婴儿期不同喂养方式与儿童龋病关系的探讨
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摘要
龋病是被世界卫生组织(WHO)列为继癌症、心血管疾病之后的第三大慢性非传染性疾病，其患病率高，危害范围广，它的发生、发展直接影响儿童的牙、颌、面的发育、功能及美观，其造成的疼痛症状还严重地影响生活、学习和精神活动。因此致力于寻找其发病原因，并采用有效的措施进行预防，一直是龋病研究的热点。
母乳喂养被公认是婴儿的最佳喂养方式，这是因为母乳是婴儿最理想的天然食品，含有婴儿生长发育中必不可少的各种营养成分，而人工喂养不利于小儿的消化吸收，且牛乳还易受细菌的污染。国外有研究报道母乳喂养的婴儿其口腔疾病的发生较人工喂养的小儿少。而奶瓶喂养所致的奶瓶龋在儿童口腔疾病中占有很高的比例。本课题通过实验室研究及流行病调查，探讨婴儿期不同喂养方式对儿童龋病发生、发展的影响。其意义在于对指导幼儿喂养方式的选择与宣教，提供理论性资料。对降低我国儿童患龋率，提高我国儿童口腔保健水平，发挥更大的社会效益。
武汉大学同等学力人员申请硕士学位论文
研究目的
本课题旨在探讨不同喂养方式(母乳、人工)与儿童龋病的发生、
发展的关系，以期能对儿童龋齿的早期预防提供理论性资料。
研究方法
1.以问卷形式调查湖北省武汉市及周边郊县幼儿园1603名3一5岁
儿童婴儿期喂养方式，井检查其口腔患龋情况，分析两种不同喂养方式
的儿童患龋情况。
2.随机选择2~3岁幼儿40名，按婴儿期的喂养方式不同(母乳，
人工)分为两组。采用吐唾法收集幼儿口腔唾液，采用酶联免疫吸附法
(ELIsA)分析唾液中特异性抗变形链球菌IgA、IgM、IgG抗体水平。
3.收集40名2~3岁母乳喂养、人工喂养的幼儿唾液，采用氟离子
选择电极和电感祸合等离子体发射光谱仪对比分析其微量元素水平Ca、
F、zn、Fe、Mg、Cu、K、Na等。
4.随机抽样调查湖北省汉川县幼儿园2一4岁儿童426名，仔细检
查并记录口腔患龋情况，问卷调查其婴儿期喂养方式，持续时间，母亲
教育水平和家庭收入情况。采用Logistic回归分析法探讨影响儿童龋病
发病的危险因素。
结果
1.湖北省城乡两地婴儿期不同喂养方式1603名儿童的龋病情况调
查结果显示:无论城市或乡村母乳喂养儿童的龋患率均显著较人工喂养
儿童的龋患率低(P<0.05)。
2.采用ELISA方法检测两组幼儿口腔唾液特异性抗变链抗体水平，
发现母乳喂养组的幼儿其抗s.M Ingbritt的s一IgA水平显著高于人工喂养
组(P< 0.05)，而IgG，IgM则无明显差异(P>.05)。
武汉大学同等学力人员申请硕士学位论文
3.用氟离子选择电极和电感祸合等离子体发射光谱仪对40名不同
喂养方式幼儿口腔唾液中8种微量元素的含量进行定量分析，经统计学
处理发现母乳喂养组和人工喂养组之间F，Ca，Zn，Cu，4种微量元素差
异有显著性印<0.05)。F， Cu，Zn母乳喂养组高于人工喂养组，而Ca母乳
喂养组低于人工喂养组。
4.对喂养龋的调查结果表明:母乳喂养组患龋率显著低于人工喂养
组(p<0.05)。喂养龋与喂养方式相关(oR值为 5.27)。而儿童患龋水平
与社会经济状况的两因素即母亲教育水平和家庭经济收入无统计学意
义。
结论
通过对40名幼儿口腔中抗体水平和微量元素的检测以及流行病学
的调查分析，结论为:母乳喂养的幼儿唾液中抗s.M high血的s一地A水
平较人工喂养的幼儿高;防龋元素F，Cu，Zn水平前者较高。母乳喂养
的儿童患龋率较人工喂养的儿童低。提示婴儿期母乳喂养对儿童龋病有
一定的预防作用。
Objective: The aim of this study was to assess the relationship between caries prevalence and feeding patterns in 2-5 year old children in Hubei province.
Materials and Methods: 1603 children aged 3-5 year old from kindergarten of urban and suburb in Wuhan city were clinically examined according to the WHO oral survey methods. The feeding patterns of these children in infants were collected by a very short questionnairs which were given to the mothers.
