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目的 调查贵州省燃煤污染型地方性氟中毒(简称燃煤型氟中毒)重点病区8～12岁儿童氟斑牙患病情况,评估防控效果.方法 2014年,在贵州省23个重点病区县(市、区,以下简称县),每个县按照东、南、西、北、中方位各抽取1个乡镇,每个乡镇抽取1所病区村完全小学,按《氟斑牙诊断》(WS/T208-2011)对全体在校8～12岁儿童进行氟斑牙检查.收集2000、2007年相关调查资料并与2014年进行比较.结果 8～12岁儿童总的氟斑牙检出率为32.31％(5 803/17 962),有个3县的检出率＜15％,12个县的检出率在15％～30％,8个县的检出率＞30％.极轻、轻度、中度、重度病例数分别占48.39％(2 808/5 803)、30A3％(1 766/5 803)、15.16％(880/5 803)、6.01％ (349/5 803).男、女性儿童的检出率分别为33.05％(3 083/9 329)、31.51％(2 720/8 633),二者比较差异有统计学意义(x2=4.86,P＜0.05);8、9、10、11、12岁年龄组儿童氟斑牙检出率分别为17.79％(224/1 259)、26.02％(871/3 348)、30.28％(1 255/4 144)、34.07％(1 595/4682)、41.02％(1 858/4529),检出率随年龄增大呈升高趋势(X2=345.78,P＜0.01).2000、2007、2014年儿童氟斑牙检出率比较,除修文县、威宁县、黔西县、清镇市、六枝特区、西秀区外(X2=0.84、4.19、3.67、5.03、1.98、2.37,P均＞0.05),其他17个县均呈逐渐降低趋势(P均＜ 0.05).有21.74％(25/115)的村氟斑牙检出率＜15％,32.17％(37/115)的村氟斑牙检出率在15％～30％,46.09％(53/115)的村氟斑牙检出率＞30％.结论 贵州省燃煤型氟中毒重点病区8～12岁儿童氟斑牙病情逐渐减轻,综合防治效果正逐渐显现.

Objective To investigate the prevalence of dental fluorosis in children aged 8-12 in coalburning-borne endemic fluorosis areas in 23 counties in Guizhou Province,and to evaluate the effects of prevention and control measures.Methods In 2014,five towns were selected according to their location of the east,the south,the west,the north and the center of the 23 counties,one primary school in each town was chosen.All the students aged 8-12 in each school were selected,according to the "Diagnosis of Dental Fluorosis" (WS/T 208-2011),dental fluorosis was examined.At the same time,the detection rate of dental fluorosis of children aged 8-12 was investigated in 23 counties in 2000 and 2007.Analysis and comparison of the data in 2000,2007 and 2014 were done.Results The total detectable rate of dental fluorosis of children aged 8-12 was 32.31％ (5 803/17 962).The detection rate of 3 counties was lower than 15％,12 counties ranged from 15％ to 30％ and 8 counties more than 30％.Very light,mild,moderate,and severe cases of dental fluorosis cases accounted for 48.39％ (2 808/5 803),30.43％ (1 766/5 803),15.16％ (880/5 803) and 6.01％ (349/5 803).Male and female children's overall detection rate was 33.05％ (3 083/9 329) and 31.51％ (2 720/8 633),the difference was statistically significant (x2=4.86,P ＜ 0.05).The detection rates of dental fluorosis of children aged 8,9,10,11 and 12 were 17.79％ (224/1 259),26.02％ (871/3 348),30.28％ (1 255/4 144),34.07％ (1 595/4 682) and 41.02％ (1 858/4 529),indicating that the detection rate increased with age (x2 =345.78,P ＜ 0.01).After longitudinal comparison of the detection rates of dental fluorosis of children aged 8-12 in 2000,2007 and 2014,we found that 17 counties were gradually decreased (all P ＜ 0.05) except Xiuwen,Weining,Qianxi,Qingzhen,Liuzhi and Xixiu (x2 =0.84,4.19,3.67,5.03,1.98,2.37,all P ＞ 0.05).The ratio of dental fluorosis detection rate ＜ 15％,15％-30％ and ＞ 30％ was accounted for 21.74％ (25/115),32.17％ (37/115) and 46.09％ (53/115),respectively,in the 115 villages.Conclusion The detection rate of dental fluorosis of children aged 8-12 in coal-burning-borne endemic fluorosis areas is significantly dropped,and the comprehensive prevention and control effect is gradually apparent.