西藏不同海拔地区藏族青少年生长迟缓检出率及其影响因素研究

Study on the Prevalence of Stunting and its Influencing Factors among Tibetan Adolescents at Different Altitudes in Xizang

目的调查西藏不同海拔地区藏族青少年生长迟缓检出率,分析影响因素。方法采用随机抽样的方法,于2017年在西藏不同海拔地区四所县中学抽取11~18岁993名藏族青少年学生,采用问卷调查的方式收集学生一般状况并进行体格检查。连续型变量以均值和标准差(呈正态分布)进行描述,分类变量以频数和率(百分比)进行描述,均数的比较采用t检验或方差分析,率的比较采用χ2检验。为控制混杂因素影响,采用泊松回归进行多因素分析。结果结果显示生长迟缓检出133人(13.4%)。单因素分析结果显示15.0~17.9岁、性别为男性、出生顺次为第3胎及以上、父亲未上过学、家庭中有3个及以上孩子、家庭月收入<1000元的学生生长迟缓检出率最高。多因素结果显示年龄为13.0~14.9岁、15.0~17.9岁的学生生长迟缓检出率分别是11.0~12.9岁学生的1.662倍、2.574倍。家庭中有2个孩子、3个及以上孩子的学生生长迟缓检出率分别是1个孩子的2.989倍、3.222倍。高海拔到低海拔组、高海拔组、低海拔到高海拔组生长迟缓检出率分别是低海拔组的1.913倍、5.380倍、5.872倍。结论海拔是藏族青少年发生生长迟缓的主要影响因素,年龄、家庭中孩子数量同样对生长迟缓具有影响。

Objective To investigate the prevalence of stunting among Tibetan adolescents at different altitudes in Tibet and to analyse the influencing factors.Methods In 2017,993 Tibetan adolescent students aged 11~18 were selected from middle schools in four counties at different altitudes in Xizang and a questionnaire survey was used to collect the general condition of the students and followed by physical examinations.Continuous variables were described as mean and standard deviation(normally distributed),categorical variables were described as frequency and rate(percentage),t-test or ANOVA were used for comparison of means,andχ2 test was used for comparison of rates.In order to control the influence of confounding factors,poisson regression was used for multivariate analysis.Results According to the results of this survey,133 people(13.4%)were diagnosed with growth retardation.The results of univariate analysis showed that the detection rate of stunting was the highest among students aged 15.0~17.9 years old,male,born in order of the third child or above,with father who had never gone to school,had three or more children in the family and had a monthly family income less than 1000yuan.The multivariate results showed that the detection rate of growth retardation in students aged 13.0~14.9 and 15.0~17.9 years was 1.662 times and 2.574 times that of students aged 11.0~12.9 years,respectively.The detection rate of stunting in students with 2 children and 3 or more children in the family was 2.989 times and 3.222 times that of 1 child,respectively.The detection rates of stunting in the high-altitude to low-altitude group,the high-altitude group,and the low-altitude to high-altitude group were 1.913 times,5.380 times,and 5.872 times higher than those in the low-altitude group,respectively.Conclusion Altitude is the main influencing factor for stunting in Tibetan adolescents,and age and the number of children in one family also have an impact on stunting.