The crowd characteristics of uterine fibroids detection among Dong ethnic women aged 30-79 in Guizhou Province
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摘要:
目的 采用潜在类别分析（latent class analysis，LCA）的方法对贵州省30~79岁世居侗族妇女子宫肌瘤人群风险特征进行分析，为不同特征群体实施针对性的干预措施提供依据。 方法 采用分层多阶段抽样的方法抽取3 790名贵州省黔东南苗族侗族自治州的侗族女性，利用“西南地区少数民族聚集地世居自然人群队列研究”的调查问卷收集侗族女性人群特征；使用B超（Apogee 1200，中国）检查研究对象是否患有子宫肌瘤。将χ2检验有统计学意义的变量作为子宫肌瘤风险特征，利用LCA对侗族妇女进行分类，并比较不同类别人群子宫肌瘤检出率，从而识别高危人群。 结果 不同居住类型、文化程度、初潮年龄、人工流产史、年龄、BMI、流产史、生育次数及月经状况女性子宫肌瘤检出率差异具有统计学意义（均有P < 0.05）。LCA将侗族女性子宫肌瘤风险特征分为5种不同类型，即农村老年型，农村中年型、农村青年型、城镇中老年型和城镇中青年型；其中农村青年型子宫肌瘤检出率最高（4.43%），其次是城镇老年型（3.89%），农村老年型检出率最低（0.79%）。 结论 贵州省侗族女性子宫肌瘤高危人群存在城乡差异，农村以青年人为主，城市以老年人为主；共同的风险特征为较高流产率、初中及高中文化水平。 Abstract:Objective By using the statistical method of latent class analysis(LCA) to analyze the crowd characteristics of uterine fibroids detection among Dong ethnic women aged 30-79 in Guizhou Province. Methods Stratified multi-stage sampling method was used to study 3790 Dong ethnic women in Qiandongnan Miao and Dong Autonomous Prefecture, Guizhou province. B-ultrasound (Apogee 1200, China) was used to detect whether they had uterine fibroids. Variables with statistical significance by Chi square test were salected as the risk characteristics of uterine fibroids. The potential category analysis was used to classify Dong women, the detection rate of uterine fibroids in different groups were compared, then the high-risk group was identified. Results There were statistically significant differences in the detection rate of uterine fibroids among women with different living types, educational level, menarche age, abortion history, age, BMI, abortion history, birth frequency and menstrual status (all P < 0.05). According to the latent class analysis, the crowd characteristics of Dong ethnic women's uterine fibroids were divided into five types:rural elderly type, rural middle-aged type, rural youth type, urban middle-aged type and urban young middle-aged type. The detection rate of rural youth type was the highest (4.43%), followed by the urban elderly type (3.89%), and the rural elderly type was the lowest (0.79%). Conclusions The high-risk groups of uterine fibroids in Dong ethnic women in Guizhou province are different between urban and rural areas. Young people are the majority in rural areas, while old people are the majority in urban areas. Common crowd characteristics are higher abortion rates and high school and middle school education. -
Key words:
- Guizhou province /
- Dong women /
- Uterine fibroids /
- Latent class analysis /
- Crowd characteristics
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表 1 研究对象的一般情况表
Table 1. Table of general conditions of study subjects
类别 例数 构成比(%) 文化程度 小学及以下 2 715 72.67 初中 539 14.43 高中(中专) 226 6.05 大专及以上 256 6.85 年龄(岁) ≥30 474 12.51 40~ 1 109 29.26 50~ 1 194 31.50 ≥60 958 25.28 BMI(kg/m2) 偏瘦 189 5.43 正常 1 728 49.66 超重 1 190 34.20 肥胖 373 10.72 服用避孕药 否 3 089 82.70 是 646 17.30 生育环 否 1 343 35.44 是 2 392 63.11 居住类型 农村 3 073 82.28 城镇 662 17.72 婚姻状况 已婚 3 227 86.38 未婚 509 13.62 职业类型 农民 1 786 47.81 待业 1 123 30.06 工人 158 4.23 行政管理人员 253 6.77 服务行业者 330 8.83 其他 86 2.30 人工流产史 否 2 468 65.12 是 1 269 33.48 流产史 否 1 976 52.14 是 1 814 47.86 月经状况 是 1 286 34.43 否 2 449 65.57 
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表 2 研究对象的子宫肌瘤检出情况的卡方分析表[n(%)]
Table 2. The distribution of uterine fibroids in various variables [n(%)]
