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北京大学学报（医学版） ›› 2024, Vol. 56 ›› Issue (5): 815-819. doi: 10.19723/j.issn.1671-167X.2024.05.010

• 论著 • 上一篇    下一篇

中国某健康体检人群痔的流行病学特征

郭呈华1, 车晓玉1, 林芝1, 蔡珊1, 刘国臻2, 潘烺3, 吕筠1,3,4, 李立明1,3,4, 满塞丽麦5, 王波5,*(), 余灿清1,3,4,*()   

  1. 1. 北京大学公共卫生学院流行病与卫生统计学系, 北京 100191
    2. 北京大学数据研究院, 北大医信健康医疗大数据实验室, 北京 100080
    3. 北京大学公众健康与重大疫情防控战略研究中心, 北京 100191
    4. 重大疾病流行病学教育部重点实验室(北京大学), 北京 100191
    5. 北京大学医学部美年公众健康研究院, 北京 100191
  • 收稿日期:2021-02-28 出版日期:2024-10-18 发布日期:2024-10-16
  • 通讯作者: 王波,余灿清 E-mail:paul@meinianresearch.com;yucanqing@pku.edu.cn
  • 基金资助:
    2020年北京大学公共卫生学院医学部大学生创新实验项目

Epidemiological characteristics of hemorrhoids in a healthy physical examination population in China

Chenghua GUO1, Xiaoyu CHE1, Zhi LIN1, Shan CAI1, Guozhen LIU2, Lang PAN3, Jun LV1,3,4, Liming LI1,3,4, Sailimai MAN5, Bo WANG5,*(), Canqing YU1,3,4,*()   

  1. 1. Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
    2. Beijing Institute of Big Data Research & PKU Healthcare IT Company Big Data Laboratory, Beijing 100080, China
    3. Peking University Center for Public Health and Epidemic Preparedness Response, Beijing 100191, China
    4. Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
    5. Mei-nian Public Health Research Institute, Peking University Health Science Center, Beijing 100191, China
  • Received:2021-02-28 Online:2024-10-18 Published:2024-10-16
  • Contact: Bo WANG, Canqing YU E-mail:paul@meinianresearch.com;yucanqing@pku.edu.cn
  • Supported by:
    Supported by 2020 Peking University School of Public Health Health Science Center Students' Innovation Training Program

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摘要：

目的: 分析我国某健康体检人群中痔的分布特点，为痔的精准预防和早期干预提供依据。方法: 选取2018年在某全国连锁的体检中心接受健康检查的18岁以上受试者作为研究对象，进行横断面调查研究，采用Logistic回归分析受试者的一般资料及直肠检查结果，描述痔的地区和人群分布特征。以2010年第6次人口普查作为标准人口，对年龄和地区进行直接标化，报告分为性别、年龄组的痔标化检出率。结果: 共纳入2 940 295名健康体检者，平均年龄(41.7±14.0)岁，其中女性占52.6%。在全年龄组人群中，男、女性痔的标化检出率分别为17.7%和43.7%(P < 0. 001)。从年龄分布来看，女性痔标化检出率呈倒U型，30~39岁年龄组的痔标化检出率最高(63.5%)；男性痔标化检出率随年龄增加，以50~59岁年龄组最高(17.2%)，60岁及以上年龄组检出率略有降低(趋势检验P < 0.001)。此外，男性痔标化检出率随体重指数升高呈上升趋势(趋势检验P < 0.001)，高血压人群痔标化检出率在男性和女性中均显著高于正常血压人群(P < 0.001)。结论: 我国成人痔检出率与性别、年龄、肥胖及高血压等因素密切相关，但本研究基于体检人群开展，结论外推到一般人群时需慎重；识别出痔患病的高危人群和危险因素，有针对性地开展健康宣教工作和早期筛查，可以减少痔的发生，提升我国居民生活质量和健康水平。

关键词: 痔, 健康检查, 检出率

Abstract:

Objective: To describe the epidemiological distribution of hemorrhoids in a physical examination population in China, which could provide evidence for precision prevention and early intervention of hemorrhoids. Methods: Chinese subjects over 18 years of age who underwent a physical examination in a nationwide chain of physical examination centers in 2018 were studied in a cross-sectional design, which collected information by a questionnaire and physical examination results from each subject. The epidemiological distribution of hemorrhoids was described using Logistic models. The gender-, age-, and region-detection rates of hemorrhoids were standardized to the Sixth National Population Census of the People's Republic of China (2010). Results: A total of 2 940 295 adult subjects were included in the study, of whom the average age was (41.7±14.0) years, and 52.6% were females. The standardized detection rate of hemorrhoids was higher for females (43.7%) than that for males (17.7%; P < 0.001) in this study. In the females, the age distribution of hemorrhoids was inverted U-shaped, with the highest standardized detection rate of hemorrhoids in the age group of 30-39 years (63.5%). In the males, the standardized detection rate of hemorrhoids increased along with age, with the highest percentage of 17.2% in the age group of 50-59 years, and the standardized detection rate of hemorrhoids in the age group of 60 and above decreased slightly (P < 0.001 for trend test). The participants with hypertension had a higher standardized detection rate of hemorrhoids than those with normal blood pressure in both males and females (P < 0.001). The standardized detection rate of hemorrhoids showed a positive correlation with body mass index (P < 0.001 for trend test in males). Conclusion: The detection rate of hemorrhoids varied to gender, age, obesity, and hypertension status, which could help to identify the risk factors and the high-risk sub-groups, and hence to strengthen health education and early detection accordingly, which could eventually reduce the incidence of hemorrhoids and improve the quality of life and health in the Chinese population. This study was conducted in a physical examination population, and the conclusions of this study should be extrapolated with caution.

