2014年上海国际马拉松赛：参赛者的就诊情况与危险因素

2014 Shanghai International Marathon: Visiting Medical Services and Risk Factors among Participants

[目的]了解2014年上海国际马拉松赛参赛者就诊情况,探索伤病发生的危险因素,提出针对性预防措施建议。[方法]记录马拉松比赛中就诊者的个人信息和就诊信息,分析就诊情况。将较重伤病就诊者（66人,1人不接受调查）作为病例组（65人）,每名病例按性别、年龄、参赛项目3个条件从参赛人群中随机选择2名对照匹配（130人）。电话调查赛前训练情况、比赛着装、以往参赛情况、身体状况等方面危险因素,计算就诊率、优势比,并利用logistic回归分析伤病影响因素。[结果]本次赛事共34 352人参加,就诊率5.5%,医院转运率1.5/104,无死亡。66名较重伤病就诊者中,重伤就诊率1.9‰;最高为30岁以下年龄组（2.6‰）和参加半程马拉松项目的男性（5.0‰）。开赛后第2—3小时发病/受伤人数最多（38人,57.6%）,下肢肌肉骨骼损伤和外伤是参赛者就诊的主要原因。多因素logistic回归分析发现每周长跑天数增加（OR=2.187;95%CI：1.262-3.791）、比赛时穿着旧的运动鞋（OR=16.758;95%CI：3.054-91.968）是发生伤病的危险因素;而在训练计划中设置配速跑（OR=0.046,95%CI：0.007-0.315）和耐力跑（OR=0.181,95%CI：0.046-0.714）、运动鞋穿着时间增加（OR=0.875,95%CI：0.792-0.967）是保护因素。[结论]马拉松赛事中应加强后半程医疗力量的配置。开展赛前训练、相关装备合理配置方面的健康宣教能减少马拉松比赛中伤病的发生。

[ Objective ] To describe the visiting medical services occurred and associated risk factors among participants of 2014 Shanghai International Marathon, and to put forward preventive suggestions. [ Methods ] Personal details and medical information of each runner visiting official medical stations were recorded and analyzed. Patients with severe injuries/illnesses （n=66, one runner refused investigation） were involved in the case group （n=65）, and each case was matched by age, gender, and race distance with two controls （n=130） selected on random. Cases and controls were investigated on pre-marathon training, running apparel and shoes, race experience, and physical conditions through telephone. The patient presentation rate （PPR） and OR value were calculated. The injury related impact factors were assessed using logistic regression models. [ Results ] Totally 34 352 runners participated in 2014 Shanghai International Marathon. The PPR was 5.5%, the higherqevel medical facility transferring rate was 1.5/10^4, and no fatality was reported. Among the 66 severe patients, the PPR of severe injure was 1.9‰, and the highest PPRs were found in the group of below 30 years old （2.6‰） and the males who ran half-marathon （5.0‰）. Most injuries/illnesses were acquired 2-3 h after the marathon started （38 cases, 57.6%）. Musculoskeletal injuries and trauma in lower limbs were the major causes for seeing a doctor. Multivariable logistic regression analysis indicated that increasing weekly running distance （OR=2.187, 95%CI： 1.262-3.791） and wearing used shoes （OR=16.758, 95%CI： 3.054-91.968） were risk factors; tempo run （OR=0.046, 95%CI： 0.007-0.315） and endurance run （OR=0.181, 95%CI： 0.046-0.714） which were included in the training program and longer shoes wearing time （OR=0.875, 95%CI： 0.792-0.967） were protective factors. [ Conclusion ] The medical resource at the second half of marathon needs strengthening. Pre-match training and health education on sports apparel could reduce the occurrence of injuries and illnesses during marathons.