晚期血吸虫病伤残权重的初步评定及影响因素分析  

A preliminary study on the evaluation of disability weight and its influential factors for advanced schistosomiasis japonica

作　　者：许毅从[1] 段琼红 邹先胜 蔡栋[1] 朱晓华[1] 

机构地区：[1]浙江大学医学院附属第二医院医务部病案室,杭州310009 [2]武汉市结核病防治所,武汉430030 [3]湖北省黄石市血吸虫病防治所,黄石435000

出　　处：《国际医学寄生虫病杂志》2014年第2期61-65,共5页International JOurnal of Medical Parasitic Diseases

基　　金：湖北省卫生厅血防科研联合攻关项目（XF06C30）;Supported by a Joint Research Project in Schistosomiasis from Health Department of Hubei Province （XF06C30）

摘　　要：目的 发展适合我国晚期血吸虫病疾病负担评价的伤残权重,并分析伤残权重的影响因素,为评估其疾病负担提供参考依据. 方法 以全球疾病负担研究中疾病的六级失能等级标准为依据,评定我国晚期血吸虫病的年龄别和性别平均伤残权重.通过问卷调查的方式对湖北省阳新县125例晚期血吸虫病患者进行调查,全部数据采用EpiData3.1软件建库,应用SAS8.1软件进行分析.分别采用Wilcoxon秩和检验、Kruskal-Wallis秩和检验比较性别和年龄别伤残权重,用Nemenyi法对年龄别伤残权重进行两两比较,并通过通径分析模型分析伤残权重的影响因素. 结果 我国湖区晚期血吸虫病患者伤残权重均值为0.307.年龄别伤残权重为0.096～0.377,高于全球疾病负担研究中确定的0.005～0.006.伤残权重值随着年龄增长呈上升趋势,年龄组差异有统计学意义（x2=34.559,P＜ 0.01）.男、女性伤残权重分别为0.265和0.357,女性明显高于男性,差异具有统计学意义（Z=2.503,P＜ 0.05）.通径分析显示：对伤残权重有直接作用的变量按作用大小依次为年龄,患病年数,收入水平,性别、营养不良、消瘦,文化程度,贫血和记忆力下降;有间接作用的变量按作用大小依次为年龄、收入水平、患病年数和性别;总体影响前3位的分别为年龄、患病年数、收入水平. 结论 晚期血吸虫病患者每存活1年平均损失近3/10个健康寿命年.该评定结果高于全球疾病负担研究的确定值,初步反映了我国晚期血吸虫病患者的失能情况.Objective To establish suitable disability weights for advanced schistosomiasis japonica in China and analyze its influential factors,so as to offer the reference for quantifying the burden of the disease of schistosomiasis.Methods Based on the criteria of a six classes of disability in global burden of disease （GBD）,average disability weights for advanced schistosomiasis japonica were obtained by age and gender.One hundred and twenty-five advanced schistosomiasis patients from Yangxin County were investigated by questionnaire.The whole data was managed by Epidata 3.1 and analyzed by SAS8.1.The gender-specific and age-specific weight were compared using Wilcoxon test and Kruskal-Wallis test,respectively.Pairwise comparisons of age-specific weight were analyzed by Nemenyi method.The path analysis was used to analyze the influential factors of disability weight.Results The average disability weight of advanced schistosomiasis japonica in lake regions was 0.307.The age-specific disability weight ranged from 0.096 to 0.377,which was higher than the level of 0.005 ～ 0.006 identified by GBD,and the disability weights increased with age.The difference between age groups was significant （x2 =34.559,P〈 0.01）.It was assigned that a disability weight of 0.265 in male and 0.357 in female,and the difference between two genders was significant （Z=2.503,P〈 0.05）.Path analysis showed that direct influential factors were age,illness years,income levels,gender,weight loss,education,anemia and memory decline by the order,and the indirect influential factors were age,income levels,illness years and gender.The top three influential factors were age,illness years and income levels.Conclusion The average disability weight of 0.307 for advanced schistosomiasis japonica indicated that 3/10 healthy year lost for each survived life year of the patients.The disability weight resulted from this study was higher than that in the data of GBD.This disability weight was suitable for the advanced schistosomiasis patients in lake

关 键 词：晚期血吸虫病 伤残权重 疾病负担 通径分析 

分 类 号：R532.21[医药卫生—内科学]