甘肃省少数民族地区儿童氟斑牙患病情况及危险因素

吕程程; 陈晓燕; 张婕; 张勇; 杨琳; 闫娟; 刘艳丽; 张本忠

doi:10.16462/j.cnki.zhjbkz.2023.09.007

甘肃省少数民族地区儿童氟斑牙患病情况及危险因素

doi: 10.16462/j.cnki.zhjbkz.2023.09.007

吕程程¹,
陈晓燕²,
张婕³,
张勇¹,
杨琳¹,
闫娟¹,
刘艳丽¹,
张本忠^1, ,

1.
兰州大学公共卫生学院劳动卫生与环境卫生研究所，兰州 730030
2.
甘肃省疾病预防控制中心地方病防制科，兰州 730030
3.
西宁市卫生健康委员会疾病预防控制科，西宁 810003

基金项目:

甘肃省中医药科研课题 GZKP-2020-27

详细信息

通讯作者:
张本忠，E-mail: zhangbzh@lzu.edu.cn

中图分类号: R181
计量
- 文章访问数: 222
- HTML全文浏览量: 60
- PDF下载量: 26
- 被引次数: 0
出版历程
- 收稿日期: 2022-04-11
- 修回日期: 2022-07-01
- 网络出版日期: 2023-10-12
- 刊出日期: 2023-09-10

Prevalence and risk factors of dental fluorosis among children from minority areas of Gansu Province

1.
Institute of Occupational Hygiene and Environmental Hygiene, School of Public Health, Lanzhou University, Lanzhou 730030, China
2.
Department of Endemic Disease Control, Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730030, China
3.
Department of Disease Control and Prevention, Xining Municipal Health Commission, Xining 810003, China

Funds:

Research Project of Traditional Chinese Medicine in Gansu Province GZKP-2020-27

More Information

Corresponding author: ZHANG Benzhong, E-mail: zhangbzh@lzu.edu.cn

摘要

摘要: 目的了解甘肃省少数民族地区儿童氟斑牙的患病情况，探讨氟斑牙发病的危险因素。方法于2019年6―11月采用分层整群随机抽样方法，对甘肃省8个少数民族县的1 344名在校学生进行资料收集、氟斑牙诊断和尿样中氟化物检测。结果甘肃省少数民族地区8~12岁儿童氟斑牙患病率为29.1%，尿氟浓度几何均值为1.02 mg/L。居住在阿克塞哈萨克族自治县(阿克塞县)(OR=2.625, 95% CI: 1.530~4.597, P=0.001)、肃南裕固族自治县(肃南县)(OR=2.421, 95% CI: 1.411~4.154, P=0.001)、天祝藏族自治县(天祝县)(OR=2.813, 95% CI: 1.599~4.946, P＜0.001)和夏河县(OR=1.719, 95%CI: 1.022~2.892, P=0.041)、具有饮茶习惯(OR=1.508, 95% CI: 1.072~2.120, P=0.018)、年龄较大(8~12岁)(OR=1.122, 95% CI: 1.021~1.233, P=0.017)、尿氟浓度较高(0.10~5.87 mg/L)(OR=1.549, 95% CI: 1.223~1.962, P＜0.001)是影响儿童氟斑牙患病率的危险因素。结论甘肃省少数民族地区儿童氟斑牙患病率较高，地区、饮茶习惯、年龄、尿氟等因素均会影响氟斑牙患病率，应针对性地开展饮茶型地氟病持续性防制工作。
- 氟斑牙 /
- 尿氟 /
- 氟中毒 /
- 危险因素
Abstract: Objective This study seeks to understand the prevalence of dental fluorosis in children residing in ethnic minority areas of Gansu Province and to explore the risk factors of dental fluorosis. Methods Between June and November 2019, 1 344 students from eight ethnic minority counties in Gansu Province were included using the stratified cluster random sampling method. These participants underwent data collection, dental fluorosis diagnosis and fluoride detection in urine samples. Results The prevalence of dental fluorosis among children aged 8-12 years in minority areas of Gansu Province was 29.1%, with a geometric mean urinary fluoride concentration of 1.02 mg/L. Living in the areas of Aksai (OR=2.625, 95% CI: 1.530-4.597, P=0.001), Sunan (OR=2.421, 95% CI: 1.411-4.154, P=0.001), Tianzhu (OR=2.813, 95% CI: 1.599-4.946, P < 0.001) and Xiahe (OR=1.719, 95% CI: 1.022-2.892, P=0.041) counties, having tea-drinking habits (OR=1.508, 95% CI: 1.072-2.120, P=0.018), older age (8-12 years old)(OR = 1.122, 95% CI: 1.021-1.233, P=0.017) and high urinary fluoride concentration (0.10-5.87 mg/L)(OR=1.549, 95% CI: 1.223-1.962, P < 0.001) were risk factors affecting the prevalence of dental fluorosis in children. Conclusions The prevalence of dental fluorosis among children is high in ethnic minority areas of Gansu Province. The factors such as region, tea-drinking habits, age, and urinary fluoride can affect the prevalence of dental fluorosis. Continuous prevention and treatment of tea-drinking type dental fluorosis should be carried out in a targeted manner.
- Dental fluorosis /
- Urinary fluoride /
- Fluorosis /
- Risk factors

