基于唾液s.mutans、s.sobrinus定量值的儿童龋病Logistic预测模型研究

A caries prediction model based on salivary S.mutans、S.sobrinus in preschool children.

目的:为了进一步了解儿童乳牙龋病活性与口腔变形链球菌和乳酸杆菌(s.mutans、s.sobrinus)数更精确的量化关系,尝试建立新的可行的基于唾液s.mutans、s.sobrinus定量值的儿童龋病Logistic预测模型。方法:建立s.mutans、s.sobrinus的定量检测方法-FQ PCR法,对203名3～5岁儿童进行龋病调查,同时采用FQ PCR方法检测其口腔唾液s.mutans、s.sobrinus数量。6个月后回访检查,根据调查结果建立儿童龋病Logistic回归分析模型,对儿童龋病危险性进行评估分析。结果:3～5岁儿童患龋率和s.mutans、s.sobrinus检出率都随年龄的增加而上升;龋病组和龋活跃组唾液s.mutans、s.sobrinus检出率、数量明显高于健康组和龋不活跃组;本实验选择相关性最好的3个指标(唾液s.mutans、s.sobrinus计数对数值、龋失补牙面数)建立的儿童龋病Logistic回归模型的特异性为92.78%,灵敏性为81.52%,总体正确率达89.24%,显示了很好的预测效果。结论:基于FQ PCR构建的儿童龋病预测模型,预测准确率、特异性、灵敏性均优于其它预测模型,显示了较好的临床实用性。

Objective：Mutans streptococci,especially s.mutans and s.sobrinus,were believed as the chief cariogenic bacteria in oral cavity,and it might be useful to quantify them in saliva for screening children in high caries risk.This study was designed to build a sensitive and effective prediction model in preschool children by quantitatively detecting the salivary s.mutans and s.sobrinus.Method： In the beginning of our investigation,the dental caries of 203 preschool children with the age from 3 to 5 years were examined and recorded,and 1 ml unstimulated whole saliva were acquired from each individual,then they were tested for s.mutans and s.sobrinus quantification by the FQ PCR methods established in the previous studies.6 months later,the children were reexamined for caries status.Then these data were analysis by Logistic Regression Analysis.Result：In the final Logistic prediction model,3 factors were chosen for their high relationship with future caries,they were saliva s.mutans counts,saliva s.sobrinus counts and past caries experiences（dmfs value）.The evaluation indexes for this caries prediction model were as follows： Se =81.52 %,Sp =92.78 % correct rate（π）= 89.24 %.Conclusions： the Logistic prediction model established in this study displayed a specific and sensitive property compared with the other prediction models,and this study make it possible to screen the high risk children in active caries more earlier.