MMP-9、MMP-13的活性逐渐增高,其中氟斑牙重度、中度组与正常组比较,差异有统计学意义(P<0.05);重度组与可疑+极轻度组间差异有统计学意义(P<0.05)。③氟暴露人群尿氟与MMP-2、MMP-9、MMP-13活性呈正相关(r=0.808、r=0.795、r=0.790,P<0.05);氟斑牙程度与MMP-2、MMP-9、MMP-13活性呈正相关(r=0.332、r=0.358、r=0.316,P<0.05)。[结论]氟可能通过诱导MMP-2、MMP-9、MMP-13活性增高,影响骨代谢,进而导致氟斑牙的发生发展。
[Objective] To explore the relationship between the changes of serum matrix metalloproteinase (MMP-2, MMP-9, MMP-13) activities and dental fluorosis in fluorosis exposed people. [Method] A total of 191 cases of fluorosis exposed area in Liuchang Township, Qingchang Town, Guizhou Province were selected as the survey subjects. According to the range of actual urine fluoride test results, the fluorosis exposed persons were divided into four groups: <1.2 mg / gC (r95), 1.2 mg / gCr ~ (43), 1.8 mg / gCr ~ (24) and 2.4 mg / gCr ~ (29). To understand its relationship with the degree of dental fluorosis, The diagnostic criteria of dental fluorosis were divided into normal group (34 cases), suspicious + minimal group (37 cases), mild group (33 cases), moderate group (56 cases), severe group example). Urinary fluoride levels were measured by fluoride ion electrode method in patients exposed to fluoride, and the activity of MMP-2, MMP-9 and MMP-13 in serum samples was detected by enzyme linked immunosorbent assay (ELISA). [Results] ① The levels of MMP-2, MMP-9 and MMP-13 increased gradually with the increase of urinary fluoride level in fluoride exposure group, among which urinary fluoride 1.2mg / gCr, 1.8mg / gCr- and 2.4mg / The difference of MMP-2, MMP-9 and MMP-13 activity between the two groups was statistically significant (P <0.05) with <1.2mg / gCr group; urine fluoride 2.4mg / gCr ~ , The difference was statistically significant (P <0.05). Urinary fluoride 2.4mg / gCr ~ group MMP-2 and MMP-9 activity and 1.8mg / gCr ~ group, the difference was statistically significant (P <0.05). (2) With the increase of dental fluorosis, the activity of MMP-2, MMP-9 and MMP-13 increased gradually, especially in dental fluorosis. The difference was statistically significant (P <0.05). There was significant difference between severe group and suspicious + very mild group (P <0.05). There was a positive correlation between urinary fluoride and the activities of MMP-2, MMP-9 and MMP-13 (r = 0.808, r = 0.795, r = 0.790, 9, MMP-13 activity was positively correlated (r = 0.332, r = 0.358, r = 0.316, P <0.05). [Conclusion] Fluoride may increase the activity of MMP-2, MMP-9 and MMP-13 and affect bone metabolism, leading to the occurrence and development of dental fluorosis.