西藏察雅县2022年幼儿园藏族儿童乳牙龋与营养状况的相关性

郭蕾; 唐本玉; 施欣; 李颖; 尼玛; 朱顺叶

doi:10.16835/j.cnki.1000-9817.2023.08.027

西藏察雅县2022年幼儿园藏族儿童乳牙龋与营养状况的相关性

doi: 10.16835/j.cnki.1000-9817.2023.08.027

郭蕾¹,
唐本玉¹,
施欣¹,
李颖²,
尼玛³,
朱顺叶^1, ,

1.
中山大学附属第三医院儿科，广东广州 510630
2.
察雅县人民医院口腔科
3.
察雅县人民医院妇幼科

详细信息

作者简介:
郭蕾(1982-)，女，河南焦作人，硕士，主治医师，主要研究方向为儿童生长发育

通讯作者:
朱顺叶，E-mail：zhushuny@mail.sysu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R788⁺¹ R153.2 R556
计量
- 文章访问数: 197
- HTML全文浏览量: 165
- PDF下载量: 19
- 被引次数: 0
出版历程
- 收稿日期: 2023-01-19
- 修回日期: 2023-04-07
- 网络出版日期: 2023-08-26
- 刊出日期: 2023-08-25

Investigation of the prevalence of deciduous teeth caries and its correlation with nutritional status among kindergarten children in Zhag'yab of Tibet in 2022

GUO Lei¹,
TANG Benyu¹,
SHI Xin¹,
LI Ying²,
NIMA³,
ZHU Shunye^{1
, ,}

1.
Department of Pediatrics, Dediatrics Department, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou(510630), China

摘要

摘要: 目的了解西藏察雅县幼儿园藏族儿童的口腔健康状况及乳牙龋病对营养状况的影响，为当地儿童龋病防治工作提供参考依据。方法 2022年6—7月采用横断面调查方法，对西藏察雅县13个乡镇所有3~7岁幼儿园藏族儿童1 263名进行口腔检查以及身高、体重测量和血红蛋白检测。依据WHO龋病、营养不良及贫血诊断标准，评价儿童乳牙健康情况，探讨乳牙龋病与营养状况的相关性。结果察雅县幼儿园藏族儿童乳牙患龋率为62.6%，龋均(4.0±4.6)。3，4，5，6，7岁儿童乳牙患龋率分别为31.1%，55.3%，63.8%，70.9%，76.6%，龋均分别为(1.1±2.0)(2.9±3.4)(3.5±3.3)(5.4±5.4)(5.9±6.6)，年龄间差异均有统计学意义(χ²/F值分别为72.17，33.47，P值均 < 0.05)。有龋儿童营养不良总体检出率(25.4%)、生长迟缓率(12.3%)、低体重率(12.6%)、消瘦率(10.9%)及贫血率(29.6%)均高于无龋儿童(19.5%，8.1%，6.1%，6.6%，15.5%)，差异均有统计学意义(χ²值分别为5.81，5.49，13.61，6.52，32.02，P值均 < 0.05)，有龋儿童超重率(3.7%)高于无龋儿童(3.4%)，肥胖率(1.3%)低于无龋儿童(1.9%)，差异均无统计学意义(χ²值分别为0.07，0.82，P值均>0.05)。结论察雅县幼儿园儿童乳牙龋病问题较为严重，且与营养不良及贫血的发生密切相关。应加强对当地儿童龋病的预防和干预。
- 龋齿 /
- 营养状况 /
- 方差分析 /
- 儿童，学龄前 /
- 少数民族
Abstract: Objective To investigate the health of deciduous teeth and the effect of deciduous teeth caries on the nutritional status of Tibetan children in kindergartens in Zhag'yab of Tibet, so as to provide a reference for the prevention and treatment of dental caries in local children. Methods A cross-sectional survey was conducted among all Tibetan children aged 3 to 7 years in kindergartens from 13 districts in Zhag'yab of Tibet, a total of 1 263 eligible children were included. Oral examination, height, weight measurement and hemoglobin test were performed. The health status of children was evaluated according to WHO diagnostic criteria of dental caries rate, average of decayed-missing-filled tooth(DMFT), malnutrition and anemia, and the correlation between deciduous teeth caries and nutritional status of children were analyzed. Results The overall deciduous teeth caries prevalence rate of Tibetan children in Zhag'yab kindergarten was 62.6%, and the mean dmft was (4.0±4.6). Aged 3, 4, 5, 6, 7-year-old children's deciduous teeth caries rate were 31.1%, 55.3%, 63.8%, 70.9%, 76.6%, respectively, mean dmft were (1.1±2.0) (2.9±3.4) (3.5±3.3) (5.4±5.4) (5.9±6.6) respectively. The prevalence of deciduous teeth caries and mean dmft increased with age, and the differences among age groups were statistically significant (χ²/F=72.17, 33.47, P < 0.05). The overall detection rate of malnutrition(25.4%), stunting(12.3%), underweight(12.6%), wasting(10.9%) and anemia(29.6%) in caries children were higher than those in children without caries(19.5%, 8.1%, 6.1%, 6.6%, 15.5%), the differences were statistically significant (χ²=5.81, 5.49, 13.61, 6.52, 32.02, P < 0.05). Caries children's overweight rate (3.7%) was higher than that of children without caries (3.4%), obesity rate (1.3%) was lower than that of children without caries(1.9%), there was no statistically significant difference (χ²=0.07, 0.82, P>0.05). Conclusion The problem of deciduous teeth caries in kindergartens in Zhag'yab is serious, and it is closely related to the occurrence of malnutrition and anemia. The prevention and intervention of dental caries in local children should be strengthened.
- Dental caries /
- Nutritional status /
- Analysis of variance /
- Child, preschool /
- Minority groups
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 察雅县不同人口统计学特征幼儿园藏族儿童乳牙患龋率比较

