浏阳市12~16岁学生恒牙龋病发展轨迹的潜类别增长模型分析  

Trajectory of the development of caries in the permanent dentition of 12-to 16-year-old students based on a latent class growth model analysis in Liuyang

作　　者：谭杨朋 许欣 张红 寻寒 杨土保[1] TAN Yangpeng;XU Xin;ZHANG Hong;XUN Han;YANG Tu-bao(XiangYa School of Public Health,Central South University,Changsha 410078,China;Liuyang Central for Disease Control and Prevention,Liuyang 410399,China)

机构地区：[1]中南大学湘雅公共卫生学院,湖南长沙410078 [2]浏阳疾病预防控制中心,湖南浏阳410399

出　　处：《口腔疾病防治》2023年第6期426-433,共8页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：湖南省重点研发计划项目(2018SK2073)。

摘　　要：目的 探讨浏阳市12~16岁学生恒牙龋病的发展轨迹,为制定龋齿防治措施提供参考。方法 浏阳市疾病预防控制中心每年9~11月开展中小学生龋齿筛查,对象为辖区范围内所有在籍中小学生,选取2013~2019年龋齿监测记录完整且过往乳牙龋监测记录可查的12~16岁学生7 297名,利用龋失补指数(decayed missing filled teeth,DMFT)建立零膨胀负二项-潜类别增长模型(zero-inflated negative binomial-latent class growth model,ZINB-LCGM)描述个体恒牙龋病轨迹间的动态变化。结果 浏阳市12~16岁学生DMFT构成中以龋坏牙(decayed teeth,DT)为主,最好发于第一恒磨牙。根据ZINB-LCGM模型,将恒牙龋发展轨迹分为三个潜类别:“缓慢增长型”(28.55%)、“快速增长型”(6.59%)、“平稳型”(64.86%),不同潜类别间遵循不同的非线性增长轨迹,有乳牙龋的女性更容易表现出“缓慢增长型”和“快速增长型”恒牙龋轨迹。男、女性和有、无乳牙龋的轨迹间均有显著性差异。结论 12~16岁学生龋病轨迹有群体异质性,遵循不同的发展模式,需重点关注女性、曾经患乳牙龋的学生群体。Objective To explore the trajectory of the development of permanent caries in 12-to 16-year-old students in Liuyang and to provide a reference for the prevention and management of caries.Methods Primary and secondary school students who were registered within the Liuyang jurisdiction were screened for caries from September to November by the Liuyang Center for Disease Control and Prevention.A total of 7 297 students between the ages of 12and 16 years with complete permanent dentition caries monitoring records and traceable deciduous dentition caries monitoring records were selected from 2013 to 2019,and a zero-inflated negative binomial-latent class growth model(ZINBLCGM) was established to describe the trajectory of the development of individual caries using the decayed missing filled teeth(DMFT) indicators.Results DMFT of 12-to 16-year-old students in Liuyang were mainly decayed teeth(DT),with the majority occurring in the first permanent molar.According to the ZINB-LCGM model,the students were classified into three latent categories,"slow growth pattern"(28.55%),"rapid growth pattern"(6.59%),and "stable pattern"(64.86%),which followed different nonlinear caries growth trajectories.Females with deciduous teeth caries were more likely to have trajectories showing a“rapid growth pattern”and a“slow growth pattern”.There were significant differences in the trajectories between men and women,as well as between those with and without primary dentition caries.Conclusion The trajectory of the development of caries in 12-16-year-old students shows heterogeneity in terms of different developmental patterns of latent categories,suggesting that females with deciduous dental caries should receive more attention.

关 键 词：龋病 龋失补指数 轨迹 潜类别增长模型 人群特征 群体异质性 零膨胀 学校卫生 学生 

分 类 号：R78[医药卫生—口腔医学]