HTML全文

表 1 不同特征儿童氟斑牙患病情况比较

Table 1. Comparison of the prevalence of dental fluorosis in children with different characteristics

特征 Feature	人数(占比/%) Number ofpeople(proportion/%)	正常 Normal	氟斑牙分级 Classification of dental fluorosis				氟斑牙检出人数(占比/%) Number of detectedfluorosis(proportion/%)	χ²值 value	P值 value
特征 Feature	人数(占比/%) Number ofpeople(proportion/%)	正常 Normal	极轻度 Extremelymild	轻度 Mild	中度 Moderate	重度 Heavy	氟斑牙检出人数(占比/%) Number of detectedfluorosis(proportion/%)	χ²值 value	P值 value
地区/县 Region/county								172.559	< 0.001
阿克塞 Aksai	244(18.2)	129	57	50	7	1	115(47.1)
康乐 Kangle	95(7.1)	82	8	3	2	0	13(13.7)
玛曲 Maqu	216(16.1)	195	13	8	0	0	21(9.7)
肃北 Subei	42(3.1)	37	4	1	0	0	5(11.9)
肃南 Sunan	223(16.6)	117	59	24	23	0	106(47.5)
天祝 Tianzhu	124(9.2)	67	26	22	7	2	57(46.0)
夏河 Xiahe	180(13.4)	140	34	5	1	0	40(22.2)
卓尼 Zhuoni	220(16.4)	186	19	14	0	1	34(15.5)
民族 Nationality								117.933	< 0.001
汉族 Han	187(13.9)	112	42	16	16	1	75(40.2)
回族 Hui	112(8.3)	94	12	4	2	0	18(16.1)
藏族 Tibetan	637(47.4)	517	74	40	5	1	120(18.9)
裕固族 Yugur	134(10.0)	74	33	16	10	1	60(44.7)
蒙古族 Mongolian	42(3.1)	37	4	1	0	0	5(11.9)
哈萨克族 Kazak	232(17.3)	119	55	50	7	1	113(48.7)
性别 Sex								2.119	0.145
男 Male	663(49.3)	458	111	66	26	2	205(30.9)
女 Female	681(50.7)	495	109	61	14	2	186(27.3)
年龄组/岁 Age group/years								12.467	< 0.001
8	262(19.5)	189	42	24	6	1	73(27.9)
9	278(20.7)	213	42	17	6	0	65(23.4)
10	331(24.6)	248	48	30	3	2	83(25.1)
11	214(15.9)	146	35	22	11	0	68(31.8)
12	259(19.3)	157	53	34	14	1	102(39.4)
饮茶 Drinking tea								95.639	< 0.001
无 No	682(50.7)	565	65	37	13	2	117(17.2)
有 Yes	662(49.3)	388	155	90	27	2	274(41.4)
合计 Total	1 344(100.0)	953	220	127	40	4	391(29.1)

下载: 导出CSV

表 2 不同氟斑牙分级、地区儿童尿氟浓度情况比较

Table 2. Comparison of urinary fluoride concentration among children in different dental fluorosis grades and regions

