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目的了解农药自杀未遂者流行特征以及环境因素与儿茶酚胺氧位甲基转移酶(COMT)基因多态性的关系,为该人群自杀行为的预防提供科学依据。方法对从2003年1至12月在综合医院收集到的农药自杀未遂者107例,分别调查其相关影响因素和收集1ml全血进行COMT基因多态性分析。结果107例中,男女之比为1∶1.55;年龄13～81岁,主要集中在20～44岁(67.3%);文化程度以小学及以下为主(59.8%);有精神障碍史者13例(12.1%)。一年内有情感冲突者84例(78.5%)。有自杀冲动性者30例(28.0%)。一级亲属中有过自杀行为者5例。多因素分析显示:精神障碍、自杀未遂冲动性与COMT基因间存在相互作用,其关联强度值分别为0.052(95%CI:0.006～0.437)、2.917(95%CI:1.097～7.760)。结论在该人群中,尤其应重视年轻女性,有精神障碍、一年内有情感冲突者。COMT基因存在遗传异质性,且与精神障碍、自杀冲动具有相互作用。
Objective To understand the prevalence of suicide attempts of pesticides and the relationship between environmental factors and polymorphisms of catecholamine oxygen methyltransferase (COMT) gene and to provide a scientific basis for the prevention of suicide. Methods A total of 107 cases of attempted suicide of pesticides collected in general hospitals from January to December 2003 were investigated. The related factors and 1ml of whole blood were collected for COMT gene polymorphism analysis. Results Among the 107 cases, the ratio of men to women was 1: 1.55; the age ranged from 13 to 81 years old, mainly in the age range from 20 to 44 (67.3%); the primary and secondary education was 59.8%; the history of mental disorders was 13 Example (12.1%). There were 84 emotional conflict (78.5%) in a year. There are 30 cases of suicide impulsivity (28.0%). There were 5 suicides among first-degree relatives. Multivariate analysis showed that there was interaction between mental retardation and suicide attempt implication and COMT gene. The correlation strength was 0.052 (95% CI: 0.006-0.437) and 2.917 (95% CI: 1.097-7.760) respectively. Conclusion In this population, particular attention should be paid to young women, mental disorders, and emotional conflict within a year. COMT gene exists genetic heterogeneity, and with mental disorders, suicide impulse interaction.