安徽省灵璧县居民肝癌死亡率与距濉河距离的相关性研究  

Association between mortality rate of hepatic carcinoma and the distance from Suihe River in Lingbi county, Anhui province

作　　者：赵辉 郭启高 周脉耕[2] 窦燕生 於坛春 刘韫宁[2] 王晓风 陈叶纪[5] 张业武 

机构地区：[1]安徽省宿州市灵璧县疾病预防控制中心,234200 [2]中国疾病预防控制中心慢性非传染性疾病预防控制中心 [3]环境与健康相关产品安全所 [4]公共卫生监测与信息服务中心 [5]安徽省疾病预防控制中心

出　　处：《中华预防医学杂志》2013年第6期529-533,共5页Chinese Journal of Preventive Medicine

基　　金：十一五科技支撑项目（2006BAI19B03）

摘　　要：目的探索安徽省宿州市灵璧县居民肝癌死亡率与距濉河距离之间的相关性。方法利用疾病制图和空间统计分析技术，对2005至2010年灵璧县肝癌死亡率空间分布情况进行描述，以村庄与污染河流距离作为环境暴露代理变量，以各村肝癌死亡率作为应变量，采用Glimmix模型和贝叶斯（BYM）模型进行单因素和多因素分析，研究灵璧县距濉河距离与肝癌死亡率相关性。结果灵璧县肝癌高死亡率呈现较明显向污染水系聚集的现象。Glimmix模型结果显示，无论是否考虑空间自相关，与污染河流距离越近，肝癌死亡率越大；单因素BYM模型结果显示，与距离濉河大于12km的村庄『肝癌死亡率为33．12／10万人年（1068／3224562）]相比，距离濉河6km以内村庄肝癌死亡率[42．48／10万人年（777／1829004）]的RR值为1．38（95％CI：1．06～1．82），距离濉河6～12km村庄[肝癌死亡率为35．65／10万人年（651／1825848）]RR值为1．13（95％CI：O．92～1．39）；在BYM模型中增加单位耕地面积下的化肥、农药使用量，人均国内生产总值（GDP）等进行多因素分析，肝癌死亡率与河流距离关系保持不变。结论灵璧县肝癌死亡率与污染河流暴露有一定的相关关系，生活于污染河流区可能增加临近居民肝癌死亡率。Objective To explore the association between mortality rate of hepatic carcinoma and the distance from Suihe River in Lingbi county, Suzhou, Anhui province. Methods Using the disease mapping and spatial statistical analysis techniques, we described the spatial distributions of the mortality rate of hepatic carcinoma from 2005 to 2010 in Lingbi county. Taking the distance between villages and polluted rivers as proxy variable of environmental exposure, mortality rate of hepatic carcinoma in each village as dependant variable, and using the Glimmix model and Bayesian spatial model （BYM） to undertake the univariate and multivariate analysis, we investigatived the association between mortality rate of hepatic carcinoma and the water pollution of Suihe River in Lingbi county. Results Obvious clustering of high mortality rate of hepatic carcinoma along the polluted river was observed in Lingbi county. Results of Glimmix model showed that whether spatial autocorrelation was considered or not, closer to the polluted river has higher mortality rate of hepatic carcinoma. Results of univariate analysis of the BYM model showed that, compared with the villages far from the polluted river more than 12 km （the mortality rate of hepatic carcinoma was 33.12/100 000 （1068/3 224 562）） , the RR values of the hepatic carcinoma mortality was 1.38 （ 95 % CI： 1.06 - 1.82） for the villages apart from the polluted river within 6 km（ the mortality rate of hepatic carcinoma was 42. 48/100 000 （ 777/1 829 064 ） ） , and 1.13 （95% CI： 0. 92 - 1.39 ） for villages apart from the river between 6 and 12 km（ the mortality rate of hepatic carcinoma was 35.65/100 000（651/ 1 825 848 ） ）. In the BYM model multivariate analysis, adding the volume of fertilizer and pesticides used per cultivated area, GDP per capita to do multivariate analysis were, the relation between mortality rate of hepatic carcinoma and distance from polluted rivers remains unchanged. Conclusion The mortality rate of hepatic carcinoma was ass

关 键 词：肝肿瘤 死亡率 环境污染 贝叶斯定理 

分 类 号：R735[医药卫生—肿瘤]