Table 1. Comparison of caries prevalence of primary teeth among Tibetan children with different demographics characteristics in kindergartens in Zhag' yab County

人口统计学指标		人数	患龋人数	χ²值	P值
年龄/岁	3	103	32(31.1)	72.17	< 0.01
	4	293	162(55.3)
	5	337	215(63.8)
	6	423	300(70.9)
	7	107	82(76.6)
性别	男	720	445(61.8)	0.49	0.49
	女	543	346(63.7)
地区	城市	443	269(60.7)	1.06	0.30
	农村	820	522(63.7)
注：()内数字为患龋率/%。

下载: 导出CSV

表 2 察雅县不同人口统计学特征幼儿园藏族儿童乳牙龋均比较(x±s)

Table 2. Comparison of caries prevalence in deciduous teeth among Tibetan children with different demographics characteristics in kindergartens in Zhag' yab County(x±s)

人口统计学指标		人数	龋均	t/F值	P值
年龄/岁	3	103	1.1±2.0	33.47	< 0.01
	4	293	2.9±3.4
	5	337	3.5±3.3
	6	423	5.4±5.4
	7	107	5.9±6.6
性别	男	720	3.8±4.4	1.79	0.07
	女	543	4.3±4.9
地区	城市	443	3.9±4.2	0.59	0.56
	农村	820	4.1±4.8

下载: 导出CSV

表 3 察雅县幼儿园乳牙有无患龋儿童营养评价指标及血红蛋白水平比较(x±s)

Table 3. Comparison of nutrition evaluation indexes and hemoglobin levels in children with and without deciduous teeth caries in Zhag' yab County(x±s)

有无患龋	人数	WAZ	HAZ	BAZ	WHZ	Hb/(g·L^-1)
有	791	-0.5±1.5	-0.4±1.4	-0.3±1.6	0.0±1.8	135.6±13.7
无	472	-0.2±1.3	-0.3±1.3	0.0±1.6	0.1±1.5	137.1±12.3
合计	1 263	-0.4±1.4	-0.3±1.3	-0.2±1.6	0.0±1.6	136.2±13.2
t值		3.48	1.59	3.13	0.28	1.99
P值		< 0.01	0.11	< 0.01	0.78	0.05

下载: 导出CSV

表 4 察雅县乳牙有无患龋儿童营养不良及贫血检出率比较

Table 4. Comparison of nutritional status and anemia of children with and without deciduous teeth caries in Zhag' yab County

有无患龋	人数	生长迟缓	低体重	消瘦	超重	肥胖	营养不良	贫血
有	791	97(12.3)	100(12.6)	86(10.9)	29(3.7)	10(1.3)	201(25.4)	234(29.6)
无	472	38(8.1)	29(6.1)	31(6.6)	16(3.4)	9(1.9)	92(19.5)	73(15.5)
合计	1 263	135(10.7)	129(10.2)	117(9.3)	45(3.6)	19(1.5)	293(23.2)	309(24.5)
χ²值		5.49	13.61	6.52	0.07	0.82	5.81	32.02
P值		0.02	< 0.01	0.01	0.80	0.36	0.02	< 0.01
注： ()内数字为检出率/%。

