【摘要】：目的：通過比較分析四川阿壩藏族羌族自治州兩個歷史上世代不通婚、但地理位置相近的藏族和羌族二者大骨節(jié)病發(fā)生的環(huán)境與遺傳因子綜合模型,探索族群之間影響大骨節(jié)病發(fā)生原因的異同點。 方法：在利用GIS軟件等技術,分析了整個阿壩州大骨節(jié)病空間和時間分布趨勢的基礎上,選擇了空間地理位置(經(jīng)緯度)比較相近的藏族和羌族聚集區(qū)域進行人群橫斷面數(shù)據(jù)調(diào)研,分別構建并比較了兩個族群大骨節(jié)病環(huán)境因子和遺傳因子綜合作用模型的異同點。最后,利用灶狀分布個案比較研究,進一步分析和驗證當?shù)卮蠊枪?jié)病三間分布特征。 結果：阿壩州大骨節(jié)病患病率在空間分布上有差異性,表現(xiàn)出高海拔、低氣溫、多降水地區(qū)大骨節(jié)病患病率要高于其他地區(qū),p0.05。大骨節(jié)病患病率時間分布由于干預措施的實施表現(xiàn)出逐年下降的趨勢,P0.05。 在人群分布上,控制地理位置、海拔等地理因素后,影響藏族與羌族大骨節(jié)病患病的危險因素有異同點。共同危險因素是家庭類型和年齡因素。其中,藏族父母均為病患家庭患病危險度及其95%可信區(qū)間[OR(95%CI)]為6.204(2.819～13.657),羌族此類家庭OR(95%CI則為4.830(2.671～8.735)。年齡因素是由于在藏區(qū)和羌區(qū)國家實施大骨節(jié)病干預措施實施后,與高年齡組相比較,小年齡組人群患病率大大下降的結果。 比較分析影響藏族和羌族不同危險因子時發(fā)現(xiàn),藏族主要影響因子為教育程度、子代患病數(shù)以及父親年齡。其中,教育程度高可降低大骨節(jié)病患病可能性,OR(95%CI)為0.556(0.311～0.996)；子代患病數(shù)多,可以預測到上一代大骨節(jié)病患病人數(shù)多,OR(95%CI)為3.331(1.927～5.760)；在控制被調(diào)查者年齡、父親患病等因子后,發(fā)現(xiàn)父親年齡大時生育可降低子一代患病率,其OR(92%CI)為0.924(0.855～0.998)。 與羌區(qū)人群是否患病有關的因素包括居住村落、遷居的具體地點、遷居地是否為病區(qū)、新鮮蔬菜的攝入頻率以及父親的患病程度。一直居住在某些村落[OR值及95%CI為0.154(0.049～0.486)]、從一個地區(qū)遷移到其他地區(qū)[0.950(0.915～0.985)],都可降低大骨節(jié)病發(fā)病率；如遷移定居地點為病區(qū),則可大大增加人群患病的危險性[OR(95%)值為3.844(1.247～11.851)]；多攝入新鮮蔬菜對大骨節(jié)病有保護作用[0R(95%)值為0.076(0.010～0.554)]；父親大骨節(jié)病越嚴重的家庭,子代患大骨節(jié)病的可能性反而降低,其OR值及95%CI為0.331(0.139～0.786)。 結論：藏族和羌族大骨節(jié)病患病率受遺傳和環(huán)境因素共同影響,各有側重點。遺傳因素對藏族患病影響要大于羌族,尤以父親(生育)年齡和父親患病嚴重程度影響較大。環(huán)境因素中,教育程度影響藏族患病率,而羌族患病率與居住具體地點及維生素攝入多少密切相關。
[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.
【學位授予單位】：中央民族大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R684.1;P208

【參考文獻】

相關期刊論文 前10條

1 熊紹禮;吉林省大骨節(jié)病與飲用地下水中某些膠原元素關系的研究[J];地方病通報;1991年03期

2 莎日,孫天志,伊力奇,趙洪昌,崔江源,王潤成,趙麗光,高美英;大骨節(jié)病區(qū)外環(huán)境21種元素水平與病區(qū)活躍指數(shù)的相關分析[J];地方病通報;1992年02期

3 畢華銀,龐偉,呂旌喬,張富軍;榆林病區(qū)水黃腐酸對大鼠的急性毒性實驗報告[J];地方病通報;1998年03期

4 畢華銀,鄭濱,張富軍,陳萍;~3H-黃腐酸在雛雞體內(nèi)的示蹤實驗觀察[J];地方病通報;1998年03期

5 安永會;賈小豐;李旭峰;何錦;韓雙寶;張徽;;中國大骨節(jié)病地質(zhì)環(huán)境特征及其病因研究[J];中國地質(zhì);2010年03期

6 楊林生,呂瑤,李海蓉,李順江,李永華,王五一,譚見安;西藏山地半淋溶土壤分布與大骨節(jié)病關系研究[J];地理科學進展;2005年02期

7 郭雄,張矢遠,殷紅;真菌及其毒素與大骨節(jié)病關系的研究現(xiàn)狀[J];中國地方病防治雜志;1994年03期

8 畢華銀,王治倫;關于大骨節(jié)病的病因問題——提示大骨節(jié)病病毒病因的組織學證據(jù)[J];中國地方病防治雜志;1995年03期

9 譚緒恕,呂秀文,郭英華,劉鵬,張軍,呂文和,譚寧,梁延杰,武秋華;大骨節(jié)病病因研究新假說——產(chǎn)生硫酸軟骨素CHS酶的厭氧菌是主要病因[J];中國地方病防治雜志;1996年01期

10 張矢遠,郭雄,于志道,羅毅,馮建林,張理漢,楊進生;大骨節(jié)病區(qū)糧及患者血清中鐮刀菌毒素的檢測[J];中國地方病防治雜志;1996年02期

相關博士學位論文 前1條

1 劉國;川西北高原壤塘縣大骨節(jié)病病區(qū)水文地球化學特征及其與病情相關關系的研究[D];成都理工大學;2011年

相關碩士學位論文 前2條

1 任欣;四川省松潘縣大骨節(jié)病致病因素研究[D];成都理工大學;2010年

2 馬宏宇;四川茂縣維城鄉(xiāng)前、后山地質(zhì)災害危險性分析[D];成都理工大學;2010年

，

本文編號：2439816