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上海市崇明区中学生功能性便秘筛查状况

庄羽骁 许俊 周红艳 徐慧鲜 王志勇 胡颖

庄羽骁, 许俊, 周红艳, 徐慧鲜, 王志勇, 胡颖. 上海市崇明区中学生功能性便秘筛查状况[J]. 中国学校卫生, 2022, 43(9): 1391-1395. doi: 10.16835/j.cnki.1000-9817.2022.09.027
引用本文: 庄羽骁, 许俊, 周红艳, 徐慧鲜, 王志勇, 胡颖. 上海市崇明区中学生功能性便秘筛查状况[J]. 中国学校卫生, 2022, 43(9): 1391-1395. doi: 10.16835/j.cnki.1000-9817.2022.09.027
ZHUANG Yuxiao, XU Jun, ZHOU Hongyan, XU Huixian, WANG Zhiyong, HU Ying. Screening of functional constipation among adolescents in Chongming District, Shanghai[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2022, 43(9): 1391-1395. doi: 10.16835/j.cnki.1000-9817.2022.09.027
Citation: ZHUANG Yuxiao, XU Jun, ZHOU Hongyan, XU Huixian, WANG Zhiyong, HU Ying. Screening of functional constipation among adolescents in Chongming District, Shanghai[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2022, 43(9): 1391-1395. doi: 10.16835/j.cnki.1000-9817.2022.09.027

上海市崇明区中学生功能性便秘筛查状况

doi: 10.16835/j.cnki.1000-9817.2022.09.027
基金项目: 

上海交通大学医学院附属新华医院崇明分院2017年度院级科研基金项目 YL201705

上海中医药大学附属曙光医院2020年度四明基金 SKKJ-202021

详细信息
    作者简介:

    庄羽骁(1993-),男,江苏苏州人,硕士,主治医师,主要研究方向为功能性胃肠病的诊治

    通讯作者:

    胡颖,E-mail:no531208922@sina.com

  • 利益冲突声明  所有作者声明无利益冲突。
  • 中图分类号: R181.3 G478 R179 R725.7

Screening of functional constipation among adolescents in Chongming District, Shanghai

  • 摘要:   目的  了解上海市崇明区中学生功能性便秘(functional constipation, FC)的流行病学特征及相关因素。  方法  采用多级分层整群随机抽样法, 于2019年3-6月对上海市崇明区18周岁以下的4 969名在读初、高中生进行问卷调查。  结果  上海市崇明区中学生FC患病率为13.95%, 不同性别、学段、城乡之间患病率差异均无统计学意义(P值均>0.05)。在高中组中, 临毕业年级组FC的患病率(17.36%, 130/749)高于非临毕业年级组(13.77%, 201/1 460)(χ2=5.01, P=0.03), 市示范性高中组FC的患病率(18.23%, 115/631)高于普通高中组(13.07%, 49/375)和区示范性高中组(13.88%, 167/1 203)(χ2=7.43, P=0.02)。多因素Logistic回归分析显示, 体育锻炼频率、食用辛辣食品频率高、饮食中辛辣食品占比、食用蔬菜频率、饮食中蔬菜占比、每日饮水量、是否纳差、睡眠质量、是否就读于示范型学校与中学生FC有关(OR=0.11~7.71, P值均 < 0.05)。  结论  FC为上海市崇明区中学生的常见病, 好发于高中临毕业年级组, 且危险因素较多。
    1)  利益冲突声明  所有作者声明无利益冲突。
  • 表  1  上海市崇明区中学生FC影响因素的单因素Logistic回归分析(n=4 969)

    Table  1.   Single-factor Logistic regression analysis on the influencing factors of FC among middle school students in Chongming District(n=4 969)