下载: 导出CSV

参考文献(24)

[1]	贾艳红, 谷丽紧. 北京市西城区2014—2018年5岁以下儿童营养监测结果分析[J]. 中国妇幼健康研究, 2019, 30(12): 1570-1573. https://www.cnki.com.cn/Article/CJFDTOTAL-SANE201912020.htm JIA Y H, GU L J. Nutrition status of children under 5 years old in Xicheng District, Beijing from 2014 to 2018[J]. Chin J Woman Child Health Res, 2019, 30(12): 1570-1573. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SANE201912020.htm
[2]	邓晓宇, 仁青色格, 霍媛媛, 等. 西藏自治区城区和牧区儿童患龋情况与相关因素分析[J]. 国际口腔医学杂志, 2020, 47(4): 383-390. https://www.cnki.com.cn/Article/CJFDTOTAL-GWKQ202004002.htm DENG X Y, RENQING S G, HUO Y Y, et al. Caries status and relevant factor analysis among children in urban and pasture areas of Tibet Autonomous Region[J]. Int J Stomatol, 2020, 47(4): 383-390. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GWKQ202004002.htm
[3]	柳键, 荣文笙. 口腔健康调查基本方法(翻译版)[M]. 5版. 北京: 人民卫生出版社, 2017. LIU J, RONG W S. Basic methods of oral health survey (translated edition)[M]. 5 edit. Beijing: People's Medical Publishing House, 2017. (in Chinese)
[4]	王卫平, 孙琨, 常立文. 儿科学[M]. 9版. 北京: 人民卫生出版社, 2018. WANG W P, SUN K, CHANG L W. Pediatrics[M]. 9 edit. Beijing: People's Medical Publishing House, 2018. (in Chinese)
[5]	杨祺, 张颖, 朱国伟, 等. 西藏萨迦县0~7岁藏族儿童营养状况调查分析[J]. 中国儿童保健杂志, 2016, 24(6): 638-641. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201606026.htm YANG Q, ZHANG Y, ZHU G W, et al. Survey on the nutrition status of Tibetan children aged under seven years in Sa'gya county[J]. Chin J Child Health Care, 2016, 24(6): 638-641. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201606026.htm
[6]	WHO. WHO child growth standards: methods and development[Z]. Geneva: WHO. 2006.
[7]	WHO. Growth reference data for 5-19 years[Z]. Geneva: WHO. 2007.
[8]	薛寒, 李珑, 陈军, 等. 西藏山南儿童入园体检944例分析[J]. 中国儿童保健杂志, 2021, 29(7): 798-801. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO202107027.htm XUE H, LI L, CHEN J, et al. Analysis of physical examination for entering kindergartens of 944 children in Shannan, Tibet[J]. Chin J Child Health Care, 2021, 29(7): 798-801. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO202107027.htm
[9]	冯希平. 中国居民口腔健康状况: 第四次中国口腔健康流行病学调查报告[C]//2018年中华口腔医学会第十八次口腔预防医学学术年会. 西安, 2018. FENG X P. Oral health status of Chinese residents: the fourth epidemiological survey of oral health in China[C]//The 18th annual conference of oral preventive medicine of Chinese Stomatological Association in 2018. Xi'an, 2018. (in Chinese)
[10]	李荣, 黄荣, 彭璐婷, 等. 龋病对儿童生长和营养状况影响的调查研究[J]. 南京医科大学学报(自然科学版), 2018, 38(11): 1625-1629. doi: 10.7655/NYDXBNS20181133 LI R, HUANG R, PENG L T, et al. Investigation on the effect of caries on the growth and nutritional status of children[J]. J Nanjing Med(Univ Nat Sci), 2018, 38(11): 1625-1629. (in Chinese) doi: 10.7655/NYDXBNS20181133
[11]	张金山. 广州市白云区城乡结合部7~8岁儿童乳磨牙龋病和恒牙萌出与生长发育的相关性研究[D]. 广州: 南方医科大学, 2017. ZHANG J S. Relationship between primary molars caries or permanent teeth eruption and body mass index among 7-8 year-old school children in Guangzhou Baiyun District suburban areas[D]. Guangzhou: Southern Medical University, 2017. (in Chinese)
[12]	DIMAISIP-NABUAB J, DUIJSTER D, BENZIAN H, et al. Nutritional status, dental caries and tooth eruption in children: a longitudinal study in Cambodia, Indonesia and Lao PDR[J]. BMC Pediatr, 2018, 18(1): 300. doi: 10.1186/s12887-018-1277-6
