摘要目的:分析已改水合格饮水型地方性氟中毒（简称饮水型氟中毒）病区儿童氟斑牙患病影响因素。方法:2020、2021年采用整群抽样法，在天津市已改水合格饮水型氟中毒病区抽取8 ~ 12周岁儿童进行尿氟检测，氟斑牙检查及问卷调查，并采用logistic回归和分类树模型分析儿童氟斑牙患病影响因素。结果:共调查8 ~ 12周岁儿童3 795例，检出氟斑牙1 001例，氟斑牙检出率为26.38%（1 001/3 795）。logistic回归分析结果显示，年龄[比值比（ OR） = 1.193，95%置信区间（ CI）：1.115 ~ 1.277]，高尿氟（1.84 ~ 19.40 mg/L， OR = 1.510，95% CI：1.169 ~ 1.952）及家中常住人口数≥6人（ OR = 1.377，95% CI：1.090 ~ 1.739）是儿童氟斑牙患病的危险因素；母亲文化程度较高（大专及以上， OR = 0.664，95% CI：0.441 ~ 0.999），改水年限≥5年（5 ~ < 10年， OR = 0.193，95% CI：0.157 ~ 0.238；≥10年， OR = 0.254，95% CI：0.193 ~ 0.333）是儿童氟斑牙患病的保护因素。分类树模型分析结果显示，改水年限对已改水合格饮水型氟中毒病区儿童氟斑牙患病影响最大，其次为年龄、家中常住人口数和尿氟。logistic回归和分类树模型的受试者工作特征曲线下面积（AUC）分别为0.730（95% CI：0.711 ~ 0.748）、0.721（95% CI：0.702 ~ 0.739），拟合效果均较好。 结论:已改水合格饮水型氟中毒病区儿童氟斑牙检出率主要与改水年限、年龄、家中常住人口数和尿氟有关。

abstractsObjective:To analyze the influencing factors of dental fluorosis of children in the drinking-water-borne endemic fluorosis (referred to as drinking-water-borne fluorosis) areas with qualified drinking water.Methods:In 2020 and 2021, the cluster sampling method was used to select the children aged 8 to 12 years old from the drinking-water-borne fluorisis areas with qualified drinking water in Tianjin City for water and urine fluoride detection, dental fluorosis examination and questionnaire survey, and logistic regression and classification tree model were used to analyze the influencing factors of dental fluorosis in children.Results:A total of 3 795 cases children aged 8 to 12 years old were investigated, and 1 001 cases of dental fluorosis were detected, and the detection rate of dental fluorosis was 26.38% (1 001/3 795). The results of logistic analysis showed that age [odds ratio ( OR) = 1.193, 95% confidence interval ( CI): 1.115 - 1.277], high urinary fluoride (1.84 - 19.40 mg/L, OR = 1.510, 95% CI: 1.169 - 1.952) and the number of permanent residents at home ≥6 ( OR = 1.377, 95% CI: 1.090 - 1.739) were risk factors of dental fluorosis in children; and the mother's with higher education level (college degree or above, OR = 0.664, 95% CI: 0.441 - 0.999), the years of water improvement ≥5 years (5 - < 10 years, OR = 0.193, 95% CI: 0.157 - 0.238; ≥10 years, OR = 0.254, 95% CI: 0.193 - 0.333) were protective factors of dental fluorosis in children. The results of classification tree model analysis showed that the years of water improvement contributed the most to the prevalence of dental fluorosis among children in the drinking-water-borne fluorisis areas with qualified drinking water, followed by age, number of permanent residents at home and urinary fluoride. The area under the receiver operating characteristic curve (AUC) of logistic regression model and classification tree model were 0.730 (95% CI: 0.711 - 0.748) and 0.721 (95% CI: 0.702 - 0.739), respectively, with good fitting effect. Conclusion:The detection rate of children's dental fluorosis in the drinking-water-borne fluorosis areas with qualified drinking water is mainly related to the years of water improvement, age, the number of permanent residents at home and urinary fluoride.