特征 Feature	检测份数 Number ofdetections	尿氟浓度/(mg·L^-1) Urine fluoride concentration /(mg·L^-1)			超标(> 1.4 mg·L^-1) Exceeding standard(> 1.4 mg·L^-1)
特征 Feature	检测份数 Number ofdetections	G	M	范围 Scopey	超标(> 1.4 mg·L^-1) Exceeding standard(> 1.4 mg·L^-1)
氟斑牙 Dental fluorosis
否 No	953	0.91	0.90	0.10~5.87	否 No
是 Yes	391	1.39	1.42	0.18~5.43	否 No
氟斑牙分级 Classification of dental fluorosis
极轻度 Extremely mild	220	1.33	1.30	0.18~5.43	否 No
轻度 Mild	127	1.42	1.50	0.25~4.12	是 Yes
中度 Moderate	40	1.63	1.51	0.22~5.43	是 Yes
重度 Heavy	4	1.50	1.69	0.61~2.93	是 Yes
地区(县) Region(county)
阿克塞 Aksai	244	1.60	1.61	0.25~5.87	是 Yes
康乐 Kangle	95	0.54	0.55	0.13~3.61	否 No
玛曲 Maqu	216	0.90	0.90	0.46~2.09	否 No
肃北 Subei	42	0.90	0.86	0.39~1.56	否 No
肃南 Sunan	223	1.74	1.64	0.57~5.70	是 Yes
天祝 Tianzhu	124	1.64	1.68	0.53~5.22	是 Yes
夏河 Xiahe	180	0.63	0.63	0.20~2.81	否 No
卓尼 Zhuoni	220	0.65	0.60	0.10~3.52	否 No
合计 Total	1 344	1.02	1.05	0.10~5.87	否 No

下载: 导出CSV

表 3 儿童氟斑牙患病的多因素logistic回归分析

Table 3. Multivariate logistic regression analysis of dental fluorosis in children

自变量 Factor	β	s	Wald值 value	OR值 value(95% CI)	P值 value
地区(县)(ref: 卓尼)Region (county) (ref: Zhuoni)
阿克塞 Aksai	0.975	0.281	12.086	2.652(1.530~4.597)	0.001
肃南 Sunan	0.884	0.275	10.306	2.421(1.411~4.154)	0.001
天祝 Tianzhu	1.034	0.288	12.890	2.813(1.599~4.946)	< 0.001
夏河 Xiahe	0.542	0.265	4.169	1.719(1.022~2.892)	0.041
饮茶(ref: 否)Drink tea (ref: no)	0.411	0.174	5.580	1.508(1.072~2.120)	0.018
年龄组/岁 Age group/years	0.115	0.048	5.679	1.122(1.021~1.233)	0.017
尿氟浓度/(mg·L^-1) Urine fluoride concentration/(mg·L^-1)	0.438	0.121	13.170	1.549(1.223~1.962)	< 0.001

下载: 导出CSV

参考文献(15)