[13]	孟召学, 刘美岑, 曲雪琪, 等. 北京市通州区2~4岁入园体检儿童龋齿发生情况及影响因素分析[J]. 华南预防医学, 2020, 46(3): 223-226. https://www.cnki.com.cn/Article/CJFDTOTAL-GDWF202003006.htm MENG Z X, LIU M C, QU X Q, et al. Influencing factors of dental caries among children aged 2-4 years in Tongzhou District, Beijing[J]. South China J Prev Med, 2020, 46(3): 223-226. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GDWF202003006.htm
[14]	DELIMONT N M, CARLSON B N, NICKEL S. Dental caries are associated with anemia in pediatric patients: a systematic literature review[J]. J All Health, 2021, 50(1): 73-83.
[15]	FOLAYAN M O, EL TANTAWI M, SCHROTH R J, et al. Associations between early childhood caries, malnutrition and anemia: a global perspective[J]. BMC Nutr, 2020, 6: 16.
[16]	BAHDILA D, MARKOWITZ K, PAWAR S, et al. The effect of iron deficiency anemia on experimental dental caries in mice[J]. Arch Oral Biol, 2019, 105: 13-19.
[17]	高玮, 韩蕊, 马雷, 等. 青岛市718名学龄前儿童龋齿情况及其与贫血的相关性分析[J]. 精准医学杂志, 2019, 34(3): 259-264. https://www.cnki.com.cn/Article/CJFDTOTAL-SPAN201903019.htm GAO W, HAN R, MA L, et al. An analysis of the relationship between dental caries situation and anemia in 718 preschool children in Qingdao, China[J]. J Precis Med, 2019, 34(3): 259-264. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SPAN201903019.htm
[18]	丁玲辉. 浅谈影响西藏青少儿生长发育的因素[J]. 西藏科技, 2000(1): 16-20. https://www.cnki.com.cn/Article/CJFDTOTAL-XZKJ200001005.htm DING L H. On the factors affecting the growth and development of young children in Tibet[J]. Tibet Sci Technol J, 2000(1): 16-20. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XZKJ200001005.htm
[19]	DANG S, YAN H, YAMAMOTO S. High altitude and early childhood growth retardation: new evidence from Tibet[J]. Eur J Clin Nutr, 2008, 62(3): 342-348.
[20]	索朗曲珍, 李亚杰, 罗央措, 等. 西藏婴幼儿生长迟缓和低体重与海拔的关联: 基于倾向性评分匹配分析[J]. 中华疾病控制杂志, 2022, 26(9): 1043-1049. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ202209010.htm SUOLANG Q Z, LI Y J, LUO Y C, et al. The relationship between stunting and underweight of infants with altitude in Tibet: based on propensity score matching method[J]. Chin J Dis Control Prev, 2022, 26(9): 1043-1049. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ202209010.htm
[21]	党少农, 颜虹, 王学良, 等. 西藏地区3岁以下儿童辅食添加状况调查[J]. 中华流行病学杂志, 2003, 24(8): 30-33. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHLX200308011.htm DANG S N, YAN H, WANG X L, et al. The introduction of complementary food of children under the age of three years in Tibet of China[J]. Chin J Epidemiol, 2003, 24(8): 30-33. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZHLX200308011.htm
[22]	ARGNANI L, COGO A, GUALDI-RUSSO E. Growth and nutritional status of Tibetan children at high altitude[J]. Coll Antropol, 2008, 32(3): 807-812.
[23]	LEVIN A, SOKAL-GUTIERREZ K, HARGRAVE A, et al. Maintaining traditions: a qualitative study of early childhood caries risk and protective factors in an indigenous community[J]. Int J Environ Res Public Health, 2017, 14(8): 907-918.
[24]	DABAWALA S, SUPRABHA B S, SHENOY R, et al. Parenting style and oral health practices in early childhood caries: a case-control study[J]. Int J Paediatr Dent, 2017, 27(2): 135-144.