目的掌握甘肃省不同生态类型区饮水型地方性氟中毒病情现状,为制定防治策略提供科学依据。方法根据地形地貌、气象气候与水资源状况等,将病区划分为不同的生态类型,在每个生态类型区抽取病区村,用Dean氏法对调查村所有8～12岁儿童进行氟斑牙检查;根据地方性氟骨症临床诊断标准(WS192-2001),检查并诊断30岁以上成人的临床氟骨症,对诊断的患者进行X线氟骨症检查;采用离子选择电极法测定儿童及成人的尿氟含量。结果 8～12岁儿童氟斑牙检出率河西走廊戈壁区<陇南秦岭山区<黄土高原丘陵区<荒漠区<黄土高原沟壑区,氟斑牙流行强度黄土高原沟壑区、荒漠区中等流行,黄土高原丘陵区轻微流行,陇南秦岭山区是边缘,河西走廊戈壁区阴性;30岁以上成人临床氟骨症检出率陇南秦岭山区<荒漠区<黄土高原丘陵区<黄土高原沟壑区<河西走廊戈壁区;氟骨症X线检出率结果显示,陇南秦岭山区和荒漠区未检出阳性患者,黄土高原丘陵区<河西走廊戈壁区<黄土高原沟壑区;儿童尿氟几何均值黄土高原丘陵区,大于正常参考值,余各生态区几何均值均在1.5 mg/L以下;成人尿氟含量几何均值除黄土高原沟壑区大于1.5 mg/L,其余均小于1.5 mg/L。结论随着改水降氟工程的实施,甘肃省饮水型地方性氟中毒病情明显减轻,改水降氟措施发挥了明显的防病作用,各个生态区病情不同,应针对不同生态区因地制宜采取不同的防治措施。 Objective To understand the status quo of drinking water endemic fluorosis in different ecotypes of Gansu Province and to provide a scientific basis for making prevention and cure strategies. Methods According to the topography, meteorological climate and water resources, the wards were divided into different ecological types. The ward villages were drawn from each ecotype area. All the children aged 8 to 12 years were surveyed by Dean’s method for fluoride spots Tooth examination; according to the clinical diagnostic criteria of endemic fluorosis (WS192-2001), to check and diagnose clinical skeletal fluorosis in adults over the age of 30, the diagnosis of patients with X-ray fluorosis; ion-selective electrode method for the determination of children And urinary fluoride in adults. Results The detection rate of dental fluorosis in children aged 8 ~ 12 years was in Gobi area of ​​Hexi Corridor