[1]	周均泽, 宁伯福, 杨万军, 等. 宣威市2005年燃煤污染型地方性氟中毒病区8-12岁学生氟斑牙调查结果分析[J]. 中华疾病控制杂志, 2013, 17(11): 949-951. https://zhjbkz.ahmu.edu.cn/article/id/JBKZ201311009 Zhou JZ, Ning BF, Yang WJ, et al. Survey of epidemic of coal-burning related dental fluorosis among children of 8-12 years old in Xuanwei, Yunnan Province in 2005[J]. Chin J Dis Control Prev, 2013, 17(11): 949-951. https://zhjbkz.ahmu.edu.cn/article/id/JBKZ201311009
[2]	Wong MH, Fung K, Carr H. Aluminium and fluoride contents of tea, with emphasis on brick tea and their health implications[J]. Toxicol lett, 2003, 137(1-2): 111-120. DOI: 10.1016/S0378-4274(02)00385-5.
[3]	Pramanik S, Saha D. The genetic influence in fluorosis[J]. Environ Toxicol Pharmacol, 2017, 56: 157-162. DOI: 10.1016/j.etap.2017.09.008.
[4]	张昊, 黄小芳. 氟中毒地方病区域氟斑牙发生情况的影响因素研究[J]. 中国地方病防治杂志, 2016, 31, (2): 141-143. https://www.cnki.com.cn/Article/CJFDTOTAL-DYBF201602007.htm Zhang H, Huang XF. Effects of incidence of dental fluorosis endemic in fluorosis region factors[J]. Chin J Control Endemic Dis, 2016, 31(2): 141-143. https://www.cnki.com.cn/Article/CJFDTOTAL-DYBF201602007.htm
[5]	邹志方, 陈少贤, 贺凌飞, 等. 汕头市地方性氟中毒病区改水后小学生尿氟及氟斑牙患病调查[J]. 环境与健康杂志, 2011, 28(1): 41-43. DOI: 10.1624/j.cnki.1001-5914.2011.01.037. Zou ZF, Chen SX, He LF, et al. Epidemiological analysis of urine fluoride contents and dental fluorosis in pupils in endemic fluorosis areas in Shantou, Guangdong after water improvement[J]. J Environment Health, 2011, 28(1): 41-43. DOI: 10.1624/j.cnki.1001-5914.2011.01.037.
[6]	范淑玲. "十三五" 期间我国地方性氟中毒防制现状[J]. 环境与职业医学, 2020, 37(12): 1219-1223. DOI: 10.13213/j.cnki.jeom.2020.20274. Fan SL. Current prevention and control of endemic fluorosis during the Thirteenth Five-Year Plan in China[J]. Journal of Environmental and Occupational Medicine, 2020, 37(12): 1219-1223. DOI: 10.13213/j.cnki.jeom.2020.20274.
[7]	方春, 张鹏, 杨元成, 等. 甘肃省天祝藏族自治县饮茶型地方性氟中毒流行现状调查[J]. 中华地方病学杂志, 2022, 41(2): 130-134. DOI: 10.3760/cma.j.cn231583-20210412-00122. Fang C, Zhang P, Yang YC, et al. An investigation of the prevalence of tea-drinking-borne endemic fluorosis in Tianzhu Tibetan Autonomous County, Gansu Province[J]. Chin J Endemiol, 2022, 41(2): 130-134. DOI: 10.3760/cma.j.cn231583-20210412-00122.
[8]	李焕军, 牛卫东. 肃南县饮茶型地方性氟中毒调查分析[J]. 疾病预防控制通报, 2013, 28(4): 44. DOI: 10.13215/j.cnki.jbyfkztb.2013.04.044. Li HJ, Niu WD. Investigation and analysis of endemic fluorosis caused by tea drinking in Sunan County[J]. Bull Dis Control Prev, 2013, 28(4): 44. DOI: 10.13215/j.cnki.jbyfkztb.2013.04.044.
[9]	陈萍, 何多龙, 魏生英, 等. 青海省8~12岁儿童饮茶型氟中毒现况调查[J]. 中华地方病学杂志, 2014, 33(1): 53-55. DOI: 10.3760/cma.j.issn.2095-4255.2014.01.016. Chen P, He DL, Wei SY, et al. Investigation on the current situation of tea-drinking fluorosis in children aged 8-12 years in Qinghai Province[J]. Chin J Endemiol, 2014, 33(1): 53-55. DOI: 10.3760/cma.j.issn.2095-4255.2014.01.016.
[10]	Fan Z, Gao Y, Wang W, et al. Prevalence of brick tea-type fluorosis in the Tibet autonomous region[J]. J Epidemio, 2016, 26(2): 57-63. DOI: 10.2188/jea.JE20150037.
[11]	郭宝峰, 李程程, 梁丽娜, 等. 砖茶氟含量调查研究[J]. 中华地方病学杂志, 2019, 38(6): 467-471. DOI: 10.3760/cma.j.issn.2095-4255.2019.06.008. Guo BF, Li CC, Liang LN, et al. Investigation on fluoride content of brick tea[J]. Chin J Endemiol, 2019, 38(6): 467-471. DOI: 10.3760/cma.j.issn.2095-4255.2019.06.008.
[12]	Cao J, Zhao Y, Liu J. Brick tea consumption as the cause of dental fluorosis among children from Mongol, Kazak and Yugu populations in China[J]. Food Chem Toxicol, 1997, 35(8): 827-833. DOI: 10.1016/S0278-6915(97)00049-5.
[13]	刘洋, 孙静, 李丙云, 等. 我国4个民族饮茶型氟中毒病情差异研究[J]. 中华地方病学杂志, 2014, 33(3): 315-319. DOI: 10.3760/cma.j.issn.2095-4255.2014.03.020. Liu Y, Sun J, Li BY, et al. Study on the differences in the condition of tea-drinking fluorosis among four ethnic groups in my country[J]. Chin J Endemiol, 2014, 33(3): 315-319. DOI: 10.3760/cma.j.issn.2095-4255.2014.03.020.
[14]	刘娅, 王琼, 赖晋锋, 等. 氟斑牙危险因素的非条件logistic回归分析[J]. 中华疾病控制杂志, 2016, 20(11): 1144-1146. DOI: 10.16462/j.cnki.zhjbkz.2016.11.017. Liu Y, Wang Q, Lai JF, et al. logistic regression analysis on risk factors of dental fluorosis[J]. Chin J Dis Control Prev, 2016, 20(11): 1144-1146. DOI: 10.16462/j.cnki.zhjbkz.2016.11.017.
[15]	Xiong X, Liu J, He W, et al. Dose-effect relationship between drinking water fluoride levels and damage to liver and kidney functions in children[J]. Environ Res, 2007, 103(1): 112-126. DOI: 10.1016/j.envres.2006.05.008.