    自变量 选项 β 标准误 Wald χ2 OR值(OR值95%CI) P
    性别 0.10 0.08 1.44 1.10(0.94~1.30) 0.23
    学段 六年级 -0.53 0.16 11.83 0.59(0.43~0.80) <0.01
    七年级 -0.32 0.15 4.68 0.73(0.54~0.97) 0.03
    八年级 -0.28 0.15 3.58 0.76(0.57~1.01) 0.06
    九年级 -0.21 0.15 2.03 0.81(0.61~1.08) 0.15
    高一 -0.28 0.14 3.85 0.75(0.57~1.00) 0.05
    高二 -0.27 0.15 3.37 0.77(0.58~1.02) 0.06
    体育锻炼频率/(次·周-1) 每天 -1.80 0.29 39.91 0.17(0.09~0.29) <0.01
    3~6 -1.92 0.28 45.85 0.15(0.08~0.26) <0.01
    1~2 -1.59 0.29 29.67 0.21(0.12~0.36) <0.01
    高强度运动占总锻炼时间 >80%~100% -0.14 0.30 0.21 0.87(0.49~1.56) 0.64
    >50%~80% -0.34 0.26 1.69 0.71(0.43~1.19) 0.19
    >30%~50% 0.01 0.21 0.01 1.01(0.66~1.53) 0.97
    >0~30% 0.02 0.21 0.01 1.02(0.67~1.56) 0.91
    食用辛辣食品频率/(次·周-1) 0 -2.01 0.16 167.98 0.13(0.10~0.18) <0.01
    1~2 -1.20 0.13 81.77 0.30(0.23~0.39) <0.01
    3~6 0.05 0.15 0.12 1.05(0.79~1.40) 0.73
    饮食中辛辣食品占比 0 -0.55 0.36 2.38 0.58(0.29~1.16) 0.12
    >0~30% -0.90 0.35 6.76 0.41(0.21~0.80) 0.01
    >30%~50% -0.55 0.35 2.50 0.58(0.29~1.14) 0.11
    >50%~80% 1.32 0.37 13.00 3.73(1.82~7.62) <0.01
    食用蔬菜频率/(次·周-1) 每天 -2.52 0.23 124.26 0.08(0.05~0.13) <0.01
    3~6 -1.41 0.22 42.43 0.24(0.16~0.37) <0.01
    1~2 -0.36 0.22 3.27 0.70(0.46~1.07) 0.10
    饮食中蔬菜占比 >80%~100% -0.59 0.34 2.99 0.55(0.28~1.08) 0.08
    >50%~80% -0.64 0.32 4.03 0.53(0.28~0.99) 0.05
    >30%~50% 1.01 0.32 10.25 2.75(1.48~5.11) <0.01
    >0~30% 1.44 0.32 20.62 4.22(2.27~7.84) <0.01
    食用水果频率/(次·周-1) 每天 -0.51 0.33 2.36 0.60(0.31~1.15) 0.33
    3~6 -0.23 0.25 0.85 0.79(0.49~1.30) 0.36
    1~2 -0.14 0.20 0.47 0.87(0.59~1.29) 0.50
    饮食中水果食品占比 >80%~100% -0.15 0.33 0.21 0.86(0.46~1.63) 0.65
    >50%~80% -0.07 0.32 0.05 0.93(0.50~1.73) 0.83
    >30%~50% -0.04 0.12 0.09 0.97(0.76~1.22) 0.77
    >0~30% 0.10 0.12 0.55 1.10(0.86~1.40) 0.46
    每日饮水量/mL >1 600 -0.57 0.17 12.12 0.56(0.41~0.78) <0.01
    >1 200~1 600 -1.39 0.17 69.28 0.25(0.18~0.35) <0.01
    >600~1 200 0.72 0.16 20.28 2.06(1.50~2.81) <0.01
    学习紧张、神经压抑、学业压力大 几乎不 -1.80 0.22 70.27 0.17(0.11~0.25) <0.01
    偶尔 -1.54 0.22 49.65 0.21(0.14~0.33) <0.01
    经常 -0.25 0.29 0.79 0.78(0.44~1.36) 0.38
    睡眠质量 睡眠时间充足、睡眠质量好 -1.32 0.29 21.04 0.27(0.15~0.47) <0.01
    不容易入睡 0.23 0.29 0.61 1.25(0.71~2.20) 0.43
    睡眠质量差、易醒 -0.49 0.34 2.09 0.61(0.32~1.19) 0.15
    家人有无排便困难 没有 -0.39 0.42 8.65 0.68(0.30~1.54) 0.03
    部分 0.11 0.42 0.07 1.11(0.49~2.53) 0.80
    烧心/胸骨后不适 0.09 0.13 0.46 1.09(0.85~1.41) 0.50
    纳差 0.81 0.09 87.98 2.24(1.89~2.65) <0.01
    恶心/呕吐 0.23 0.12 3.72 1.25(1.00~1.58) 0.05
    反酸、嗳气 0.01 0.09 0.01 1.01(0.84~1.21) 0.95
    临近毕业 0.24 0.09 7.27 0.79(0.67~0.94) <0.01
    示范性学校 普通高中 -0.39 0.19 4.55 0.67(0.47~0.97) 0.03
    区示范性高中 -0.32 0.13 5.97 0.72(0.56~0.94) 0.02
    下载: 导出CSV