Key words: Hemorrhoid, Physical examination, Detection rate

中图分类号: 

  • R181.2

表1

研究对象的年龄、地区分布特征"

ItemsMale Female
n % n %
Age group/years
  18-29 344 952 11.7 327 775 11.2
  30-39 378 289 12.9 408 239 13.9
  40-49 262 811 8.9 326 106 11.1
  50-59 235 372 8.0 289 863 9.9
  60-69 125 337 4.3 153 567 5.2
  70- 46 168 1.6 41 816 1.4
Region of China
  North 190 821 13.7 162 330 10.5
  Northeast 36 078 2.6 63 415 4.1
  East 616 890 44.3 768 956 49.7
  Central 86 196 6.2 84 692 5.5
  South 195 183 14.0 225 644 14.6
  Southwest 93 361 6.7 99 292 6.4
  Northwest 174 400 12.5 143 037 9.2
Total 1 392 929 47.4 1 547 366 52.6

表2

我国18岁以上体检人群痔检出情况"

Items Male Female
Crude rate/%(95%CI) Standardized rate/%(95%CI) Crude rate/%(95%CI) Standardized rate/%(95%CI)
Age group/years
  18-29 9.1 (7.5-10.6) 7.3 (5.8- 8.8) 32.2 (27.5-36.9) 50.6 (32.2-68.9)
  30-39 17.3 (14.8-19.7) 13.9 (11.6-16.3) 47.3 (42.1-52.4) 63.5 (45.5-81.4)
  40-49 22.7 (19.8-25.7) 16.6 (13.3-19.8) 51.1 (46.1-56.0) 62.6 (40.7-84.4)
  50-59 24.8 (21.7-27.8) 17.2 (13.1-21.3) 47.7 (43.0-52.4) 56.2 (32.3-80.0)
  60-69 24.9 (21.5-28.3) 14.9 (10.9-18.8) 44.8 (39.2-50.3) 50.8 (27.3-74.2)
  70- 26.7 (22.6-30.9) 16.6 (9.5-23.6) 47.7 (39.4-56.1) 45.0 (17.3-72.7)
Region of China
  North 20.7 (13.6-27.9) 14.8 (7.5-22.2) 40.6 (28.9-52.4) 22.4 (＜0.1-47.2)
  Northeast 16.1 (7.4-24.7) 16.5 (7.3-25.6) 27.0 (19.0-34.9) 25.1 (20.6-29.5)
  East 19.1 (15.4-22.8) 18.0 (14.6-21.3) 49.3 (41.5-57.1) 39.5 (20.0-59.0)
  Central 31.7 (24.6-38.7) 9.8 (7.0-12.7) 47.2 (38.0-56.4) 53.1 (45.0-61.2)
  South 19.0 (15.3-22.7) 17.0 (13.0-21.0) 46.3 (39.5-53.0) 50.4 (42.6-58.2)
  Southwest 22.3 (15.2-29.4) 21.1 (13.8-28.5) 40.5 (30.6-50.5) 45.5 (37.0-54.0)
  Northwest 5.8 (2.9- 8.6) 4.1 (＜0.1- 9.5) 31.4 (12.0-50.9) 9.5 (＜0.1-26.2)
Total 18.5 (16.0-21.0) 17.7 (14.3-21.1) 44.7 (40.0-49.5) 43.7 (30.2-57.2)

表3

我国18岁以上体检人群BMI和血压水平对痔检出的影响"

ItemsMale Female
Crude rate/%(95%CI) Standardized rate/%(95%CI) OR(95%CI) Crude rate/%(95%CI) Standardized rate/%(95%CI) OR(95%CI)
BMI
  Underweight 10.0 (8.2 -11.7) 13.7 (19.9-17.5) 0.73 (0.70-0.75) 35.0 (30.6-39.5) 38.9 (28.0-49.9) 0.79 (0.78-0.81)
  Normal weight 17.0 (14.7-19.4) 17.0 (13.7-20.3) 1.00 45.2 (40.4-50.0) 45.8 (34.8-56.9) 1.00
  Overweight 20.3 (17.6-23.0) 18.1 (14.6-21.5) 1.10 (1.08-1.11) 46.3 (41.4-51.2) 43.2 (28.1-58.3) 0.98 (0.97-0.98)
  Obesity 19.5 (16.8-22.2) 18.7 (15.3-22.0) 1.09 (1.08-1.10) 43.5 (38.4-48.7) 38.4 (20.8-56.0) 0.89 (0.88-0.90)
Hypertension
  No 17.2 (14.9-19.6) 17.6 (14.4-20.8) 1.00 44.0 (39.1-48.9) 43.4 (30.7-56.0) 1.00
  Yes 21.1 (18.2-23.9) 18.1 (14.3-21.9) 1.02 (1.01-1.03) 45.4 (39.6-51.2) 44.8 (27.9-61.6) 1.03 (1.02-1.04)
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ISSN 1671-167X
CN 11-4691/R
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