论文部分内容阅读
目的探讨分娩方式与儿童急性白血病(childhood acute leukemia,CAL)的关系。方法以2011年10月~2012年9月在河南某大学附属医院儿童血液科就诊的177例15岁以下新发CAL患儿且排除患唐氏综合征者作为病例组,按照同居住地类型、同性别、年龄±1岁的要求,以1︰1个体匹配方式,选取177例同时期在该医院儿童保健科门诊就诊或小儿外科住院治疗、排除血液系统疾病及其他恶性肿瘤疾病的患儿作为对照组。对病例和对照患儿的父母进行面对面问卷调查,内容包括研究对象的人口统计学资料、分娩情况以及21项其他CAL相关因素。应用SAS9.1统计分析软件包进行条件Logistic回归分析。结果 177例CAL病例中,急性淋巴细胞白血病134例,男、女分别为82、52例;急性非淋巴细胞白血病43例,男、女分别为27、16例。病例和对照患儿年龄中位数分别为4.3、4.5岁,四分位数间距分别为4.7、4.4岁。病例居住地为城镇、农村的分别为31、146例。条件Logistic回归分析显示,与CAL相关的因素包括:分娩方式(OR=2.497,95%CI:1.115~5.594)、家庭装修史(OR=3.047,95%CI:1.271~7.304)、恶性肿瘤家族史(OR=2.148,95%CI:1.087~4.242)、放射线暴露史(OR=1.810,95%CI:1.005~3.261)、母亲有毒有害物质职业暴露史(OR=1.864,95%CI:1.127~3.082)、杀虫剂暴露史(OR=1.730,95%CI:1.082~2.768)、父亲有毒有害物质职业暴露史(OR=1.348,95%CI:1.044~1.742)、感冒频率(OR=1.394,95%CI:1.030~1.886)。结论分娩方式与CAL的发生相关,剖宫产是CAL的一个危险因素。
Objective To investigate the relationship between mode of delivery and childhood acute leukemia (CAL). Methods From October 2011 to September 2012, 177 newborns with under 15 years of age with CAL who were diagnosed as Down syndrome were enrolled in the pediatric hematology department of a university affiliated hospital in Henan Province. According to the type of cohabitation, Gender and age of ± 1 year, with a 1: 1 individual matching method, 177 cases were selected as controls during the same period in outpatient pediatric clinic or pediatric surgical hospitalization, excluding hematologic diseases and other malignant diseases group. Face-to-face questionnaires were conducted among parents of patients and control children, including demographic data, delivery status and 21 other CAL related factors. SAS9.1 statistical analysis software package for conditional Logistic regression analysis. Results Of 177 cases of CAL, 134 cases of acute lymphoblastic leukemia, male and female were 82,52 cases; acute non-lymphocytic leukemia in 43 cases, male and female were 27,16 cases. The median age of cases and controls were 4.3 and 4.5 years respectively, and the interquartile range was 4.7 and 4.4 years respectively. The cases live in cities and towns, with 31,146 cases in rural areas. Conditional logistic regression analysis showed that the factors related to CAL included: mode of delivery (OR = 2.497, 95% CI: 1.115-5.594), family decoration history (OR = 3.047, 95% CI: 1.271-7.304), family history of malignancy (OR = 2.148, 95% CI: 1.087 ~ 4.242), history of radiation exposure (OR = 1.810,95% CI: 1.005-3.261), occupational exposure to maternal toxic and hazardous substances (OR = 1.864, 95% CI: 1.127-3.0821 ), The history of pesticide exposure (OR = 1.730, 95% CI: 1.082-2.768), the occupational exposure history of poisonous and harmful substances to dad (OR = 1.348, 95% CI: 1.044-1.742), the frequency of cold (OR = 1.394, % CI: 1.030 ~ 1.886). Conclusion The mode of delivery is related to the occurrence of CAL. Cesarean section is a risk factor for CAL.