40 children aged 2-3 year old were randomly assigned to breast feeding group and nursing-bottle feeding group according to the difference of feeding patterns. Saliva of children were collected by methods of spitting saliva. The levels of anti-S.mutans Ingbritt S-IgA, IgM and IgG in saliva were analysised by ELISA. The Flouride electrode and ICP-AES were used to detect the levels of 8 trace elements (Ca, F, Zn, Fe, Mg, Cu, K,Na).
426 children aged 2-4 year old were randomly selected from kindergartens in one suburban area of the city of Hanchuan in Hubei
Province. Dental caries of these children were checked and recorded. A form included question about infant feeding, duration of breast-feeding, and about the level of parental education and family income. Parents, of all children examined, completed the questionnaire form. The influence of risk factors on development of dental caries was assessed by Logistic regression.
Results: The results from 1603 children showed that caries prevalence of primary teeth in nursing-bottle feeding group(73.22%) were higher than those in breast feeding group(37.21%), whether in city or in suburban.
The levels of anti-S.mutans Ingbritt S-IgA in breast feeding group were higher than those in nursing-bottle feeding group (p<0.05), but those of IgG and IgM were not significant difference in both groups (p>0.05).
The levels of F, Ca, Zn and Cu in saliva of children were significant difference between breast feeding group and nursing-bottle feeding group. The levels of F , Zn and Cu in breast feeding group were higher than those in nursing-bottle feeding group, contrary to the levels of Ca.
Children who had been wholly bottle-fed had 5 times the risk of having rampant caries compared to children who were breast-fed, there was no statistically signficant relationship between level of mothers' education or family income with caries prevalence and patterns of disease.
ConcIusions:Caries prevalence of children of breast feeding were lower than those of nursing-bottle feeding. The levels of anti-S.mutans Ingbritt S-IgA and F in children of breast feeding were higher than those in nursing-bottle feeding. These suggested that breast feeding in infants had certain preventive effects on dental caries of children.
母乳喂养被公认是婴儿的最佳喂养方式，这是因为母乳是婴儿最理想的天然食品，含有婴儿生长发育中必不可少的各种营养成分，而人工喂养不利于小儿的消化吸收，且牛乳还易受细菌的污染。国外有研究报道母乳喂养的婴儿其口腔疾病的发生较人工喂养的小儿少。而奶瓶喂养所致的奶瓶龋在儿童口腔疾病中占有很高的比例。本课题通过实验室研究及流行病调查，探讨婴儿期不同喂养方式对儿童龋病发生、发展的影响。其意义在于对指导幼儿喂养方式的选择与宣教，提供理论性资料。对降低我国儿童患龋率，提高我国儿童口腔保健水平，发挥更大的社会效益。
武汉大学同等学力人员申请硕士学位论文
研究目的
本课题旨在探讨不同喂养方式(母乳、人工)与儿童龋病的发生、
发展的关系，以期能对儿童龋齿的早期预防提供理论性资料。
研究方法
1.以问卷形式调查湖北省武汉市及周边郊县幼儿园1603名3一5岁
儿童婴儿期喂养方式，井检查其口腔患龋情况，分析两种不同喂养方式
的儿童患龋情况。
2.随机选择2~3岁幼儿40名，按婴儿期的喂养方式不同(母乳，
人工)分为两组。采用吐唾法收集幼儿口腔唾液，采用酶联免疫吸附法
(ELIsA)分析唾液中特异性抗变形链球菌IgA、IgM、IgG抗体水平。
3.收集40名2~3岁母乳喂养、人工喂养的幼儿唾液，采用氟离子
选择电极和电感祸合等离子体发射光谱仪对比分析其微量元素水平Ca、
F、zn、Fe、Mg、Cu、K、Na等。
4.随机抽样调查湖北省汉川县幼儿园2一4岁儿童426名，仔细检
查并记录口腔患龋情况，问卷调查其婴儿期喂养方式，持续时间，母亲
教育水平和家庭收入情况。采用Logistic回归分析法探讨影响儿童龋病
发病的危险因素。
结果
1.湖北省城乡两地婴儿期不同喂养方式1603名儿童的龋病情况调
查结果显示:无论城市或乡村母乳喂养儿童的龋患率均显著较人工喂养
儿童的龋患率低(P<0.05)。
2.采用ELISA方法检测两组幼儿口腔唾液特异性抗变链抗体水平，
发现母乳喂养组的幼儿其抗s.M Ingbritt的s一IgA水平显著高于人工喂养
组(P< 0.05)，而IgG，IgM则无明显差异(P>.05)。
武汉大学同等学力人员申请硕士学位论文
3.用氟离子选择电极和电感祸合等离子体发射光谱仪对40名不同
喂养方式幼儿口腔唾液中8种微量元素的含量进行定量分析，经统计学
处理发现母乳喂养组和人工喂养组之间F，Ca，Zn，Cu，4种微量元素差
异有显著性印<0.05)。F， Cu，Zn母乳喂养组高于人工喂养组，而Ca母乳
喂养组低于人工喂养组。
4.对喂养龋的调查结果表明:母乳喂养组患龋率显著低于人工喂养
组(p<0.05)。喂养龋与喂养方式相关(oR值为 5.27)。而儿童患龋水平
与社会经济状况的两因素即母亲教育水平和家庭经济收入无统计学意
义。
结论
通过对40名幼儿口腔中抗体水平和微量元素的检测以及流行病学
的调查分析，结论为:母乳喂养的幼儿唾液中抗s.M high血的s一地A水
平较人工喂养的幼儿高;防龋元素F，Cu，Zn水平前者较高。母乳喂养
的儿童患龋率较人工喂养的儿童低。提示婴儿期母乳喂养对儿童龋病有
一定的预防作用。
Objective: The aim of this study was to assess the relationship between caries prevalence and feeding patterns in 2-5 year old children in Hubei province.
