双酚A与复发性流产的相关性  

A correlative study on Bisphenol A and recurrent spontaneous abortion

作　　者：刘银梅[1] 沈月平[1] 梁红 王燕[3] 罗晓明[4] 沈宗姬[5] 陈昕[6] 袁伟 

机构地区：[1]苏州大学医学部放射医学与公共卫生学院流行病与卫生统计教研室,215123 [2]上海计划生育科学研究所 [3]苏州大学医学部放射医学与公共卫生学院放射医学七年制 [4]昆山市妇幼保健所 [5]苏州大学附属第一人民医院妇产科 [6]苏州大学附属第二人民医院妇产科

出　　处：《中华预防医学杂志》2011年第4期344-349,共6页Chinese Journal of Preventive Medicine

基　　金：基金项目：国家自然科学基金（30872176）;国家重点基础研究发展计划（2010CB529505）;苏州大学医学发展基金重点项目（EE126705）;国家大学生创新性实验计划项目（5731503110）志谢苏州大学医学部放射医学与公共卫生学院的王畅和刘敏老师在实验方法、操作和仪器使用上给予了很大的指导和帮助

摘　　要：目的探讨双酚A与不明原因复发性流产的关系，为预防复发性流产提供科学依据。方法采用以医院为基础的1：1匹配病例-对照，对60例不明原因复发性流产者按年龄±2岁、同一地区、同一孕周进行匹配。用柱前荧光-高效液相色谱法检测60例不明原因复发性流产者（患者组）和60名正常怀孕妇女（对照组）尿液中双酚A的含量。按文化程度、职业分布和吸烟状况进行分组比较。统计分析采用Wilcoxon秩和检验、秩转换方差分析SNK法、单因素和多因素条件logistic回归模型分析。统计软件为SAS9．1．3。结果患者组和对照组尿液双酚A含量分别是（0．10±0．21）、（0．03±0．08）μg／ml（中位数±四分位数间距），差异有统计学意义（Z=3．988，P〈0．0001）。在文化程度为高中者，患者组双酚A水平明显高于对照组（中位数分别为0．10、0．06μg/ml，Z=1．996，P=0．0459）；文化程度为大专者，患者组双酚A水平明显高于对照组（含量分别为0．14、0．03μg／ml，Z=2．586，P=0．0097）。在职业为工人或农民者，患者组双酚A水平明显高于对照组（含量分别为0．08、0．03μg／ml，Z=2．265，P=0．0235）；职业为商业者，患者组双酚A水平明显高于对照组（含量分别为0．10、0．03μg/ml，Z=2．544，P=0．0109）。在无被动吸烟者中，患者组双酚A水平明显高于对照组（含量分别为0．09、0．03μg／ml，Z=3．767，P=0．0002）。在调整年龄、身体质量指数、婚姻状况等因素后，以双酚A浓度≤0．06μg／ml为参比，双酚A浓度在0．06～0．20μg／ml之间的DR值为4．03，95％CI值为1．67～9．74，双酚A浓度〉0．20μg／ml的OR值为5．46，95％CI值为1．95～15．27，且随着双酚A水平的升高，发生复发性流产的风险也在增加（x^2=13．042，P=0．0003）；经秩转换方差分析SNK法检验发现，正常妊娠者、复发性流产2次与�Objective This study was to investigate the association of Bisphenol A and unexplained recurrent spontaneous abortion. Methods A hospital-based 1：1 matched case-control study was conducted. Sixty patients with unexplained recurrent abortion were included. Each case was matched with one normal control by age （ ± 2 years） ,living district and the same gestational age. The levels of Bisphenol A in urine for 60 cases and 60 controls were detected using high performance liquid chromatography after fluorescent derivatization. The levels of urinary Bisphenol A in case was compared with that in control in education levels, occupation, smoking history. Data was analyzed by means of Wilcoxon-test, Student- Newman-Keuls after rank transform, univariate and multivariate conditional Logistic regression analysis. The software used was SAS 9. 1. 3. Results The values of urinary Bisphenol A in cases and controls were（0. 10± 0. 21 ）μg/ml, （ 0.03 ± 0.08 ） μg/ml, respectively. The level of urinary Bisphenol A in cases was significantly higher than that in controls （ Z = 3. 988 ,P 〈 0. 0001 ）. The urinary Bisphenol A levels in cases were significant higher than those in controls from senior middle school （the levels were 0. 10,0. 06 μg/ml respectively,Z = 1. 996,P =0. 0459） , college （ the levels were 0. ld ,0.03 μg/ml respectively,Z = 2. 586, P = 0. 0097 ）, workers or farmers （ the levels were 0. 08,0. 03μg,/ml respectively, Z = 2. 265, P = 0. 0235 ）, businessmen （ the levels were 0. 10,0. 03 μg/ml respectively, Z = 2. 544, P = 0. 0109 ） , and no passive smokers （the levels were 0. 09,0. 03 μg/ml respectively,Z = 3. 767, P = 0. 0002）. After adjustment by age, body mass index, marital status during pregnancy and other factors, compared to Bisphenol A below 0. 06 μg/ml,the adjusted OR was d. 03 （ 1.67 - 9. 74） for Bisphenol A levels between 0. 06 μg/ml and 0. 20 μg/ml,and was 5.46 （ 1.95 - 15.27 ） for Bisphenol A over 0. 20 μg/ml. The risk of unexplained recurrent spontane

关 键 词：流产 习惯性 双酚A 病例-对照研究 因果律 

分 类 号：R714.21[医药卫生—妇产科学]