3岁儿童患龋过程中龋易感因素的相关分析  

Analysis of caries susceptibility factors during transition from caries-free to caries in three-year-old children

作　　者：郝文婧[1] 徐赫[1] 陈霄迟[2] 周琼[1] 张萍[3] 秦满[1] 

机构地区：[1]北京大学口腔医学院·口腔医院儿童口腔科,100081 [2]北京大学口腔医学院·口腔医院生物教研室,100081 [3]北京市海淀区妇幼保健院口腔保健中心

出　　处：《中华口腔医学杂志》2014年第4期193-198,共6页Chinese Journal of Stomatology

基　　金：国家临床重点专科建设项目（2013-2014）;首都医学发展科研基金（2009-2032）;首都临床特色应用研究项目（z121107001012028）

摘　　要：目的 观察3岁儿童从无龋到患龋过程中龋易感因素的变化,以期为低龄儿童龋齿风险评估提供相关依据.方法 选择144名34 ～38个月龄无龋儿童观察1年.在观察基线、6个月及12个月时分别采集口腔龈上集合菌斑和相关问卷调查;根据各观察期末不同患龋状况,将研究对象分成无龋组（12个月保持无龋）、6个月患龋组（6个月时有龋或充填体）和12个月患龋组（6个月时无龋、12个月时有龋或充填体）.应用实时荧光定量PCR比较不同组间变形链球菌（Streptococcus mutans,Sm）和远缘链球菌（Streptococcus sobrinus,Ss）数量的差异.结果 130名儿童完成了12个月的复查,失访率为9.7％（14/144）.在12个月观察期末,无龋组为58人,6个月患龋组为44人,12个月患龋组为28人.在基线、6个月和12个月时3组儿童的口腔卫生和饮食习惯自身前后对比差异均无统计学意义（P＞0.05）.基线时无龋组进甜食和睡前进甜食或甜饮料的频率均显著低于6个月患龋组和12个月患龋组（P ＜0.001）.基线时6个月患龋组Sm和Ss的数量[Sm拷贝数：（6.33±2.21）×103,Ss拷贝数：（1.99±0.45）×103]均显著高于无龋组[Sm拷贝数：（5.81 ±2.43）×103,Ss拷贝数：（1.34±0.53）×103] （P ＜0.05）;6个月复查时,12个月患龋组Sm和Ss的数量[Sm拷贝数：（6.81 ±2.32）×103,Ss拷贝数：（1.97±1.43）×103]均显著高于无龋组[Sm拷贝数：（6.09±2.31）×103,Ss拷贝数：（1.34±0.55）×103] （P ＜0.05）.结论 3岁儿童在临床检出龋齿前6个月时Sm和Ss数量已显著升高;高频率摄取甜食及睡前进甜食或甜饮料是儿童未来患龋的重要易感因素.Objective To investigate the changes of caries susceptibility factors during the transition from caries-free to caries in three-year-old children.Methods The study included 144 caries-free children aged 34-38 months.All participants underwent clinical examination and full-mouth supragingival plaque collection.Survey of children＇s oral health behaviors involving feeding habits and oral health care was also taken from children＇ s parents of all participants.The children were reexamined 6 and 12 months later.According to the potential changes of caries status in twelve months follow up,all the participants were divided into three groups：caries-free group （caries free children in twelve months follow up）,caries at 6-month group（children who were found with caries or cavities fillings at six months review） and caries at 12-month group（children who were caries free at six months but found with caries or cavities fillings at twelve months）.Streptococcus mutans （Sm）and Streptococcus sobrinus （Ss） loads were compared among the three groups by real time fluorescence quantitative polymerase chain reaction （FQ-PCR）.Results One hundred and thirty children completed twelve months review,the dropout rate was 9.7％ （14/144）.At the end of twelve months follow up,the number of children in caries-free group,caries at 6-month group and caries at 12-month group was 58,44 and 28 respectively.The changes of oral behavioral habits in caries-free group,caries at 6-month group and caries at 12-month group during twelve months follow up were not significantly different（P ＞0.05）.At baseline,the frequency of sweets consumption and eating sweets before sleeping in caries-free group was significantly lower than that in caries at 6-month group and caries at 12-month group （P ＜ 0.001）.At baseline,the quantity of Sm and Ss in caries at 6-month group [copy number of Sm：（6.33 ± 2.21） × 103,copy number of Ss：（1.99 ±0.45） × 103] was significantly higher than that in the caries-free group

关 键 词：龋齿 牙菌斑 儿童口腔医学 实时荧光定量聚合酶链反应 

分 类 号：R788.1[医药卫生—口腔医学]