Materials and Methods: 1603 children aged 3-5 year old from kindergarten of urban and suburb in Wuhan city were clinically examined according to the WHO oral survey methods. The feeding patterns of these children in infants were collected by a very short questionnairs which were given to the mothers.
40 children aged 2-3 year old were randomly assigned to breast feeding group and nursing-bottle feeding group according to the difference of feeding patterns. Saliva of children were collected by methods of spitting saliva. The levels of anti-S.mutans Ingbritt S-IgA, IgM and IgG in saliva were analysised by ELISA. The Flouride electrode and ICP-AES were used to detect the levels of 8 trace elements (Ca, F, Zn, Fe, Mg, Cu, K,Na).
426 children aged 2-4 year old were randomly selected from kindergartens in one suburban area of the city of Hanchuan in Hubei
Province. Dental caries of these children were checked and recorded. A form included question about infant feeding, duration of breast-feeding, and about the level of parental education and family income. Parents, of all children examined, completed the questionnaire form. The influence of risk factors on development of dental caries was assessed by Logistic regression.
Results: The results from 1603 children showed that caries prevalence of primary teeth in nursing-bottle feeding group(73.22%) were higher than those in breast feeding group(37.21%), whether in city or in suburban.
The levels of anti-S.mutans Ingbritt S-IgA in breast feeding group were higher than those in nursing-bottle feeding group (p<0.05), but those of IgG and IgM were not significant difference in both groups (p>0.05).
The levels of F, Ca, Zn and Cu in saliva of children were significant difference between breast feeding group and nursing-bottle feeding group. The levels of F , Zn and Cu in breast feeding group were higher than those in nursing-bottle feeding group, contrary to the levels of Ca.
Children who had been wholly bottle-fed had 5 times the risk of having rampant caries compared to children who were breast-fed, there was no statistically signficant relationship between level of mothers' education or family income with caries prevalence and patterns of disease.
ConcIusions:Caries prevalence of children of breast feeding were lower than those of nursing-bottle feeding. The levels of anti-S.mutans Ingbritt S-IgA and F in children of breast feeding were higher than those in nursing-bottle feeding. These suggested that breast feeding in infants had certain preventive effects on dental caries of children.
引文
1 母乳与母爱—中日专家谈，石油工业出版社，1994
2 Sayegh A, Dini EL, Holt RD, Bedi R. Caries prevalence and patterns and their relationship to social class, infant feeding and oral hygiene in 4-5-year-old children in Amman, Jordan. Community Dent Health, 2002,19 (3): 144-51
3 Valaitis R, Hesch R, Passarelli C, Sheehan D, Simon J. A systenmatic review of the relationship between brestfeeding and early childhood caries. Can J Public Health, 2000, 91 (6): 411-7
4 赵淑霞，韩学臻．婴儿期的喂养方式对学龄前期龋病的影响．中国妇幼保健，1992，7(4)：43
5 第二次全国口腔健康流行病学抽样调查．北京：人民卫生出版社，1999，132
2 Sayegh A, Dini EL, Holt RD, Bedi R. Caries prevalence and patterns and their relationship to social class, infant feeding and oral hygiene in 4-5-year-old children in Amman, Jordan. Community Dent Health, 2002,19 (3): 144-51
3 Valaitis R, Hesch R, Passarelli C, Sheehan D, Simon J. A systenmatic review of the relationship between brestfeeding and early childhood caries. Can J Public Health, 2000, 91 (6): 411-7
4 赵淑霞，韩学臻．婴儿期的喂养方式对学龄前期龋病的影响．中国妇幼保健，1992，7(4)：43
5 第二次全国口腔健康流行病学抽样调查．北京：人民卫生出版社，1999，132