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目的:探讨改水后儿童氟斑牙患病情况和儿童体内化学元素的关系。方法:采用分层抽样调查方法，根据西安市疾病预防控制中心近20年的监测资料，将西安市饮水型地方性氟中毒病区按照改水年限1 ~ 、5 ~ 、10 ~及≥15年进行分层，每层抽取2个病区自然村为调查点。每个调查点选择7 ~ 13岁学龄期儿童为调查对象，检查氟斑牙患病情况；并采集血样，检测血清中14种化学元素（钙、铁、镁、铜、锌、碘、硒、铅、砷、镉、铬、氟、汞、镍）含量。分析不同改水年限以及不同氟斑牙患病情况儿童体内化学元素含量的差异。结果:不同改水年限的病区村（1 ~、5 ~、10 ~及≥15年）儿童氟斑牙检出率分别为51.40%（55/107）、16.92%（11/65）、16.67%（17/102）和5.08%（6/118），差异有统计学意义（χn 2 = 74.444，n P < 0.05）。不同改水年限儿童体内血清钙、铜、铁、镁、锌、碘、硒、铅、砷、铬、氟、镍含量比较，差异均有统计学意义（ n P均< 0.05）。氟斑牙儿童体内铁、锌、镍含量均低于正常儿童（n P均< 0.05），氟斑牙儿童体内氟含量高于正常儿童（n P 0.05）。n 结论:改水年限≥15年的病区村儿童氟斑牙检出率最低，改水降氟可减少儿童氟斑牙检出率。病区儿童存在部分化学元素缺乏的问题。“,”Objective:To explore the relationship between dental fluorosis and serum chemical elements in children after water modification.Methods:Using the method of stratified sampling, according to the monitoring data of the Xi'an Center for Disease Control and Prevention in the past 20 years, the drinking-water-borne fluorosis areas in Xi'an City were changed according to the water-improvement period of 1-, 5-, 10- and ≥15 years, and 2 villages in each layer were selected as the survey sites. Each survey site selected school-age children aged 7 to 13 years old as the survey subjects to detect the prevalence of dental fluorosis; and blood samples were collected to detect 14 chemical elements contents in the serum [calcium (Ca), iron (Fe), magnesium (Mg), copper (Cu), zinc (Zn), iodine (I), selenium (Se), lead (Pb), arsenic (As), cadmium (Cd), chromium (Cr), fluorine (F), mercury (Hg), nickel (Ni)]. The differences of chemical element contents in children with different water improvement years and different dental fluorosis conditions were analyzed.Results:The prevalence of dental fluorosis of children were 51.40% (55/107), 16.92% (11/65), 16.67% (17/102) and 5.08% (6/118) in the villages with different water improvement period, the difference was statistically significant (χn 2 = 74.444, n P < 0.05). Serum levels of Ca, Fe, Mg, Cu, Zn, I, Se, Pb, As, Cr, F and Ni in children of different water improvement period were compared, the difference were statistically significant ( n P < 0.05). Levels of Fe, Zn and Ni in dental fluorosis patients were lower than those in normal children ( n P < 0.05), and the serum fluoride level was higher than that of normal children ( n P 0.05).n Conclusions:The detection rate of dental fluorosis in children in ward villages whose water has been improved for more than 15 years is the lowest, and the detection rate of children with dental fluorosis can be reduced by improving water to reduce fluoride. Children in the drinking-water-borne fluorosis areas are deficient in some trace element.