2023年陕西省饮水型地方性氟中毒病区儿童氟斑牙和龋齿患病调查结果分析  

Investigation of dental fluorosis and dental caries among children in drinking water-borne endemic fluorosis areas of Shaanxi province in 2023

作　　者：周蓉[1] 杨敏[1] 丁琼洁 陈彬彬 范中学[1] 李晓茜[1] ZHOU Rong;YANG Min;DING Qiong-jie;CHEN Bin-bin;FAN Zhong-xue;LI Xiao-qian(Department of Endemic Fluorosis and Arsenism,Shaanxi Provincial Institute for Endemic Disease Control,Xi’an,Shaanxi 710003,China)

机构地区：[1]陕西省地方病防治研究所地方性氟砷中毒防研室,陕西西安710003

出　　处：《环境与健康杂志》2024年第9期783-787,共5页Journal of Environment and Health

摘　　要：目的了解陕西省饮水型氟中毒病区改水降氟后8~12岁儿童氟斑牙和龋齿患病情况及尿氟水平,为后期开展综合防治措施提供科学依据。方法于2023年4—10月,采取随机抽样的方法抽取7市11个饮水型氟中毒病区县,在每个病区县抽取5个病区村作为调查村,调查改水降氟工程运行情况及水氟含量。对调查村全部8~12岁儿童开展氟斑牙和龋齿患病检查,按年龄段随机选取50名儿童采集即时尿样测定尿氟含量。氟斑牙诊断采用《氟斑牙诊断标准》(WS/T 208—2011),龋齿的检查及诊断采用WHO公布的《口腔健康调查基本方法》,尿氟测定采用《尿中氟化物测定离子选择电极法》(WS/T 89—2015)。结果共调查81个病区村,已全部改水且改水工程均正常运转,水氟范围为0.10~3.15 mg/L,水氟含量超标村6个,占7.41%(6/81)。调查8~12岁儿童7008人,检出氟斑牙患者399人,氟斑牙检出率为5.69%(399/7008),氟斑牙指数0.09,患者以极轻度和轻度为主。水氟含量超标村儿童氟斑牙的检出率高于水氟含量合格村(χ^(2)=16.13,P<0.01)。随着年龄的增长,儿童氟斑牙的检出率呈上升趋势(χ_(趋势)^(2)=53.03,P<0.001)。8~12岁儿童龋齿患病率为22.29%(1562/7008),不同水氟含量组中0.3~0.6 mg/L组龋齿患病率较高[30.60%(381/1245)]。检测儿童即时尿样2275份,尿氟含量范围为0.10~7.96 mg/L,几何均值为1.17 mg/L。水氟超标村儿童的尿氟含量高于水氟合格村(Z=-6.402,P<0.001)。结论儿童氟斑牙病情低于国家控制标准,部分地区龋齿患病率较高。病区存在改水后水氟含量超标村,今后应加强改水工程的后期管理和提升改造,持续加大氟中毒健康教育力度,增加儿童口腔保健知识的宣教,巩固防治成果,控制氟中毒危害。Objective To understand the prevalence of dental fluorosis and dental caries and urinary fluoride levels in children aged 8-12 after the water-improvement in drinking water-borne endemic fluorosis in Shaanxi province,and to provide the scientific basis for comprehensive prevention and control in the later stage.Methods From April to October 2023,11 drinking water-borne endemic fluorosis counties in 7 cities were chosen by random sampling.In each county five villages were chosen as the investigated villages.To investigate the operation of water improvement projects and water fluorine content in per village,and dental fluorosis and dental caries were examined in all children aged 8-12 in the village,and 50 children were randomly selected according to the age group to collect instant urine samples to determine urinary fluoride concentration.The dental fluorosis was determined by“Diagnosis of Dental Fluorosis”(WS/T 208-2011).Dental caries was determined by“Oral Health Surveys:Basic Methods.5th ed”.Urinary fluoride was determined by“Determination of Fluoride in Urine-Ion Selective Electrode Method”(WS/T 89-2015).Results The monitoring villages had all completed water improvement project,and all of the water-improved projects were operating normally.Totally 81 endemic fluorosis villages were investigated,all of which had been constructed the water-improved projects and operated normally.The range of water fluoride was 0.10-3.15 mg/L.There were 6 villages with excessive water fluoride levels,accounting for 7.41%.Totally 7008 children aged 8-12 were investigated and 399 with dental fluorosis,and the detection rate of dental fluorosis was 5.69%,and the dental fluorosis index was 0.09.The patients were mainly very light and mild.The detection rate of children with fluorosis in villages without qualified water fluoride content was higher than that in villages with qualified water fluoride content(P<0.01).With the increase of age,the detection rate of dental fluorosis in children was on the rise(P<0.001).The rate

关 键 词：氟中毒 牙 龋齿 患病率 尿氟 

分 类 号：R123.1[医药卫生—环境卫生学]