    表  2  上海市崇明区中学生FC影响因素的多因素Logistic回归分析(n=4 969)

    Table  2.   Multivariate Logistic regression analysis on the influencing factors of FC among middle school students in Chongming District(n=4 969)

    自变量 选项 β 标准误 Wald χ2 OR值(OR值95%CI) P
    体育锻炼频率/(次·周-1) 每天 -1.99 0.54 13.76 0.14(0.05~0.39) <0.01
    ≥3 -2.07 0.53 15.04 0.13(0.05~0.36) <0.01
    1~2 -1.64 0.55 9.01 0.19(0.07~0.57) <0.01
    食用辛辣食品频率/(次·周-1) 0 -0.61 0.32 3.57 0.55(0.30~1.02) 0.06
    1~2 0.59 0.28 4.45 1.80(1.04~3.10) 0.03
    ≥3 0.91 0.28 10.29 2.49(1.43~4.34) <0.01
    饮食中辛辣食品占比 0 0.87 0.70 1.55 2.39(0.61~9.44) 0.21
    >0~30% 0.80 0.70 1.34 2.22(0.58~8.57) 0.25
    >30%~50% 1.27 0.70 3.34 3.57(0.91~14.00) 0.07
    >50%~80% 2.04 0.72 8.07 7.71(1.89~31.54) <0.01
    食用蔬菜频率/(次·周-1) 每天 -2.18 0.36 36.12 0.11(0.06~0.23) <0.01
    3~6 -0.68 0.36 3.58 0.51(0.25~1.03) 0.06
    1~2 -0.17 0.36 0.21 0.85(0.42~1.71) 0.64
    饮食中蔬菜占比 >80%~100% -0.24 0.47 0.26 0.79(0.32~1.97) 0.79
    >50%~80% 0.57 0.42 1.85 1.77(0.78~4.04) 0.17
    >30%~50% 1.07 0.42 6.64 2.92(1.29~6.60) 0.01
    >0~30% 0.80 0.42 3.53 2.22(0.97~5.08) 0.06
    每日饮水量/mL >1 600 0.56 0.33 2.94 1.75(0.92~3.30) 0.09
    >1 200~1 600 -0.40 0.33 1.47 0.67(0.35~1.28) 0.23
    >600~1 200 1.32 0.31 18.09 3.74(2.04~6.86) <0.01
    纳差 0.38 0.17 4.96 1.46(1.05~2.04) 0.03
    睡眠质量 睡眠时间充足、睡眠质量好 -0.90 0.52 3.03 0.41(0.15~1.12) 0.03
    不容易入睡 0.01 0.52 0.01 1.01(0.37~2.78) 0.98
    睡眠质量差、易醒 -0.84 0.60 1.93 0.43(0.13~1.41) 0.17
    示范性学校 普通高中 -0.57 0.43 1.74 0.57(0.25~1.32) 0.19
    区示范性高中 -1.03 0.43 5.70 0.36(0.16~0.83) 0.02
    下载: 导出CSV
  • [1] DROSSMAN D A, HASLER W L. Rome Ⅳ-Functional GI Disorders: Disorders of gut-brain interaction[J]. Gastroenterology, 2016, 150(6): 1257-1261. doi: 10.1053/j.gastro.2016.03.035
    [2] LACY B E, MEARIN F, CHANG L, et al. Bowel disorders[J]. Gastroenterology, 2016, 150(6): 1393-1407. doi: 10.1053/j.gastro.2016.02.031
    [3] DENNISON C, PRASAD M, LLOYD A, et al. The health-related quality of life and economic burden of constipation[J]. Pharmacoeconomics, 2005, 23(5): 461-476. doi: 10.2165/00019053-200523050-00006
