改水降氟10年后儿童氟斑牙及尿氟状况调查

目的评价防氟改水对预防儿童氟斑牙效果。方法对已改水10年的地方性氟中毒村进行了氟斑牙检查及水氟、尿氟检测。结果吴坡村儿童氟斑牙患病率为37．57％，氟斑牙指数0．68，水氟、尿氟均超过国家卫生标准；巴邑村儿童氟斑牙患病率为11．61％，氟斑牙指数0．22。结论防氟改水是预防饮水型氟中毒的根本性措施。     

青岛市地方性氟中毒病区成人氟骨症流行现状调查分析

目的了解青岛市地方性氟中毒病区成人氟骨症的流行现状。方法采用流行病学抽样调查的方法,对青岛市主要氟病区平度、莱西、胶州、即墨等4市(县)1517例30岁以上成年人进行了临床症状与体征及X线检查。结果4市(县)共检查30岁以上成年人1517例,临床与X线氟骨症阳性检出率平均为15.00%,病情以平度市最为严重,检出率高达27.80%,并出现了10例临床3度、13例X线Ⅲ期病例;不同年龄段之间氟骨症检出率存在明显差异,随着年龄的增高检出率逐渐上升,且病情也随之加重;在不同性别人群之间氟骨症检出率无明显差异,但男性较女性显示了上升的趋势。结论青岛市病区成人氟骨症尚存在一定程度的流行,地方性氟中毒尚未达到完全控制;不同年龄段人群均有病例出现,随着年龄增长氟骨症检出率逐渐上升,且病情随之加重。     

陕西省定边县地方性氟骨症X线分析

目的观察定边县饮水型地方性氟中毒骨关节损害的放射学特点。方法在定边县平原区随机选拍片对象共443人,拍摄骨盆、右前臂、右小腿正位片。结果定边县氟骨症的X线检出率为72.23% ,前臂、小腿阳性征象的检出率高于骨盆,X线诊断与临床诊断不完全吻合,X线检出率、X线改变指数与水氟之间呈正相关。结论临床表现与骨X线改变的不一致,给氟骨症的早期诊断造成困难,应加强对其机理的探讨。     

甘肃省通渭县改水工程与防治碘缺乏病和地氟病关系研究

为了解甘肃省“121”集雨窖水中碘、氟的含量与碘缺乏病和氟中毒的防治关系,2002年选择实施项目的通渭县典型高氟低碘病区襄南乡马店村8～10岁儿童50名测其尿碘,进行甲状腺触诊检查;同时对调查对象所在的50户家庭,进行水碘、水氟实验室检测;随机抽取调查对象所在家庭30户,检测盐碘、粮食氟;与改水前进行比较。结果显示水碘由改水前的6．0μg/L下降到改水后的3．7μg/L;合格碘盐覆盖率由改水前的94．3％上升到100%;尿碘中位数由改水前的210．0μg/L上升至改水后的238．5μg/L;甲肿率由改水前的6．0％下降至0。水氟由改水前的2．00mg/L下降到改水后的0．094mg/L;粮食氟改水前后分别为6.836mg／kg,6．632mg/kg;尿氟由改水前的2．000mg／L下降至改水后的1．541mg／L;氟斑牙指数由改水前的33％下降至13％。调查证实饮用低氟窖水是控制氟中毒的有效途径,在饮用“121”集流窖水的病区提高合格碘盐的覆盖率是有效控制碘缺乏病的关键。     

内蒙古新巴尔虎右旗地方性氟中毒流行病学调查

目的 确定贝尔湖附近牧区是否是病区，搞清病情现状及摄氟来源。方法 现况流行病学调查，按Dean氏法调查8-12岁儿童氟斑牙患病情况；检查30岁以上成年人氟骨症患病情况；用氟离子选择电报法测定儿童尿氟、饮水氟、奶茶氟及砖茶氟含量，入户调查饮奶茶量，计算人均日饮奶茶摄氟量。结果 宝东和贝尔2个调查点儿童氟斑牙患病率分别为58．65％和66．00％：成人X线氟骨症检出率分别为39．33％和31．46％，以轻度和中度为主；饮水含氟量均值分别为4．37mg／L和4．12mg／L;奶茶氟含量均值分别为5．80mg／L和5．88mg／L；人均日饮奶茶摄氟量分别为8．70mg和9．50mg。结论 贝尔湖附近牧区是以饮水型为主的饮水饮茶混合型病区；饮水含氟量和奶茶含氟量及儿童尿含氟量均较高，达到重病区水平，但儿童氟斑牙和成人氟骨症相对较轻，其原因有待进一步研究。     

