西藏自治区八宿县常驻居民泌尿系结石的流行病学调查及影响因素分析

Epidemiological investigation of urinary calculi among the permanent residents in Basu County,Tibet Autonomous Region and analysis on its influencing factors

目的调查分析西藏自治区八宿县常驻居民泌尿系结石的流行病学特点,为该地区和西藏高原地区泌尿系结石的防治提供依据。方法采取整群分层随机抽样的调查方法,于2019年9月至2019年12月选取西藏自治区八宿县3个镇、1个乡的34个行政村共7359例常驻居民为调查对象。通过问卷调查获取研究对象的人口学资料、生活饮食习惯和家族史,采用B型超声检查确诊泌尿系结石患者,并对当地的饮用水进行水质分析。采用单因素分析和多因素Logistic回归分析明确当地居民泌尿系结石患病的影响因素。结果7359例调查对象中泌尿系结石患者1119例,患病率15.20%。不同性别、年龄、婚姻状况的居民泌尿系结石患病率比较,差异有统计学意义(P<0.05)。单因素分析显示:吸烟、体质量指数、不同日饮水量、睡前是否饮水、不同食用绿色蔬菜量也影响着当地居民泌尿系结石的患病率(P<0.05)。对藏区特有的膳食生活习惯调查也显示:不同频率的食用酥油茶、牛羊肉、青稞酒的居民泌尿系结石患病率差异有统计学意义(P<0.05)。不同饮用水源的居民泌尿系结石患病率的差异也有统计学意义(P<0.05)。进一步经多因素Logistic回归分析显示:性别、年龄、吸烟、睡前饮水、饮用酥油茶和青稞酒量,以及饮用水水质为八宿县居民泌尿系结石患病的独立影响因素(P<0.05)。饮用水水质检测显示八宿县居民的饮用水中钙、镁含量超标,以山泉水、井水超标更为显著(P<0.05)。结论西藏自治区八宿县居民泌尿系结石的患病率较高,部分影响因素与平原地区一致,还具有一些藏区特有的生活环境、膳食习惯等因素,应针对这些高危因素开展藏区泌尿系结石的防治工作。

Objective This paper tries to investigate the epidemiological characters of urinary calculi among the permanent residents in Basu County,Tibet Autonomous Region and to analyze the influencing factors.These results are expected to provide a basis for the prevention and treatment of urinary calculi in this area and the whole Tibetan plateau.Methods By using stratified cluster random sampling method,we enrolled 7359 permanent residents in 34 administrative villages from 3 towns and 1 townships in Basu County,Tibet Autonomous Region from September to December in 2019.The questionnaire was employed to investigate the demographic data,the living and dietary habits,and the family history of disease.Urinary calculi was diagnosed by type B ultrasonography.Local drinking water quality was also analyzed.Univariate analysis and multivariate Logistic regression analysis were conducted on the influencing factors for urinary calculi in local residents.Results Among the 7359 subjects,1119 subjects were diagnosed with urinary calculi with a prevalence rate of 15.21%.The prevalence rate of urinary calculi has statistically significant differences among populations with different genders,ages,marital status(P<0.05).Univariate analysis also showed that smoking,BMI,drinking water amount,drinking before sleeping,the frequency of eating green vegetables also influenced the incidence of urinary calculi in the local residents(P<0.05).The investigation on the special dietary habits in Tibetan areas also showed that the prevalence rate of urinary calculi was significantly different among populations with different daily drinking amount of buttered tea and highland barley wine,different frequency of eating beef and mutton,and different drinking water quality(P<0.05).Multivariate Logistic regression analyses showed that age,gender,smoking,drinking before sleeping,the daily drinking amount of buttered tea and highland barley wine,and the drinking water quality were the independent influencing factors of urinary calculi(P<0.05).The test of drinking water quality showed that the content of calcium and magnesium exceeded the standard in the drinking water in Basu County,especially in the mountain spring water and the well water(P<0.05).Conclusions The prevalence of urinary calculi among the permanent residents in Basu County,Tibet Autonomous Region is relatively higher.Some influencing factors are consistent with the plain area,and there are also other factors including the environment,the dietary habits unique to Tibetan areas.The prevention and treatment of urinary calculi in Tibet should be carried out by pointing to these high risk factors.