饮水氟暴露与学龄儿童氟斑牙相关性的Meta分析  

Association of fluoride exposure through drinking water and dental fluorosis of school-age children: A meta-analysis

作　　者：戴馨[1] 宁浩然 熊培生[1] 石青[1] 周素华[1] 张碧云[1] Dai Xin;Ning Haoran;Xiong Peisheng;Shi Qing;Zhou Suhua;Zhang Biyun(Department for Endemic Disease Control,Institute for Chronic Disease Control,Hubei Provincial Center for Disease Control and Prevention,Wuhan 430079,China)

机构地区：[1]湖北省疾病预防控制中心慢病所地方病部,武汉430079

出　　处：《中华地方病学杂志》2019年第9期769-774,共6页Chinese Journal of Endemiology

摘　　要：目的系统评价饮水氟暴露与学龄儿童氟斑牙的相关性。方法计算机检索中国知网数据库(CNKI)、万方数据知识服务平台(WanFangData)、维普中文期刊数据库(VIP)和中国生物医学文献数据库(CMB),查找关于饮水氟暴露与氟斑牙发生相关的研究,检索时限为2000年1月1日至2018年1月1日。采用RevMan5.3软件进行Meta分析。利用漏斗图和失安全系数法评价发表偏倚,并采用固定效应模型和随机效应模型对资料进行敏感性分析。结果最终纳入20个研究,氟暴露组79814人,对照组181876人。Meta分析结果显示,纳入的20个研究存在异质性,采用随机效应模型进行分析,合并比值比(OR)及95%可信区间(CI)为4.25(3.66~4.94),即氟暴露组发生氟斑牙的危险是对照组的4.25倍。漏斗图不对称,失安全系数为47791.56,是纳入研究的2389.6(47792/20)倍,文献发表偏倚较小。敏感性分析显示,两种模型计算结果相似,合并后的研究结果基本可靠。结论过量饮水氟暴露可能是导致儿童氟斑牙发病的主要危险因素之一。Objective To systematically review the correlation between fluoride exposure through drinking water and dental fluorosis of school-age children, and to provide a theoretical basis for further development of prevention strategies against dental fluorosis. Methods Such databases as China National Knowledge Infrastructure (CNKI), WanFang Data, VIP Database and China Biology Medicine Disc (CBM) were searched through computer to find out the relationship between fluoride exposure through dringking water and occurrence of dental fluorosis. The retrieval time was from January 1, 2000 to January 1, 2018. Meta-analysis was performed using RevMan 5.3. Funnel plot and fail-safe method were used to evaluate publication bias, and these data were analyzed sensitivity with random and fixed effect models. Results Totally 20 literatures entered into this study, 79 814 people in fluoride exposure group, and 181 876 people in control group. The meta-analysis showed that, 20 literatures were inhomogeneous through the heterogeneity test, which was analyzed in the random effect model, the pooled odds ratio (OR) value and 95% confidence interval (95%CI) was 4.25 (3.66 - 4.94), which suggested that the risk of dental fluorosis in the fluoride exposure group was 4.25 times higher than that in control group. Funnel plot was asymmetrical, the fail-safe number was 47 791.56, which was 2 389.6 (47 792/20) times higher than included literatures. Literatures publication bias was small, sensitivity analysis revealed that the results were basically reliable. Conclusion Excessive fluoride exposure through dringking water could be one of the main risk factors leading to dental fluorosis.

关 键 词：氟中毒 牙 饮水 META分析 学龄儿童 

分 类 号：R781.2[医药卫生—口腔医学]