湖南省永州地区城乡居民咀嚼槟榔习惯流行病学调查
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摘要
目的:了解湖南省永州地区15岁及以上城乡居民咀嚼槟榔习惯的流行情况和口腔粘膜下纤维性变(Oral submucous fibrosis,OSF)发病情况,探讨其流行病学特征及相关因素,为OSF和口腔癌早期防治提供依据。
     方法:采用分层随机抽样方法抽取研究样本,第一阶段根据永州地区行政划分和人口比例,随机抽取一个城区和一个乡镇,第二个阶段于该城区和乡镇各随机抽出一个街道和一个村,以户为单位进行调查,共调查了239位城市居民和352位农村居民,完成问卷591份,采用问卷调查方式调查居民咀嚼槟榔及抽烟喝酒相关情况,并进行口腔检查,观察并记录OSF的发病情况。
     结果:
     1.在被调查的591人中,有53人咀嚼槟榔,总体咀嚼率为9.0%,男性咀嚼率与女性咀嚼率相比有统计学意义(P<0.05),城市与农村总体咀嚼率比较无统计学意义(P>0.05),城市与农村曾经咀嚼率(即戒除率)比较有统计学意义(P<0.05)。
     2.城市目前咀嚼槟榔者年龄以20-29岁组及30-39岁年龄组占比重大,分别占33.3%及39.9%,这两个年龄组合计为73.2%;而农村则以15-19岁组及20-29岁组占比重大,分别为30.0%及37.0%,合计为67.0%,各年龄段咀嚼率相比,P<0.05,有统计学意义,两两比较发现15-19岁年龄组与50-59岁组、>60岁组比较,P<0.01,有统计学意义,20-29岁组与50-59岁组、>60岁组比较,P<0.01,有统计学意义,其余各组间比较均无统计学意义。
     3.目前咀嚼槟榔者中,城市受教育程度高中与本科均占33.3%,农村以初中占的比重大,占目前咀嚼槟榔者的63.0%,城乡目前咀嚼者中教育程度构成比有差异,但不同教育程度咀嚼率的比较无明显差异(P>0.05)。
     4.45名城乡目前咀嚼者中,单纯咀嚼槟榔者10人,占所有目前咀嚼者的22.2%,合并抽烟习惯者18人,占40.0%,合并饮酒习惯者3人,占6.7%,合并抽烟和饮酒习惯者14名,占31.1%。
     5.调查中共发现4例OSF,均为男性,人群患病率为0.7%。城市2例,农村2例,城市和农村的OSF患病情况差异无统计学意义(P>0.05)。
     结论:
     1.永州地区城乡居民中槟榔咀嚼率男性高于女性。
     2.永州地区城市居民槟榔戒除率高于农村,现仍有咀嚼习惯人群中年轻人所占比例大,咀嚼槟榔年轻化。
     3.文化程度与槟榔咀嚼率高低无统计学意义。
     4.永州地区城乡居民OSF患病率0.7%。
Objective
     The purpose of this study was to investigate the prevalence of betel nut chewing and oral submucous fibrosis(OSF) among over 15-year-old people in Yongzhou City,Hunan Province.To explore its epidemiological characteristics and related factors,and to provide scientific evidence for primary prevention of OSF.
     Materials and methods
     According to the standard of the third national oral health epidemiological investigation, samples were taken using stratified sampling.In the first stage the strata was based on the specific city and town.In the second stage the strata was based on the specific family in a street and a villlage, including 239 urban residents and 352 rural residenis, which 591 questionnaires surveys were finished.Questionnaires surveys were used to investigate the prevalance of betel nut chewing and oral examination were performed to investigate whether there was OSF.
     Results
     1.Among the 591 residents in Yongzhou City,53 people has betel nut chewing habits,the prevalence of betel nut chewing was 9.0%.There was significantly difference between male and female(P<0.05). There was no significant difference between urban residants and rural residants in the prevanlence of betel chewing(p>0.05),but there was significant difference between urban residants and rural residants in the prevalence of betel used chewing(P<0.05).
     2.In urban, the age group of the 30-39(33.3%) and 20-29(39.9%) had higher rates of betel nut chewing, which accounted for 73.2%; In rural, the age group of the 15-19(30.0%) and 20-29(37.0%) age group had higher rates of betel nut chewing, which accounted for 67%.There was significant difference among the different age group in the prevanlence of betel chewing (P<0.05).
     3 The rate of betel nut chewing in different level of education,in urban high schools and colleges were all 33.3%,while in rural areas 63.0% people were junior high school,there were differences between the urban and rural, but there was no significant difference among the different education in the prevanlence of betel chewing (P>0.05).
     4.There were 45 urban and rural residants who were currently chewing, betel nut chewing only were 10 people, accounting for 22.2% of those currently chewers, cigarette smoking combined were 18 people, accounting for 40.0%, drinkers combined were 3 people, accounting for 6.7%, combined cigarette smoking and drinking habits were 14 people, accounting for 31.1%.
     5.Among the samples,4 people had OSF, including 4 male and 0 female nut betel chewers,while 2 urban persons and 2 rural persons had OSF.The prevalence rate of OSF was 0.7% in urban and rural residants,There was no difference between the urban and the rural residenis in the prevalence rate of OSF.
     Conclusions
     1.Urban and rural residents in Yongzhou had habit of betel nut chewing,but the rate of betel nut chewing was much lower than areas of Xiangtan, there was significant difference between male and female in the prevanlence of betel chewing habit,and no significant difference between urban residants and rural residants in the prevanlence of betel chewing.
     2.There was a large proportion of young men in urban and rural residents who were currently betel nut chewing in Yongzhou, which indicated that people having betel nut chewing habit were younger.
     3.Betel nut chewing rate had no correlation with the level of education.
     4.The prevalence of OSF was 0.7%, lower than Changsha and Xiangtan which was the center of betel nut chewing.
     5.OSF patients often accompanied by smoking and drinking habits
引文
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