【摘要】 目的探讨饮砖茶水摄氟量与氟斑牙病情的剂量效应关系及其正常上限值,为制定砖茶含氟量卫生标准和儿童砖茶氟最大允许摄入量提供科学依据。方法在全国饮茶型氟中毒重病区四川省,选择有饮砖茶习惯的藏族牧区阿坝州阿坝县麦尔玛小学、格登寺附属小学,红原县阿木小学、江绒小学、龙让小学和希望小学,对其8～12岁儿童整群抽样,并采用Dean氏法诊断氟斑牙,采用氟离子电极法测定砖茶水氟和尿氟。再以定群调查的方法,确定每人每日从砖茶水中摄取的含氟量。结果8～12岁儿童氟斑牙检出率为52.15%,但主要为极轻病例,各年龄段检出率没有统计学差异;饮砖茶水量、和摄氟量随年龄增长呈梯度升高,但仍处在较低剂量范畴,对照组每日砖茶水摄氟量平均为(0.873±0.249)mg,病例组为(1.386±0.699)mg;儿童饮砖茶水摄氟量呈正偏态分布;各年龄段儿童饮砖茶水摄氟量的对数均值与氟斑牙指数呈直线正相关,r=0.919,P<0.05;计算出儿童每日总摄氟量正常上限值为2.243mg。结论①儿童饮茶型氟斑牙检出率虽然较高,但病情程度不重;②儿童每日砖茶氟摄入量处于较低水平,这完全符合饮茶型氟中毒儿童氟斑牙流行特点;③儿童每日砖茶氟摄入量正常上限值低于饮水型病区总摄氟量卫生标准。更多还原

【Abstract】 Objective To study the dose-response relation between dental fluorosis prevalence and the amount of fluoride intake from brick-tea and the normal upper-limit value of brick-tea fluoride intake in children,thus to provide scientific evidences for establishing healthy criteria of fluoride content in brick-tea and the allowed maximum amount of fluoride intake for children. Methods In severe drinking tea-type endemic fluorosis areas in Sichuan Province, cluster-sampling was carried out to survey the children aged from 8 to12 years old in the Tibetan pastoral areas where drinking brick-tea was a custom of local residents, the children in Maier-ma primary school, Gedeng temple primary school in Aba County, Amu primary school, Jiangrong primary school, Longrang primary school,and Xiwang primary school in Hongyuan County were selected. Dean’s criteria was used to diagnose the children’s dental fluorosis, fluoride contents in brick-tea water and children urinary were determined by fluoride ion selective electrode method, and daily fluoride intake by each child from brick-tea water was ascertained by retrospective cohort study. Results The prevalence rate of children dental fluorosis was 52.15%, but they mostly presented the slightest clinical symptom, the rates of each age group had no statistical difference. Both the amount of drinking brick-tea water and fluoride intake were increased along with the age, but they were all whithin the range of lower dose. The average amount of daily fluoride intake from drinking brick-tea in the control group was (0.873 ± 0.249)mg, and it was (1.386 ± 0.699)mg in the case group. The amount of children fluoride intake from brick-tea showed a positive skewness distribution. There was a liner positive correlation between children dental fluorosis index and the logarithmic means of the amount of fluoride intake from brick-tea in each age group, r = 0.919,P < 0.05. The daily threshold of children total fluoride intake was 2.243 mg(person/day). Conclusions ①Although the prevalence of dental fluorosis is very high, the illness is not severe. ②Daily fluoride intake from brick-tea is at a lower level, which was absolutely corresponded with the epidemic characteristics of children dental fluorosis of drinking brick-tea type. ③The daily threshold of children fluoride intake from brick-tea is lower than that allowed by healthy criteria in areas of drinking water type endemic fluorosis.更多还原