燃煤型氟中毒对男性生殖系统的影响

燃煤型氟中毒是我国特有的一种氟中毒类型,研究发现燃煤型氟中毒对男性生殖系统有一定程度的影响,其中,重度氟中毒地区男性精液的含氟量、精子存活率、精子浓度及不育症的患病率高于轻氟区和非氟中毒病区,血清中卵泡刺激素(FSH)、黄体生成素(LH)也高于轻氟区和非氟中毒区,但是抑制素B、血清睾酮以及雌二醇却有不同程度的降低。提示燃煤型氟中毒也跟其他氟中毒一样,会对男性生殖器官的结构、精子的生成以及生殖内分泌等多方面造成影响,最终导致男性生殖能力的下降。     

Effect of calcium, given before or after a fluoride insult, on hamster secretory amelogenesis in vitro

We tested the hypothesis that high-calcium medium given prior to or immediately after exposure to fluoride (F) reduces the negative effects of F on secretory amelogenesis. Hamster molar tooth germs were grown in organ culture in media with different calcium levels. Deposition of enamel matrix and matrix mineralization were monitored by incorporation of [³H]proline and uptake of ⁴⁵Ca and acid-soluble ³²PO₄. Ameloblast structure and the occurrence of a fluorotic enamel matrix were examined by light and electron microscopy. A preculture of explants in high-calcium medium partially prevented the formation of fluorotic (non-mineralizing) enamel matrix, increased matrix secretion but could not prevent F-induced hypermineralization of the pre-exposure enamel. High-calcium medium, applied after F insult, accelerated the recovery of fluorotic matrix, improved ameloblast structure, enhanced amelogenin secretion, and increased enamel thickness. The data indicate that it might be the balance between the amount of mineral deposition and that of matrix secretion which is critical for the mineralization of newly secreted enamel. Exposure to F disturbs this balance by enhancing mineralization of the pre-exposure enamel, probably generating an excess of protons. High calcium may protect against F exposure by enhancing amelogenin secretion into the enamel space, thereby increasing the local buffering capacity at the mineralization front.     

Fluoride intake by infants

Many infants are fully or partially breast fed during the early months of life; however, the percentage of such infants decreases to about 30 percent by 4 months of age. The majority of US infants are fed formulas for most of the first 10 months of life. Although fluoride (F) intakes by fully breast-fed infants are low, F intakes by partially breast-fed infants and by formula-fed infants are highly variable, depending primarily on the F content of the water used to dilute concentrated liquid or powdered infant formula products. In communities with F content of the drinking water less than 0.3 ppm, F consumption by many infants will be 30 to 40 micrograms.kg-1.d-1. The addition of a F supplement of 0.25 mg/d for a 4 kg infant would increase the F intake by 63 micrograms.kg-1.d-1, resulting in a total intake of about 100 micrograms.kg-1.d-1, an intake in the range believed to be associated with development of fluorosis of the permanent teeth. However, for the US infant population generally, many fewer infants are exposed to high F intakes from formula plus a supplement (recommended only for communities with water providing less than 0.3 ppm F) than from formula alone in communities with F content of 1 ppm in the drinking water. In assessing the possible effects of F intake during infancy on development of fluorosis, it is important to recognize that infant feeding practices have changed greatly during the past 30 years. In the 1960s, most infants over 4 months of age were fed fresh cow's milk and intakes of F were therefore low. By the mid 1970s a trend toward more extended feeding of formula was evident and this trend has continued into the 1990s. Prolonged exposure to high intakes of fluoride during infancy is much more common now than in the past.     

西藏那曲藏族学生砖茶型氟牙症调查与分析

目的了解西藏那曲藏族学生氟牙症流行情况及发病因素。方法采用单纯随机抽样的方法，对12～17周岁的471名藏族学生进口腔检查和问卷调查，氟牙症按Dean分类法，采用SPSS for Windows11．5进行统计分析，饮用酥油茶与氟牙症的相关性分析用Mantel—Haenszel．X^2检验。结果氟牙症患病率为53．5％，氟牙症指数为1．09，属中度流行地区；饮用水源氟化物含量不高（0．03～0．34mg／L），当地常用茶叶的氟化物含量高于内地（t=3．445，P〈0．05），氟牙症的发生与饮用酥油茶呈高度正相关（X^2MH=9．865，P〈0．01；OR=2．065，P〈0．01）。结论7岁前长期大量食用酥油茶是当地藏族学生氟牙症流行的主要病因，即属于砖茶型氟牙症；建议调整饮食结构，改进茶叶品质，减少酥油茶摄入量，以降低氟牙症的患病率。