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目的:掌握内蒙古自治区饮水型地方性氟中毒病区的改水情况、水氟含量及病情变化趋势。方法:2009 - 2018年，连续10年在内蒙古自治区选择11个市（区、旗、县）的30个病区村（屯，以下简称村）作为固定监测点，调查改水工程运行情况和水氟含量；检查监测点内全部8 ~ 12岁儿童氟斑牙患病情况。结果:2009 - 2018年，监测病区村的改水率自2009年的70.00%（21/30）上升至2018年的86.67%（26/30），受益人口比例自82.94%（20 921/25 224）上升至96.84%（18 513/19 118）；改水工程正常运转率由85.71%（18/21）上升至95.65%（22/23），改水工程水氟合格率由61.90%（13/21）上升至82.61%（19/23）。改水村的水氟含量范围为1.00 ~ 1.44 mg/L，未改水村为2.15 ~ 2.69 mg/L，改水村各年水氟含量均低于未改水村（n P均< 0.05）。2009 - 2018年儿童氟斑牙总检出率为27.95%（2 610/9 339），氟斑牙指数为0.56，流行强度为边缘流行。不同年份间比较，儿童氟斑牙检出率差异有统计学意义（χn 2 = 484.195，n P < 0.05）；改水工程正常运转且水氟含量合格村、改水工程非正常运转或水氟含量超标村及未改水村儿童氟斑牙检出率差异有统计学意义（χ n 2 = 210.73、143.60、22.67，n P均< 0.01）。不同改水情况间比较，改水工程正常运转且水氟含量合格村各年儿童氟斑牙检出率均低于改水工程非正常运转或水氟含量超标村及未改水村（n P均< 0.05）。n 结论:内蒙古自治区改水降氟取得了明显的效果，但依然存在一些水氟超标严重的改水工程和未改水的病区村，氟中毒病情尚未得到全面控制，仍需进一步加强辖内改水及改水后的管护工作。“,”Objective:To master the operating situation of water-improvement, water fluoride content and the disease trends in drinking-water-borne endemic fluorosis areas in Inner Mongolia Autonomous Region.Methods:From 2009 to 2018, 30 diseased villages (Tun, hereinafter referred to as village) in 11 cities (districts, banners and counties) were selected as fixed monitoring sites in Inner Mongolia Autonomous Region for 10 consecutive years to investigate the operation status of the water-improvement project and water fluoride content; the prevalence of dental fluorosis in all children aged 8 to 12 in the monitoring sites were checked.Results:From 2009 to 2018, the water-improving rate of monitoring villages increased from 70.00% (21/30) in 2009 to 86.67% (26/30) in 2018, the ratio of beneficiary population raised from 82.94% (20 921/25 224) to 96.84% (18 513/19 118); the normal operation rate of water-improvement project increased from 85.71% (18/21) to 95.65% (22/23), and the water fluoride qualification rate of the water-improvement project increased from 61.90% (13/21) to 82.61% (19/23). The water fluoride content of the village with water-improvement project was 1.00 - 1.44 mg/L, and that of the village without water-improvement project was 2.15 - 2.69 mg/L. The water fluoride content of the village with water-improvement project was lower than that of the village without water-improvement project in each year (n P < 0.05). From 2009 to 2018, the total detection rate of dental fluorosis was 27.95% (2 610/9 339), the community fluorosis index was 0.56, and the epidemic intensity was marginal. There was significant difference in the detection rate of children's dental fluorosis between different years (χ n 2 = 484.195, n P < 0.05). There were statistically significant differences in the detection rate of dental fluorosis of villages with normal operation of water-improvement project and qualified water fluoride, villages with abnormal operation of water-improvement project or excessive water fluoride content, and villages without water-improvement (χ n 2 = 210.73, 143.60, 22.67, n P < 0.01). The results showed that the detection rate of children's dental fluorosis in the villages with normal operation of water-improvement project and qualified water fluoride content was lower than that in the villages with abnormal operation of water-improvement project or excessive water fluoride content and the villages without water- improvement ( n P < 0.05).n Conclusions:The improvement of water quality and the reduction of fluoride in Inner Mongolia Autonomous Region have achieved remarkable results, but there are still some water-improvement projects and villages with serious water fluoride exceeding the standard. The fluorosis has not been fully controlled, and it is still necessary to further strengthen the work of water-improvement, and the management and protection after water-improvement.