摘要目的 分析大骨节病核心家庭的患病特征,为大骨节病病因与发病机制及防治提供科学依据.方法 对陕西省麟游县15个乡的居民进行大骨节病临床普查及相关因素问卷调查.根据亲代患大骨节病的情况,以核心家庭为单位划分为4种不同类型:父母均不患大骨节病的核心家庭(A,n=3 657)、单独母亲患大骨节病而父亲不患的核心家庭(B,n =674)、单独父亲患大骨节病而母亲不患的核心家庭(C,n=907)、父母均患大骨节病的核心家庭(D,n=748).分析大骨节病核心家庭患病率与群体患病率的关系及其不同家庭成员年龄患病率的变化.结果 ①大骨节病核心家庭患病率(38.91％,2 329/5 986)与群体患病率(14.42％,3 700/25 656)之间呈正相关关系(r=0.77,P＜0.05);②核心家庭亲代中男性与女性大骨节病患者年龄分布:0～ 10岁为9.91％(118/1 191)、11.30％(105/929);11～20岁为62.80％ (748/1 191)、58.45％(543/929);21～30岁为15.70％(187/1 191)、18.51％(172/929);31 ～40岁为7.30％(87/1 191)、7.64％(71/929);41～50岁为2.77％(33/1 191)、2.37％(22/929);51 ～60岁为1.34％(16/1 191)、1.51％(14/929);61 ～ 70岁为0.17％(2/1 191)、0.22％ (2/929);③3种患病核心家庭(B、C、D)中,当亲代患病年龄＜13岁时,子代患病年龄集中分布在＜13岁(83.33％,20/24);当亲代患病年龄为13～25岁时,子代患病年龄则主要集中分布在13～25岁(69.86％,51/73);当亲代患病年龄＞25岁时,子代患病年龄集中分布在≤25岁(84.85％,56/66);④4种核心家庭(A、B、C、D)中,子代男性与女性比较大骨节病患病率明显增高或有增高趋势[1.41％(52/3 683)比0.47％(12/2 538),r=0.47,P＞ 0.05;5.73％(31/541)比0.53％(2/378),x2=4.32,P＜ 0.05;6.48％(44/679)比0.95％(5/528),x2=4.10,P＜0.05;9.46％(66/698)比3.31％(15/453),x2=2.96,P＞ 0.05].结论 ①大骨节病核心家庭患病率与群体患病率有关;②男性和女性大骨节病患病率均与年龄相关,11～20岁是大骨节病的高发年龄;(③子代患大骨节病的年龄在一定程度上受亲代患病年龄的影响;④子代男性大骨节病发病率高于子代女性或有增高趋势.

abstractsObjective To analyze the occurrence characteristic of Kashin-Beck disease (KBD) in nuclear families,and to provide a scientific basis for KBD prevention.Methods KBD patients in 15 villages of Linyou County,Shaanxi Province were investigated using clinical and questionnaire survey.According to the prevalence of KBD,the nuclear families were divided into 4 different types:parents did not suffer from KBD (A,n =3 657),mother suffered from KBD and father did not (B,n =674),father suffered from KBD and mother did not (C,n =907),and both patients suffered from KBD (D,n =748).The relationship between prevalence of nuclear families and prevalence of population was analyzed using correlation analysis,and the changes of prevalence in different age groups of family members were analyzed.Results ①The prevalence of nuclear families (38.91％,2 329/5 986) and the prevalence of popttlation (14.42％,3 700/25 656) were significantly correlated (r =0.77,P ＜ 0.05);②The proportions of parental generation men and women with KBD were 9.91％ (118/1 191) vs 11.30％ (105/929) in 0-10 years old group,62.80％ (748/1 191) vs 58.45％ (543/929) in 11-20 years old group,15.70％ (187/1 191) vs 18.51％ (172/929) in 21-30 years old group,7.30％ (87/1 191) vs 7.64％ (71/929) in 31-40 years old group,2.77％ (33/1 191) vs 2.37％ (22/929) in 41-50 years old group,1.34％ (16/1 191) vs 1.51％ (14/929) in 51-60 years old group,and 0.17％ (2/1 191) vs 0.22％ (2/929) in 61-70 years old group,respectively.③Among the three nuclear families (B,C,D),the age of offspring with KBD was less than 13 years old when the age of their parents with KBD was less than 13 years old(83.33％,20/24);The age of the offspring with KBD was mainly distributed between the ages of 13 and 25 years old when the age of their parents with KBD was 13-25 years old (69.86％,51/73);When the age of parents with KBD was order than 25 years old,the age of their offspring with KBD was mainly less than 25 years old (84.85％,56/66);④Among the four nuclear families,the prevalence rates of male and female in the first filial generation were 1.41％ (52/3 683) vs 0.47％ (12/2 538) in A family (x2 =0.47,P ＞ 0.05),5.73％ (31/541) vs 0.53％ (2/378) in B family (x2 =4.32,P ＜ 0.05),6.48％ (44/679) vs 0.95％ (5/528) in C family (x2 =4.10,P ＜ 0.05),and 9.46％ (66/698) vs 3.31％ (15/453) in D family (x2 =2.96,P＞ 0.05),respectively.Conclusions ①The prevalence of the nuclear family with KBD is related to the population prevalence;②the prevalence of male and female with KBD is related to age,and KBD mainly occurs between the age of 11 and 20;③the age of offspring with KBD is partly influenced by the age of their parents;④the prevalence rate of male in the first filial generation is higher than that of female in the first filial generation.