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目的探讨南通地区引起成人白血病的可疑危险因素,为预防白血病的发生提供科学依据。方法对2007年12月—2008年12月就诊于南通市第一人民医院和南通大学第一附属医院的69例确诊白血病患者(病例组)及138例非血液病患者(对照组)进行回顾性调查。对所有的病例和对照采用统一问卷调查。调查受试者的一般情况、吸烟饮酒史、家庭周围居住环境、居室装修史、有害物质接触史、疾病史和家族遗传史等,应用条件Logistic回归模型对资料进行分析。分析过程遵循先单因素后多因素的原则,对单因素分析结果有意义(P<0.2)的变量再进行多因素的逐步回归分析。结果 1∶2病例-对照研究单因素Logistic回归分析显示,白血病的危险因素有:肥胖(OR=0.811,95%CI:0.646~1.017)、经常吸烟(OR=3.344,95%CI:1.395~8.016)、住所周围有“三废”污染(OR=2.545,95%CI:1.156~5.607)、农药接触史(OR=2.262,95%CI:1.093~4.680)、苯接触史(OR=2.380,95%CI:1.949~5.970)、其他有机溶剂接触史(OR=2.944,95%CI:0.952~9.101)、电磁辐射(OR=3.779,95%CI:1.410~10.131)、居室装修史(OR=3.465,95%CI:1.443~8.317)、家族癌症史(OR=2.333,95%CI:0.784~6.943)。多因素Logistic回归分析显示,危险因素为:住所周围有“三废”污染(OR=2.594,95%CI:1.050~6.409)、农药接触史(OR=3.304,95%CI:1.388~7.865)、苯(OR=4.558,95%CI:1.510~13.752)及其他有机溶剂接触史(OR=3.319,95%CI:1.084~10.159)、电磁辐射(OR=3.103,95%CI:1.156~8.332)、家庭装修史(OR=3.964,95%CI:1.512~10.395)。结论住所周围有“三废”污染、接触农药、苯和其他有机溶剂、暴露于电磁辐射、家庭装修后<3个月入住可能是南通地区成人白血病的主要危险因素,白血病的发生与多种因素相关,防治工作应从多方面立体展开。
Objective To investigate the suspicious risk factors of adult leukemia in Nantong area and provide a scientific basis for the prevention of leukemia. Methods A retrospective study was performed on 69 confirmed leukemia patients (case group) and 138 non-hematological disease patients (control group) attending the First People’s Hospital of Nantong City and the First Affiliated Hospital of Nantong University from December 2007 to December 2008. survey. A uniform questionnaire was used for all cases and controls. Investigate the general conditions of the subjects, smoking and drinking history, living environment around the home, room decoration history, contact history of harmful substances, disease history and family history, etc. Logistic regression model was used to analyze the data. The analysis followed the principle of multifactor after the first single factor, and then conducted a stepwise regression analysis of the variables with significant single factor analysis (P <0.2). Results 1: 2 Case-control study Univariate Logistic regression analysis showed that the risk factors for leukemia were obesity (OR = 0.811, 95% CI: 0.646-1.017), frequent smoking (OR = 3.344, 95% CI: 1.395-8.016 (OR = 2.545, 95% CI: 1.156 ~ 5.607), history of pesticide exposure (OR = 2.262, 95% CI: 1.093-4.680), benzene exposure history (OR = 2.380, 95% CI: 1.949 ~ 5.970), history of other organic solvents (OR = 2.944,95% CI: 0.952-9.101), electromagnetic radiation (OR = 3.779,95% CI: 1.410-10.131) 3.465, 95% CI: 1.443-8.317), family history of cancer (OR = 2.333, 95% CI: 0.784-6.943). Multivariate logistic regression analysis showed that the risk factors were: “three wastes” pollution (OR = 2.594, 95% CI: 1.050-6.409), history of pesticide exposure (OR = 3.304, 95% CI: 1.388-7.865) (OR = 3.319, 95% CI: 1.084 ~ 10.159), electromagnetic radiation (OR = 3.103, 95% CI: 1.156 ~ 8.332) and benzene (OR = 4.558,95% CI: 1.510-13.752) , The history of home decoration (OR = 3.964, 95% CI: 1.512 ~ 10.395). Conclusion The “three wastes” pollution around the residence, exposure to pesticides, benzene and other organic solvents, exposure to electromagnetic radiation, home decoration <3 months stay may be the main risk factor for adult leukemia in Nantong area, the occurrence of leukemia and a variety of Factors related to prevention and treatment should be three-dimensional multi-faceted.