基于GIS的阿坝州藏族和羌族大骨节病影响因素比较研究

发布时间：2019-03-14 08:24

【摘要】：目的：通过比较分析四川阿坝藏族羌族自治州两个历史上世代不通婚、但地理位置相近的藏族和羌族二者大骨节病发生的环境与遗传因子综合模型,探索族群之间影响大骨节病发生原因的异同点。方法：在利用GIS软件等技术,分析了整个阿坝州大骨节病空间和时间分布趋势的基础上,选择了空间地理位置(经纬度)比较相近的藏族和羌族聚集区域进行人群横断面数据调研,分别构建并比较了两个族群大骨节病环境因子和遗传因子综合作用模型的异同点。最后,利用灶状分布个案比较研究,进一步分析和验证当地大骨节病三间分布特征。结果：阿坝州大骨节病患病率在空间分布上有差异性,表现出高海拔、低气温、多降水地区大骨节病患病率要高于其他地区,p0.05。大骨节病患病率时间分布由于干预措施的实施表现出逐年下降的趋势,P0.05。在人群分布上,控制地理位置、海拔等地理因素后,影响藏族与羌族大骨节病患病的危险因素有异同点。共同危险因素是家庭类型和年龄因素。其中,藏族父母均为病患家庭患病危险度及其95%可信区间[OR(95%CI)]为6.204(2.819～13.657),羌族此类家庭OR(95%CI则为4.830(2.671～8.735)。年龄因素是由于在藏区和羌区国家实施大骨节病干预措施实施后,与高年龄组相比较,小年龄组人群患病率大大下降的结果。比较分析影响藏族和羌族不同危险因子时发现,藏族主要影响因子为教育程度、子代患病数以及父亲年龄。其中,教育程度高可降低大骨节病患病可能性,OR(95%CI)为0.556(0.311～0.996)；子代患病数多,可以预测到上一代大骨节病患病人数多,OR(95%CI)为3.331(1.927～5.760)；在控制被调查者年龄、父亲患病等因子后,发现父亲年龄大时生育可降低子一代患病率,其OR(92%CI)为0.924(0.855～0.998)。与羌区人群是否患病有关的因素包括居住村落、迁居的具体地点、迁居地是否为病区、新鲜蔬菜的摄入频率以及父亲的患病程度。一直居住在某些村落[OR值及95%CI为0.154(0.049～0.486)]、从一个地区迁移到其他地区[0.950(0.915～0.985)],都可降低大骨节病发病率；如迁移定居地点为病区,则可大大增加人群患病的危险性[OR(95%)值为3.844(1.247～11.851)]；多摄入新鲜蔬菜对大骨节病有保护作用[0R(95%)值为0.076(0.010～0.554)]；父亲大骨节病越严重的家庭,子代患大骨节病的可能性反而降低,其OR值及95%CI为0.331(0.139～0.786)。结论：藏族和羌族大骨节病患病率受遗传和环境因素共同影响,各有侧重点。遗传因素对藏族患病影响要大于羌族,尤以父亲(生育)年龄和父亲患病严重程度影响较大。环境因素中,教育程度影响藏族患病率,而羌族患病率与居住具体地点及维生素摄入多少密切相关。
[Abstract]:Objective: to compare and analyze the comprehensive models of environmental and genetic factors of Kashin-Beck disease between Tibetan and Qiang nationality in two historical generations of Aba Tibetan and Qiang autonomous prefectures in Sichuan. To explore the similarities and differences in the causes of Kashin-Beck disease (KBD) among ethnic groups. Methods: on the basis of analyzing the spatial and temporal distribution trend of Kashin-Beck disease (KBD) in Aba prefecture by using GIS software and other techniques. The cross-sectional data of Tibetan and Qiang ethnic groups with similar spatial geographical location (longitude and latitude) were investigated, and the similarities and differences of environmental and genetic factors of Kashin-Beck disease (KBD) environmental factors and genetic factors between the two populations were constructed and compared. Finally, a comparative case study of focal distribution was used to further analyze and verify the three distribution characteristics of Kashin-Beck disease. Results: the prevalence rate of Kashin-Beck disease in Aba Prefecture was different in spatial distribution, showing that the prevalence rate of Kashin-Beck disease in areas with high altitude, low temperature and heavy precipitation was higher than that in other areas (p 0.05). The prevalence time distribution of Kashin-Beck disease (KBD) showed a decreasing trend year by year due to the implementation of intervention measures, P 0.05. The risk factors of Kashin-Beck disease in Tibetan and Qiang nationality were different and same after controlling geographical factors such as geographical location and altitude. Common risk factors were family type and age. Among them, the risk and 95% confidence interval [OR (95%CI)] of Tibetan parents were 6.204 (2.819 / 13.657) and 4.830 (2.671 / 8.735), respectively. The OR of Qiang family was 4.830 (2.671 脳 8.735). The age factor was due to the fact that the prevalence of Kashin-Beck disease (Kashin) in Tibetan and Qiang areas was significantly lower than that in the high age group after the implementation of Kashin-Beck disease intervention measures in the Tibetan and Qiang regions. Comparing and analyzing the different risk factors of Tibetan and Qiang nationality, it was found that the main influencing factors of Tibetan nationality were education level, the number of diseases in offspring and the age of father. Among them, high education level can reduce the risk of Kashin-Beck disease (, OR (95%CI) is 0.556 (0.311 脳 0.996); The incidence of Kashin-Beck disease (, OR (95%CI) in the previous generation was 3.331 (1.927 / 5.760), and the incidence of Kashin-Beck disease in the previous generation was 3.331 (1.927 / 5.760). After controlling the factors such as age, father's illness and so on, it was found that when the father was older, the prevalence rate of the offspring could be reduced, and the OR (92%CI) was 0.924 (0.855 脳 0.998). The factors related to the disease include living villages, the specific location of relocation, whether the place of relocation is a disease area, the frequency of intake of fresh vegetables and the degree of illness of the father. Living in certain villages (OR and 95%CI = 0.154 (0.049 / 0.486) and moving from one area to another [0.950 (0.915 / 0.985)] can reduce the incidence of Kashin-Beck disease; The OR (95%) value was 3.844 (1.247 / 11.851); Intake of fresh vegetables had protective effect on Kashin-Beck disease [0 R (95%) = 0.076 (0.010 脳 0.554)]; The more severe the father's Kashin-Beck disease was, the less likely the offspring were to suffer from Kashin-Beck disease. The OR and 95%CI of the offspring were 0.331 (0.139 / 0.786). Conclusion: the prevalence of Kashin-Beck disease in Tibetan and Qiang nationality is influenced by genetic and environmental factors. The effect of genetic factors on Tibetan disease was greater than that of Qiang nationality, especially the age of father (fertility) and the severity of father's illness. Among the environmental factors, education level affects the prevalence of Tibetan nationality, and the prevalence rate of Qiang nationality is closely related to the specific place of residence and the amount of vitamin intake.
【学位授予单位】：中央民族大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R684.1;P208

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