拉萨市世居藏族农村居民慢性肝胆疾病患病现状及危险因素

Prevalence and risk factors of chronic hepatobiliary diseases among rural native Tibetan dwellers in Lhasa

目的了解西藏拉萨市世居藏族农村居民慢性肝胆疾病患病现状及其危险因素,为采取相应的干预措施提供参考依据。方法采用分层随机抽样方法在拉萨市墨竹工卡县和林周县抽取的1 737名年龄≥18岁世居藏族农村居民进行问卷调查、体格检查、肝胆疾病B超检查和肝功能检测。结果拉萨地区世居藏族农村居民慢性肝胆疾病总患病率为22.3%,各类型肝胆疾病患病率由高到低依次为:胆囊炎(11.3%)、胆囊结石(6.2%)、脂肪肝(4.5%)、肝包虫病(1.9%)、肝血管瘤(1.6%)、肝硬化(0.8%);多因素非条件logistic回归分析结果显示,女性、年龄≥45岁、月平均收入>2 000元、超重、肥胖、中心性肥胖和谷丙转氨酶(ALT)升高是拉萨地区世居藏族农村居民慢性肝胆疾病患病的危险因素。结论拉萨地区世居藏族农村居民慢性肝胆疾病以胆囊炎为主,女性、年龄较大、月平均收入较高、体质指数(BMI)和ALT较高以及中心性肥胖居民是该地区慢性肝胆疾病防治的重点人群。

Objective To investigate the prevalence and risk factors of chronic hepatobiliary diseases among rural native Tibetan dwellers in Lhasa,Tibet and to provide evidences for making intervention strategies for the diseases. Methods A self-administrated questionnaire survey,physical examination,and type-B ultrasound and liver function test were conducted among 1 737 adult native Tibetans（ ≥18 years old） selected with stratified random sampling from rural areas of Mozhugongka and Linzhou county of Lhasa municipality. Results The overall prevalence of chronic hepatobiliary diseases among the dwellers was 22. 3%,with the prevalences of 11. 3% for cholecystitis,6. 2% for cholelithiasis,4. 5%for hepatic adipose infiltration,1. 9% for hepatic echinococcosis,1. 6% for hepatic hemangioma,and 0. 8% for cirrhosis,respectively. The main risk factors of the chronic hepatobiliary diseases were female gender,aged ≥45 years,with average monthly income of 〉2 000 yuan RMB,overweight,obesity,central obesity,and increased alanine transferase（ ALT）based on the results of multivariate unconditional logistic regression. Conclusion Cholecystitis is one of major chronic hepatobiliary diseases among rural native Tibetan dwellers in Lhasa and females,the elderly,the dwellers with higher average monthly income,body mass index,increased ALT,and central obesity are the key populations for the prevention and teatment of chronic hepatobiliary diseases in the areas.