甘肃省大骨节病患病情况与生态环境影响因素的关系

Relationship between prevalence of Kashin-Beck disease and ecological environment in Gansu Province

目的探索大骨节病x线患病情况与生态环境影响因素之间的关系。方法收集2012—2014年甘肃省37个大骨节病病区县生态环境资料和大骨节病防控措施落实情况，包括海拔、温度、降雨量、蒸发量、无霜期、年日照时数、人口密度、人均收入、主食购入比例、退耕还林还草占原耕地比例、改种经济作物占原耕地比例．以及7～12岁儿童大骨节病X线检出情况。采用四分位数回归方法（将与大骨节病有关的11个生态环境影响因素引入四分位数回归模型），估计生态环境影响因素对大骨节病x线检出率三个分位数点的效应。结果大骨节病X线检出率与海拔、温度、蒸发量、人口密度、人均收入、改种经济作物占原耕地比例6个因素无关，与降雨量、无霜期、年日照时数、主食购入比例、退耕还林还草占原耕地比例5个因素有关。无论在任何分位数点．降雨量越高（估量值：0．0033～0．0064）、无霜期越长（估量值：0．0292～0．0438）、年日照时数越长（估量值：0．0016～0．0018）、主食购人比例越高（估量值：0．0197～0．0276），大骨节病X线检出风险越高；退耕还林还草占原耕地比例越高（估量值：-0．0372--0．0133），大骨节病x线检出风险越低。结论甘肃省大骨节病患病情况与当地的生态环境因素有着极为密切的关系。

Objective To explore the relationship between prevalence of Kashin-Beck disease （KBD） and ecological environment, and to broaden the perspective of KBD etiology. Methods In 37 counties of KBD areas in Gansu Province, information about the ecological environment and implementation situation of control measures （altitude, temperature, rainfall, evapo ration, frost free period, annual sunshine hours, population density, per capita income, the proportion of staple food, returning farmland to forest, to forestry and replant crops） and X-ray detection rate of KBD of 7-12-year-old children in 2012 - 2014 was collected. Using four quantile regression method, the regression model was introduced to analyze the 11 ecological factors which related to the pathogenesis of KBD. The effect of three points on X-ray detection rate of KBD was estimated. Results The X-ray detection rate of KBD was independent of altitude, temperature, evaporation, population density, per capita income and cash crops, and was dependent of rainfall, frost free period, annual sunshine hours, the staple food purchase ratio, and returning farmland to forest and grassland. No matter where in any place numbered, the higher rainfall （measure value： 0.003 3 to 0.006 4）, the longer frost free period （measure value： 0.029 2 to 0.043 8）, the longer annual sunshine hours （measure value： 0.001 6 to 0.001 8）, and the higher staple food purchase ratio （measure value： 0.019 7 to 0.027 6）, the higher risk of X-ray detection rate of KBD; the higher returning farmland to forest and to grassland, the lower risk of X-ray detection rate of KBD （measure value： - 0.037 2 to - 0.013 3）. Conclusion The X-ray detection rate of KBD is closely related to local ecological environment.