南京地区中学生意外伤害及其与抑郁障碍的流行病学联系

目的了解南京地区中学生人群中意外伤害的发生情况及其与抑郁障碍之间的流行病学联系。方法采用横断面研究，研究对象来自南京地区13个区县的56个学校的168个班级7161名在校的初一～高三的中学生，其中初中生占71％，高中生占29％；男生为49．4％，女生为50．6％。调查的有效应答率为92．5％。结果该样本人群中意外伤害总的年发生率为40．0％，其中车祸、骨折、摔跌伤、划刺伤和其他伤害的年发生率分别为1．0％、1．4%、16．1％、16．9％和4．6％。高中学生中车祸、骨折、摔跌伤和划刺伤的发生率都显著低于初中学生；而从每一个年级来看，高年级学生中骨折的发生率较低，高三学生中划刺伤的发生率也较低。与女性学生相比，男性学生更容易发生上述各类意外伤害；而各类意外伤害的年龄差异不显著。对可能的混杂因素进行统计控制后，抑郁障碍患者发生骨折的风险与非抑郁障碍患者相比，差异无统计学意义（OR=1．40，95％CI为0．78～2．53），但抑郁障碍患者罹患其余4种类别意外伤害的可能性仍然显著大于非抑郁障碍患者（车祸OR=2．22，95％CI为1．13—4．38；摔跌伤OR=1．28，95％CI为1．04～1．58；划刺伤OR=1．40，95％CI为1．14～1．71；其他伤害OR=1．93，95％CI为1．41～2．65）。结论抑郁障碍可能是意外伤害的一个独立的危险因素，抑郁障碍患者是意外伤害的高危人群，做好青少年的抑郁障碍防制工作将有助于意外伤害的预防与控制。

Epidemiological Relationship between Unintentional Injury and Depression

[Objective]To study the epidemiological relationship between unintentional injury and depression.[Methods] Cross sectional study was carried out on 7 161 students from 56 middle schools of Nanjing,71% and 29% of which were from junior middle school and senior middle school respectively.49.4% were male students and 50.6% were female students;the rate of effective answers of the investigation was 92.5%.[Results]The total incidence rate of unintentional injuries was(40.0%,) among which car accidents,bone fractures,falls,knife punctures and other injuries occupied 1.0%,1.4%,16.1%,16.9% and 4.6% respectively.The incidence rate of unintentional injuries among senior middle school students was significantly lower than that among the junior middle school students,and that among male students was higher than that among the female students.No significant difference was found between ages.No significant difference was found in the incidence rate of bone fractures between the depression patients and non-depression patients(OR=1.40,95%,CI=0.78~2.53);however,the possibility of other four kinds of unintentional injuries among the depression patients was significantly higher than that among the non-depression patients(OR=2.22,95%;(CI=1.13~4.38).) [Conclusion] Depression might be an individual risk factor for the unintentional injuries and the depression patients belong to high risk population of unintentional injuries;prevention and control work should be strengthened.