    [4] HYAMS J S, DI L C, SAPS M, et al. Functional disorders: children and adolescents[J]. Gastroenterology, 2016, 150: 1456-1468. doi: 10.1053/j.gastro.2016.02.015
    [5] LEE Y J, PARK K S. Understanding the changes in diagnostic criteria for functional constipation in pediatric patients: from Rome Ⅲ to Rome Ⅳ[J]. J Neurogastroenterol Motil, 2019, 25(1): 3-5. doi: 10.5056/jnm18199
    [6] KEARNEY R, EDWARDS T, BRADFORD M, et al. Emergency provider use of plain radiographs in the evaluation of pediatric constipation[J]. Pediatr Emerg Care, 2019, 35(9): 624-629.
    [7] LEWIS M L, PALSSON O S, WHITEHEAD W E, et al. Prevalence of functional gastrointestinal disorders in children and adolescents[J]. J Pediatr, 2016, 177: 39-43. doi: 10.1016/j.jpeds.2016.04.008
    [8] KOPPEN I J, VELASCO-BENITEZ C A, BENNINGA M A, et al. Is there an association between functional constipation and excessive bodyweight in children?[J]. J Pediatr, 2016, 171: 178-182. doi: 10.1016/j.jpeds.2015.12.033
    [9] RAJINDRAJITH S, DEVANARAYANA N M, ADHIKARI C, et al. Constipation in children: an epidemiological study in Sri Lanka using Rome Ⅲ criteria[J]. Arch Dis Child, 2012, 97(1): 43-45. doi: 10.1136/adc.2009.173716
    [10] MIELE E, SIMEONE D, MARINO A, et al. Functional gastrointestinal disorders in children: an Italian prospective survey[J]. Pediatrics, 2004, 114(1): 73-78. doi: 10.1542/peds.114.1.73
    [11] ZABLAH R, VELASCO-BENITEZ C A, MERLOS I, et al. Prevalence of functional gastrointestinal disorders in school-aged children in El Salvador[J]. Rev Gastroenterol Mex, 2015, 80(3): 186-191.
    [12] UDOH E E, RAJINDRAJITH S, DEVANARAYANA N M, et al. Prevalence and risk factors for functional constipation in adolescent Nigerians[J]. Arch Dis Child, 2017, 102(9): 841-844. doi: 10.1136/archdischild-2016-311908
    [13] TAM Y H, LI A M, SO H K, et al. Socioenvironmental factors associated with constipation in Hong Kong children and Rome Ⅲ criteria[J]. J Pediatr Gastroenterol Nutr, 2012, 55(1): 56-61. doi: 10.1097/MPG.0b013e31824741ce
    [14] 闫宁, 沈蕙, 徐勇. 苏州市中学生功能性便秘危险因素分析[J]. 中国学校卫生, 2014, 35(8): 1249-1250. http://www.cjsh.org.cn/article/id/zgxxws201408047

