摘要目的:了解青海省湟中、平安、乐都区饮水型地方性氟中毒（简称饮水型氟中毒）病区病情及改水降氟工程运转情况，评价控制措施效果。方法:2018年，在青海省湟中、平安、乐都区的历史饮水型氟中毒病区村进行改水状况、改水工程运转情况及水氟含量调查；对调查村所有8 ~ 12岁儿童进行氟斑牙检查；抽取3个区的3个病区村进行25岁以上成人氟骨症X线检查及尿氟含量检测。结果:3个区的82个历史饮水型氟中毒病区村已全部改水，且改水工程均正常运转，水氟含量范围为0.10 ~ 0.37 mg/L，均符合生活饮用水氟含量标准（< 1.2 mg/L）。对病区村2 503例8 ~ 12岁儿童进行氟斑牙检查，氟斑牙检出率为6.03%（151/2 503），氟斑牙指数为0.13，流行强度为阴性；3个区的氟斑牙检出率分别为6.24%（129/2 068）、4.05%（7/173）、5.73%（15/262），均达到国家控制标准（< 30%），其中81个病区村的儿童氟斑牙检出率均< 30%。X线检查25岁以上成人198例，氟骨症检出率为5.05%（10/198），尿氟几何均数为0.81 mg/L；氟骨症病例主要集中在40岁以上年龄组，均为轻度病例。结论:湟中、平安、乐都区实施改水措施后生活饮用水氟含量、儿童氟斑牙检出率均达到控制标准，氟骨症病情较轻，饮水型氟中毒防治工作取得了较好的成效，还应继续加强改水工程的后期管理和病情监测工作，防止病情反弹。

abstractsObjective:To understand the situation of drinking water-borne endemic fluorosis (short for drinking water fluorosis) in Huangzhong, Ping'an and Ledu districts of Qinghai Province and operation status of water improvement projects, and to evaluate the effect of control measures.Methods:In historical drinking water fluorosis villages of Huangzhong, Ping'an and Ledu districts of Qinghai Province in 2018, the status of water improvement, the operation of water improvement projects and the content of water fluoride were investigated; the dental fluorosis of 8-12 years old children in all investigated villages was checked; 3 villages from 3 districts were selected, X-ray examination for skeletal fluorosis and urinary fluoride detection of adults over 25 years old of age were performed.Results:Eight-two historical drinking water fluorosis villages in 3 districts were investigated and all the villages had water improvement projects, in addition, the water improvement projects were operating normally, and the water fluoride content ranged from 0.10 to 0.37 mg/L, which were in line with the drinking water fluoride content standard (< 1.2 mg/L). Totally 2 503 children aged 8-12 years old were examined, the detection rate of dental fluorosis was 6.03% (151/2 503), the index of dental fluorosis was 0.13, the epidemic intensity was negative; the detection rates of dental fluorosis in 3 districts were 6.24% (129/2 068), 4.05% (7/173), 5.73% (15/262), respectively, reaching the control standard (< 30%), and the detection rate of dental fluorosis in 81 villages was less than 30%; 198 adults over 25 years old were examined, the detection rate of skeletal fluorosis was 5.05% (10/198), the geometric mean of urinary fluoride was 0.81 mg/L, and skeletal fluorosis cases were mainly in the age group over 40 years old, all of them were mild cases.Conclusions:The fluoride content in drinking water and the detection rate of children's dental fluorosis are all up to the control standard, and the condition of skeletal fluorosis is significantly reduced after the implementation of water improvement measures in Huangzhong, Ping'an and Ledu districts. It can be seen that the prevention and control of drinking water fluorosis in Huangzhong, Ping'an and Ledu districts have achieved good results, but later management and condition monitoring of water improvement projects should be strengthened to prevent the disease from rebounding.