贵州省黔南州20岁及以上农村居民慢性肝胆疾病患病率调查

目的 了解黔南州20岁及以上农村居民慢性肝胆疾病(CHD)的患病情况，为开展防治提供依据。方法 于2018年1月—2019年12月采取整群随机抽样方法对49 387名贵州省黔南州20岁及以上农村居民采用自行编制《黔南州CHD流行病学调查表》进行问卷调查，依据《临床肝胆病学》中有关标准进行诊断，采用SPSS 19.0软件进行分析。结果 49 387名黔南州20岁及以上农村居民中，CHD现患人数为7 245例，患病率为14.67%。其中男性患病率为16.69%（4 898/29 354）。女性为11.72%（2 347/20 033），男性患病率高于女性（χ2 = 234.983，P = 0.001)。20岁～、30岁～、40岁～、50岁～、60岁～、70岁～、80岁～年龄段患病率分别为2.53%、5.09%、20.99%、23.49%、17.79%、16.75%、14.66%，不同年龄CHD患病率差异有统计学意义（χ2 = 67.823，P = 0.003）。汉族、布依族、苗族、水族、毛南族、瑶族、其他民族患病率分别为17.53%、18.06%、18.73%、21.64%、14.08%、3.07%、2.63%，不同民族CHD患病率差异有统计学意义（χ2 = 42.751，P = 0.005）。三都县、荔波县、罗甸县、平塘县、惠水县、长顺县、贵定县、龙里县、瓮安县、福泉市、独山县、都匀市CHD患病率分别为16.61%、15.99%、15.03%、14.13%、16.55%、11.98%、15.89%、13.54%、13.86%、13.99%、14.72%、13.74%。不同县市CHD患病率差异有统计学意义（χ2 = 27.253，P = 0.007）。各类型CHD患病率分别为:慢性胆囊炎（5.74%）、胆囊结石（4.48%）、脂肪肝（2.05%）、肝硬化（1.29%）、慢性病毒性肝炎（0.72%）、肝血管瘤（0.38%）。结论 黔南州20岁及以上农村居民CHD患病率处于低水平，病例类型以胆囊炎和胆囊结石为主，男性、水族居民是该地区防治的重点人群。

Epidemiological investigation of the incidence of chronic hepatobiliary diseases in rural residents aged 20 years old and above in Qiannan,Guizhou

To understand the prevalence of chronic hepatobiliary diseases (CHD) in rural residents aged 20 yearsold and over of Qiannan in Guizhou Province, and to provide scientific basis for the prevention and control of CHD for rural residents. Methods From January 2018 to December 2019, a total of 49 387 rural residents aged 20 years old and over in Qiannan Autonomous Prefecture of Guizhou Province were selected by cluster random sampling method and investigated with Epidemiological CHD Survey Questionnaire of Qiannan Autonomous Prefecture. Diagnosis was based on the clinical hepatobiliary pathology for CHD diagnosis and SPSS 19.0 was used in data analyses. Results Among 49 387 rural residents aged 20 years old and over, the number of CHD patients was 7 245, with the prevalence of 14.67% for all, 16.69% for male(4 898/29 354) and 11.72% for female(2 347/20 033). The prevalence rate of male was higher than that of female(χ2=234.983,P=0.001). The prevalence rates of 20-, 30-, 40-, 50-, 60-, 70- and 80- age groups were 2.53%, 5.09%, 20.99%, 23.49%,17.79%, 16.75% and 14.66%, respectively. There was significant difference in the prevalence of CHD among different ages(χ2=67.823, P=0.003). The prevalence rates of Han, Buyi, Miao, Shui, Maonan, Yao and other nationalities were 17.53%,18.06%, 18.73%, 21.64%, 14.08%, 3.07% and 2.63%, respectively. There was significant difference in the prevalence of CHD among different nationalities (χ2=42.751, P=0.005). The prevalence rates of CHD in Sandu, Libo, Luodian, Pingtang,Huishui, Changshun, Guiding, Longli, Wengan, Fuquan, Dushan and Duyun were 16.61% , 15.99% , 15.03% , 14.13% ,16.55%, 11.98%, 15.89%, 13.54%, 13.86%, 13.99%, 14.72% and 13.74%, respectively. There was significant difference inthe prevalence of CHD among different counties and cities (χ2=27.253, P=0.007). 7 245 residents suffered from CHD, withthe prevalence of 5.74% for chronic cholecystitis, 4.48% for cholelithiasis, 2.05% for hepatic adipose infiltration, 1.29% for cirrhosis, 0.72% for chronic hepatitis, and 0.38% for hepatic hemangioma. Conclusion The prevalence of chronic hepatobiliary diseases in rural residents aged 20 years old and over of Qiannan is at a low level. Chronic cholecystitis and cholelithiasis are major chronic hepatobiliary diseases among rural resident in Qiannan. Males and the Shui nationalities are the key populations for the prevention and teatment of chronic hepatobiliary diseases in the areas.