施引文献

资源附件(0)

访问统计

点击查看大图

特征 Feature	人数(占比/%) Number ofpeople(proportion/%)	正常 Normal	氟斑牙分级 Classification of dental fluorosis				氟斑牙检出人数(占比/%) Number of detectedfluorosis(proportion/%)	χ²值 value	P值 value
特征 Feature	人数(占比/%) Number ofpeople(proportion/%)	正常 Normal	极轻度 Extremelymild	轻度 Mild	中度 Moderate	重度 Heavy	氟斑牙检出人数(占比/%) Number of detectedfluorosis(proportion/%)	χ²值 value	P值 value
地区/县 Region/county								172.559	< 0.001
阿克塞 Aksai	244(18.2)	129	57	50	7	1	115(47.1)
康乐 Kangle	95(7.1)	82	8	3	2	0	13(13.7)
玛曲 Maqu	216(16.1)	195	13	8	0	0	21(9.7)
肃北 Subei	42(3.1)	37	4	1	0	0	5(11.9)
肃南 Sunan	223(16.6)	117	59	24	23	0	106(47.5)
天祝 Tianzhu	124(9.2)	67	26	22	7	2	57(46.0)
夏河 Xiahe	180(13.4)	140	34	5	1	0	40(22.2)
卓尼 Zhuoni	220(16.4)	186	19	14	0	1	34(15.5)
民族 Nationality								117.933	< 0.001
汉族 Han	187(13.9)	112	42	16	16	1	75(40.2)
回族 Hui	112(8.3)	94	12	4	2	0	18(16.1)
藏族 Tibetan	637(47.4)	517	74	40	5	1	120(18.9)
裕固族 Yugur	134(10.0)	74	33	16	10	1	60(44.7)
蒙古族 Mongolian	42(3.1)	37	4	1	0	0	5(11.9)
哈萨克族 Kazak	232(17.3)	119	55	50	7	1	113(48.7)
性别 Sex								2.119	0.145
男 Male	663(49.3)	458	111	66	26	2	205(30.9)
女 Female	681(50.7)	495	109	61	14	2	186(27.3)
年龄组/岁 Age group/years								12.467	< 0.001
8	262(19.5)	189	42	24	6	1	73(27.9)
9	278(20.7)	213	42	17	6	0	65(23.4)
10	331(24.6)	248	48	30	3	2	83(25.1)
11	214(15.9)	146	35	22	11	0	68(31.8)
12	259(19.3)	157	53	34	14	1	102(39.4)
饮茶 Drinking tea								95.639	< 0.001
无 No	682(50.7)	565	65	37	13	2	117(17.2)
有 Yes	662(49.3)	388	155	90	27	2	274(41.4)
合计 Total	1 344(100.0)	953	220	127	40	4	391(29.1)

表(3)

计量

文章访问数: 222
HTML全文浏览量: 60
PDF下载量: 26
被引次数: 0

姓名
邮箱
手机号码
标题
留言内容
验证码

留言板

甘肃省少数民族地区儿童氟斑牙患病情况及危险因素

doi: 10.16462/j.cnki.zhjbkz.2023.09.007

通讯作者:
张本忠，E-mail: zhangbzh@lzu.edu.cn

计量

Prevalence and risk factors of dental fluorosis among children from minority areas of Gansu Province

Corresponding author: ZHANG Benzhong, E-mail: zhangbzh@lzu.edu.cn

计量

目录

留言板

甘肃省少数民族地区儿童氟斑牙患病情况及危险因素

doi: 10.16462/j.cnki.zhjbkz.2023.09.007

通讯作者: 张本忠，E-mail: zhangbzh@lzu.edu.cn

计量

出版历程

Prevalence and risk factors of dental fluorosis among children from minority areas of Gansu Province

Corresponding author: ZHANG Benzhong, E-mail: zhangbzh@lzu.edu.cn

计量

出版历程

目录

通讯作者:
张本忠，E-mail: zhangbzh@lzu.edu.cn