烏腳病盛行地區缺血性心臟病之病例對照研究

Arsenic and Ischemic Heart Disease in the Blackfoot Disease-Endemic Area

10.6288/CJPH1995-14-06-07

林莉茹(Li-Ju Lin)；洪申發(Shan-Fa Horng)；廖崑富(Kun-Fu Liaw)；薛玉梅(Yu-Mei Hsueh)；邱弘毅(Hung-Yi Chiou)；江明禧；戴東原(Tung-Yuan Tai)；曾慶孝(Chin-Hsiao Tseng)；陳建仁(Chien-Jen Chen)

砷 ； 缺血性心臟病 ； 病例對照研究 ； Arsenic ； Ischemic Heart Disease ； Case-Control Study

中華公共衛生雜誌

14卷6期（1995 / 12 / 01）

502 - 511

繁體中文

為探討砷致動脈粥狀硬化的毒性，本研究乃以烏腳病盛行地區居民缺血性心臟病盛行病例及其健康對照，探討缺血性心臟病與長期累積砷暴露及其他危險因子的相關，藉以推斷砷所扮演的角色。根據布袋鎮好美、復興、新民三里居民在民國八十二年二月至三月接受健康檢查及問春調查的結果，選出78名經靜止心電圖診斷患有缺血性心臟病的病例及384名健康對照。研究結果顯示此地區缺血性心臟病之多重危險因子，除年齡、性別、高血壓、總膽固醇對高密度脂蛋白膽固醇比值、肥胖指數及喝酒習慣等已知危險因子之外，砷暴露指標被發現和缺血性心臟病的盛行率有顯著的劑量效應關係。與未曾暴露於含砷深井水者比較，累積砷暴露量以年•ppm為單位，暴露量為0.1-14.9和15.0以上者，其罹患缺血性心臟病的多變項調整化相對危險性分別為1.6和3.6倍。本研究結果顯示砷為烏腳病盛行地區缺血性心臟病的一個重要且獨立危險因子。

Arsenic-induced atherogenicity has been well documented. Morbidity of ischemic heart disease was examined among residents in the blackfoot disease-endemic area in southwestern Taiwan to explore the relationship between long-term arsenic exposure and ischemic heart disease. A total of 78 prevalent cases of electrocardiogram-diagnosed ischemic heart disease identified from a community-based surrey and 384 age-sex-matched healthy controls were included. Multiple logistic regression analysis showed a statistically significant association of ischemic heart disease with long-term arsenic exposure. After adjustment for age, sex, hypertension, diabetes mellitus, ratio of total cholesterol to high-density lipoprotein cholesterol, body mass index, and alcohol consumption, the odds ratio of developing ischemic heart disease was 1.60 and 3.60, respectively, for those who had a cumulative arsenic exposure of 0.1-14.9 and ＞=15.0ppm-years compared with those who had no exposure to arsenic through drinking water. Arsenic is an important and independent risk factor for ischemic heart disease in the blackfoot disease-endemic area.