新疆维吾尔自治区维吾尔族和哈萨克族及汉族女性胆囊结石的流行病学调查

Epidemiology of Cholecystolithiasis in Uygur,Kazakh and Han Women in the Xinjiang Uygur Autonomous Region

背景新疆维吾尔自治区胆囊结石患病率较高,我国女性胆囊结石患病率高于男性,但目前缺乏关于新疆维吾尔自治区女性胆囊结石患病率的研究。目的了解新疆维吾尔自治区维吾尔族、哈萨克族、汉族女性胆囊结石患病率及其影响因素,为其胆囊结石预防及治疗提供依据。方法 2011年6-9月采用典型抽样再多阶段分层随机抽样的方法选取新疆维吾尔自治区女性居民为调查对象,采用统一自制且翻译成维吾尔文的调查问卷对其进行基本情况调查,同时对调查对象行肝脏和胆囊腹部超声检查。比较不同民族以及各民族不同初潮年龄、月经不调、生育数量、分娩年龄女性胆囊结石患病率,并采用多因素Logistic回归分析女性胆囊结石患病率的影响因素。结果共发放问卷3 508份,有效问卷3 175份,有效回收率为90.5%。3 175例女性胆囊结石患病率为16.9%(535/3 175),其中维吾尔族、哈萨克族、汉族女性胆囊结石患病率分别为24.0%(222/924)、10.8%(94/873)、15.9%(219/1 378)。3个民族间胆囊结石患病率比较,差异有统计学意义(χ^2=57.913,P<0.001)。多因素Logistic回归分析结果显示,初潮年龄〔OR=1.167,95%CI(1.007,1.353)〕、月经不调〔OR=6.486,95%CI(4.636,9.532)〕、生育数量〔OR=1.355,95%CI(1.237,1.483)〕是维吾尔族女性胆囊结石的影响因素(P<0.05);初潮年龄〔OR=1.296,95%CI(1.007,1.668)〕、生育数量〔OR=1.240,95%CI(1.022,1.504)〕是哈萨克族女性胆囊结石的影响因素(P<0.05);生育数量〔OR=1.341,95%CI(1.214,1.482)〕、分娩年龄〔OR=0.942,95%CI(0.892,0.996)〕是汉族女性胆囊结石的影响因素(P<0.05)。结论新疆维吾尔自治区女性胆囊结石患病率较高,其中维吾尔族女性胆囊结石患病率与初潮年龄、月经不调、生育数量有关;哈萨克族女性胆囊结石患病率主要与初潮年龄、生育数量有关;汉族女性胆囊结石患病率主要与生育数量、分娩年龄有关。因此临床工作中应重点关注初潮年龄延迟,生育数量多,分娩年龄小的女性,尤其是胆囊结石患病率较高的维吾尔族人群。

Background It is found that the prevalence of cholecystolithiasis in Xinjiang Uygur Autonomous Region is relatively high,and its prevalence in women is higher than that in men,but there is a lack of research on the prevalence of cholecystolithiasis in women in Xinjiang Uygur Autonomous Region.Objective To study the prevalence and the influential factors of cholecystolithiasis in Uygur,Kazakh and Han women in Xinjiang Uygur Autonomous Region,and to provide evidence for the prevention and treatment of cholecystolithiasis in Uygur,Kazak and Han women.Methods Female residents in Xinjiang Uygur Autonomous Region were selected from June to September 2011 by using the method of typical sampling followed by multi-stage stratified random sampling.Self-made general data questionnaires were used and translated into Uygur.Abdominal ultrasound examinations of liver and gallbladder were performed on the subjects.The prevalence of cholecystolithiasis in women of different ethnic groups and different ages of menarche,irregular menstruation,the number of babies,age of childbirth in each ethnic group were compared,and the influential factors of the prevalence of cholecystolithiasis in women were analyzed by multivariate Logistic regression.Results A total of 3 508 questionnaires were distributed and 3 175 were valid,with an effective recovery rate of 90.5%.The prevalence of cholecystolithiasis in female was 16.9%(535/3 175)in Xinjiang Uygur Autonomous Region,and the prevalence of cholecystolithiasis in Uygur,Kazakhs and Han women was 24.0%(222/924),10.8%(94/873)and 15.9%(219/1 378),respectively.The prevalence of cholecystolithiasis among the three ethnic groups was statistically significant(χ^2=57.913,P<0.001).Multivariate Logistic regression analysis showed that the age of menarche 〔OR=1.167,95%CI(1.007,1.353)〕,irregular menstruation 〔OR=6.486,95%CI(4.636,9.532)〕,the number of births 〔OR=1.355,95%CI(1.237,1.483)〕 were influential factors of Uygur women with cholecystolithiasis(P<0.05);the age of menarche〔OR=1.296,95%CI(1.007,1.668)〕,the number of births 〔OR=1.240,95%CI(1.022,1.504)〕 were influential factors of Kazakh women with cholecystolithiasis(P<0.05);the number of births 〔OR=1.341,95%CI(1.214,1.482)〕,age of childbirth 〔OR=0.942,95%CI(0.892,0.996)〕 were influential factors of Han women with cholecystolithiasis(P<0.05).Conclusion In Xinjiang Uygur Autonomous Region,the prevalence of cholecystolithiasis in female is higher,and the prevalence of cholecystolithiasis in Uygur female is related to age of menarche,irregular menstruation and the number of babies.The prevalence of cholecystolithiasis in Kazakh women was related to the age of menarche and the number of babies.The prevalence of cholecystolithiasis in Han women is mainly related to the number of babies and the age of childbirth.Therefore,the clinical work should focus on women with delayed menarche,large number of babies,and young age of childbirth,especially in the Uygur population who have higher prevalence of cholecystolithiasis.