不同海拔地区世居藏族人群高原红细胞增多症患病率的流行病学调查  

Epidemiological investigation of high altitude polycythemia in native Tibetans dwelling in different altitude area

作　　者：白玛康卓[1] 巴桑次仁 次仁央宗[3] 罗布占堆[4] 央拉[1] 春花[1] 格桑曲珍[5] 崔超英[1] 

机构地区：[1]西藏大学医学院高原医学研究中心,拉萨850000 [2]西藏自治区藏医院检验科,拉萨850000 [3]西藏大学医学院预防医学系,拉萨850000 [4]西藏大学医学院实验中心,拉萨850000 [5]西藏大学医学院基础部,拉萨850000

出　　处：《第三军医大学学报》2016年第3期220-225,共6页Journal of Third Military Medical University

基　　金：教育部高等学校科技创新工程重大项目培育资金(707051);国家重点基础研究发展计划(973计划;2010CB534904);西藏大学青年科研培育基金(ZD10PZ03)~~

摘　　要：目的了解拉萨和阿里地区人群高原红细胞增多症（high altitude polycythemia,HAPC）的患病率和相关影响因素。方法采用多阶段整群抽样方法对拉萨（海拔3 680-3 800 m）和阿里（海拔4 400-4 700 m）2个地区的2 757例世居藏族人口进行问卷调查和实验室血液学检查,采用SPSS 13.0统计软件完成统计分析。结果 2 757例中HAPC患者共72例,总患病率为2.6%。单因素分析结果显示,阿里地区HAPC患病率明显高于拉萨地区（5.2%vs 1.9%,P〈0.05）;男性患病率明显高于女性（3.4%vs 1.9%,P〈0.05）;吸烟人群的患病率明显高于非吸烟人群（4.7%vs 2.1%,P〈0.05）;不同职业者中患病率最高的是牧民（9.2%）,其次是个体户者（7.3%）,家庭月收入最低组HAPC患病率最低（2.1%）。HAPC患病率与饮酒、文化程度和各年龄段的差异均无统计学意义（P〉0.05）。经Logistic逐步回归分析发现海拔（P〈0.01）、性别（P〈0.01）和职业（P〈0.01）是高原红细胞增多症的影响因素。结论拉萨和阿里地区人群高原红细胞增多症的总患病率较低,海拔、性别和职业是影响其发生的因素。Objective To investigate the prevalence of high altitude polycythemia（ HAPC） and its influencing factors in native long dwelling Tibetans in Lhasa and Ngari Prefecture. Methods The survey was carried out on 2 757 adult native Tibetans who dwelled in Lhasa area（ at an altitude of 3 680 - 3 800 m） or Ngari Prefecture（ at an altitude of 4 400 - 4 700 m）. Questionnaire survey and laboratory blood testing were conducted,and the results were analyzed with SPSS 13. 0 software. Results There were 72 HAPC patients found among the 2 757 subjects,with a prevalence of 2. 6% in the cohort. Univariate analysis indicated that the prevalence of HAPC was significantly higher in the Ngari Prefecture than the Lhasa area（ 5. 2% vs 1. 9%,P〈0. 05）,in the males than the females（ 3. 4% vs 1. 9%,P〈0. 05）,and in the smokers than the nonsmokers（ 4. 7% vs 2. 1%,P〈0. 05）. Among different occupations,the prevalence was the highest in herdsmen（ 9. 2%） followed by the self-employed（ 7. 3%）. But,the prevalence was the lowest in those having the lowest family＇s month-earning（ 2. 1%）. There were no significant differences in the prevalence among the alcohol consumptions,education levels and ages（ P〉0. 05）. Logistic regression analysis found that altitude（ P〈0. 01）,sex（ P〈0. 01） and occupation（ P〈0. 01） were influencing factors for HAPC.Conclusion The prevalence of HAPC is quite low for the native Tibetans dwelling in Lhasa and Ngari Prefecture. Altitude,sex and occupation are influencing factors for its occurrence.

关 键 词：高原 红细胞增多症 患病率 藏族 

分 类 号：R195.4[医药卫生—卫生统计学] R339.54[医药卫生—卫生事业管理]