变量 子宫肌瘤 χ2值 P值 未检出 检出 居住类型 22.874 ＜0.001 农村 2 987(97.20) 86(2.80) 城镇 618(93.35) 44(6.65) 婚姻状况 0.933 0.334 已婚 3 111(96.41) 116(3.59) 未婚 495(97.25) 14(2.75) 文化程度 18.322 ＜0.001 小学及以下 2 639(97.20) 76(2.80) 初中至高中 730(95.42) 35(4.58) 大专及以上 237(92.58) 19(7.42) 高血压 2.488 0.115 是 573(97.61) 14(2.39) 否 3 032(96.32) 116(3.68) 糖尿病 0.005 0.942 是 115(96.64) 4(3.36) 否 3 490(96.52) 126(3.48) 服用避孕药 0.128 0.721 是 622(96.28) 24(3.72) 否 2 983(96.57) 106(3.43) 初潮年龄(岁) 14.367 0.001 ≤12 309(94.50) 18(5.50) 13~ 2 295(96.07) 94(3.93) ≥17 1 001(98.23) 13(1.77) 节育环 0.485 0.486 是 2 305(96.36) 87(3.64) 否 1 300(96.8) 43(3.20) 人工流产史 10.096 0.001 是 1 208(95.19) 61(4.81) 否 2 399(97.20) 69(2.80) 年龄(岁) 66.645 ＜0.001 ≥30 461(97.26) 13(2.74) 40~ 1 029(92.79) 80(7.21) ≥50 2 115(98.28) 37(1.72) BMI(kg/m2) 15.378 0.002 偏瘦 188(99.47) 1(0.53) 正常 1 673(96.82) 55(3.18) 超重 1 131(95.13) 59(4.87) 肥胖 615(97.58) 15(2.42) 流产史 12.463 ＜0.001 是 1 680(95.40) 81(4.60) 否 1 927(97.52) 49(2.48) 生育次数(次) 22.322 ＜0.001 ≤2 1 792(95.12) 92(4.88) ≥3 1 815(97.95) 38(2.05) 月经状况 28.152 ＜0.001 是 1 213(94.32) 73(5.68) 否 2 392(97.67) 57(2.33)
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表 3 LCA模型各类别的多项指标比较
Table 3. Model fitting indicators for different latent classes
模型潜在类别数 LL BIC AIC L2 ν Entropy P值 1 -18 378.481 36 846.652 36 778.962 5 991.882 564 0.000 ＜0.001 2 -16 741.432 33 637.784 33 520.865 2 717.784 556 0.798 ＜0.001 3 -16 062.457 32 345.063 32 178.914 1 359.834 548 0.835 ＜0.001 4 -15 767.830 31 821.038 31 605.661 770.580 540 0.831 ＜0.001 5 -15 663.280 31 677.167 31 412.561 561.480 532 0.840 0.180 6 -15 634.934 31 685.704 31 371.869 504.788 524 0.730 0.720
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表 4 潜在类别模型的类别概率和条件概率(%)
Table 4. Category probability and conditional probability of Latent class models (%)
变量 类型1 类型2 类型3 类型4 类型5 类别概率 0.477 0.224 0.124 0.114 0.061 居住类型 农村 0.976 0.972 1.000 0.125 0.028 城镇 0.024 0.028 0.000 0.875 0.972 BMI(kg/m2) 偏瘦 0.060 0.043 0.071 0.036 0.058 正常 0.516 0.461 0.545 0.429 0.511 超重 0.330 0.366 0.307 0.382 0.333 肥胖 0.095 0.130 0.078 0.153 0.098 生育次数(次) ≤2 0.216 0.635 0.802 0.877 0.967 ≥3 0.784 0.365 0.198 0.123 0.033 流产史 否 0.812 0.632 0.613 0.360 0.426 是 0.188 0.368 0.387 0.640 0.574 月经状况 是 0.015 0.665 0.988 0.045 0.970 否 0.985 0.335 0.012 0.955 0.030 文化程度 小学及以下 0.962 0.890 0.394 0.616 0.038 初中至高中 0.038 0.109 0.539 0.241 0.459 大专及以上 0.000 0.001 0.067 0.143 0.503 年龄(岁) ≥30 0.000 0.007 0.756 0.000 0.491 40~ 0.037 0.886 0.244 0.201 0.509 ≥50 0.963 0.108 0.000 0.799 0.000
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表 5 研究对象的潜在类别特征
Table 5. The research object of latent class features
潜在类别 居住类型 生育次数(次) 流产史(%) 有月经(%) 文化程度 年龄(岁) 农村老年型 农村 ≥3 18.80 1.50 小学及以下 ≥50 农村中年型 农村 ≤2 36.80 66.50 小学及以下 40~49 农村青年型 农村 ≤2 64.00 98.80 初中至高中 30~39 城镇老年型 城镇 ≤2 38.70 4.50 小学及以下 ≥50 城镇青中年型 城镇 ≤2 57.40 97.00 大专及以上 30~49
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表 6 子宫肌瘤检出情况与潜在类别类型的差异[n(%)]
Table 6. Differences between the detection of uterine fibroids and their potential types [n(%)]
潜在类别 子宫肌瘤 χ2值 P值 未检出 检出 农村老年型 类型1 1 768(99.21) 14(0.79) 93.420 ＜0.001 农村中年型 类型2ace 810(96.77) 27(3.23) 0.003 农村青年型 类型3abde 443(95.47) 21(4.43) 0.002 城镇老年型 类型4ace 409(96.01) 17(3.89) 0.003 城镇中青年型 类型5abcd 223(97.81) 5(2.19) 0.003 注：a表示两两比较中，与类型1比较；b表示与类型2比较；c表示与类型3比较有差异；d表示与类型4比较；e表示与类型5比较。
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