    YAN N, SHEN H, XU Y. Analysis of risk factors for functional constipation among middle school students in Suzhou[J]. Chin J Sch Health, 2014, 35(8): 1249-1250. http://www.cjsh.org.cn/article/id/zgxxws201408047
    [15] 周立平, 邓凌, 黄格丽, 等. 青少年功能性便秘的流行病学调查[J]. 中国儿童保健杂志, 2010, 18(7): 566-568. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201007013.htm

    ZHOU L P, DENG L, HUANG G L, et al. Epidemiologic study on functional constipation in adolescents[J]. Chin J Child Health Care, 2010, 18(7): 566-568. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201007013.htm
    [16] 吕峻峰, 熊勇, 刘玉玲, 等. 儿童及青少年功能性便秘流行病学调查及危险因素分析[J]. 中国妇幼保健, 2012, 27(21): 3301-3303. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201221033.htm

    LYU J F, XIONG Y, LIU Y L, et al. Epidemiological investigation and analysis of risk factors of functional constipation in children and adolescents[J]. Matern Child Health Care Chin, 2012, 27(21): 3301-3303. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201221033.htm
    [17] 周惠清, 李定国, 宋艳艳, 等. 全国城市中小学生功能性便秘危险因素研究[J]. 临床儿科杂志, 2008, 26(2): 113-115. https://www.cnki.com.cn/Article/CJFDTOTAL-LCAK200802014.htm

    ZHOU H Q, LI D G, SONG Y Y, et al. Risk factors of functional constipation in adolescents in China[J]. J Clin Pediatr, 2008, 26(2): 113-115. https://www.cnki.com.cn/Article/CJFDTOTAL-LCAK200802014.htm
    [18] WU T C, CHEN L K, PAN W H, et al. Constipation in Taiwan elementary school students: a nationwide survey[J]. J Chin Med Assoc, 2011, 74(2): 57-61. doi: 10.1016/j.jcma.2011.01.012
    [19] ZHOU H, YAO M, CHENG G Y, et al. Prevalence and associated factors of functional gastrointestinal disorders and bowel habits in Chinese adolescents: a school-based study[J]. J Pediatr Gastroenterol Nutr, 2011, 53(2): 168-173. doi: 10.1097/MPG.0b013e3182125388
    [20] ASAKURA K, MASAYASU S, SASAKI S. Dietary intake, physical activity, and time management are associated with constipation in preschool children in Japan[J]. Asia Pac J Clin Nutr, 2017, 26(1): 118-129.
    [21] 俞汀, 姜柳琴, 林琳. 功能性便秘的新认识: 罗马Ⅳ标准更新点解读[J]. 中华胃肠外科杂志, 2017, 20(12): 1334-1338.

    YU T, JIANG L Q, LIN L. Update of the Rome criteria for functional constipation[J]. Chin J Gastrointest Surgery, 2017, 20(12): 1334-1338.
    [22] MUGIE S M, BENNINGA M A, DI LORENZO C. Epidemiology of constipation in children and adults: a systematic review[J]. Best Pract Res Clin Gastroenterol, 2011, 25(1): 3-18. doi: 10.1016/j.bpg.2010.12.010
    [23] VAN DEN BERG M M, BENNINGA M A, DI LORENZO C. Epidemiology of childhood constipation: a systematic review[J]. Am J Gastroenterol, 2006, 101(10): 2401-2409. doi: 10.1111/j.1572-0241.2006.00771.x
    [24] 叶飞, 王巧民. 慢性便秘的流行病学研究进展[J]. 中国临床保健杂志, 2010, 13(6): 665-667. https://www.cnki.com.cn/Article/CJFDTOTAL-LZBJ201006051.htm

    YE F, WANG Q M. Epidemiological research progress of chronic constipation[J]. Chin J Clin Health, 2010, 13(6): 665-667. https://www.cnki.com.cn/Article/CJFDTOTAL-LZBJ201006051.htm
    [25] KOLOSKI N A, JONES M, WAI R, et al. Impact of persistent constipation on health-related quality of life and mortality in older community-dwelling women[J]. Am J Gastroenterol, 2013, 108(7): 1152-1158. doi: 10.1038/ajg.2013.137
    [26] FATTAHI M R, ALORIZI S M E, NIMROUZI M, et al. A randomized clinical trial on treatment of chronic constipation by traditional Persian medicine recommendations compared to allopathic medicine: a pilot study[J]. Int J Prev Med, 2017, 8(1): 50.
    [27] NELLESEN D, CHAWLA A, OH D L, et al. Comorbidities in patients with irritable bowel syndrome with constipation or chronic idiopathic constipation: a review of the literature from the past decade[J]. Postgrad Med, 2013, 125(2): 40-50. doi: 10.3810/pgm.2013.03.2640
    [28] MASON H J, SERRANO-IKKOS E, KAMM M A. Psychological morbidity in women with idiopathic constipation[J]. Am J Gastroenterol, 2000, 95(10): 2852-2857.
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出版历程
  • 收稿日期:  2022-03-09
  • 修回日期:  2022-05-18
  • 网络出版日期:  2022-09-23
  • 刊出日期:  2022-09-25

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