成人再生障碍性贫血危险因素的病例-对照研究  

A case-control study on the risk factors of aplastic anemia in adult

作　　者：顾明华[1,2] 高香[3] 朱静怡[4] 吕玲[1] 

机构地区：[1]复旦大学附属华山医院,上海200040 [2]上海市疾病预防控制中心,上海200336 [3]潍坊市人民医院,山东潍坊261041 [4]复旦大学附属中学,上海200433

出　　处：《中国工业医学杂志》2012年第2期87-90,共4页Chinese Journal of Industrial Medicine

摘　　要：目的研究与成人再生障碍性贫血(AA)发病有关的危险因素。方法采用医院内1∶2病例-对照研究方法。病例组130例,符合AA诊断标准,无肿瘤病史和放化疗史;对照组260例,为病例组同一医院的其他病种患者,性别、年龄、住院日和居住地均与病例组配对。问卷调查内容包括个人一般情况、既往病史、家族史、发病前5年内用药史、发病前职业性和生活性有害物质接触史。采用STATA7.0统计软件对调查结果进行1∶2配对资料单因素和多因素分析。结果对照组的文化程度明显高于病例组。单因素和多因素分析均发现,职业性苯接触、发病1年内家庭或工作场所装修和乙肝病史是AA发病的独立危险因素(OR>1,P<0.05),接受过高等教育是AA发病的保护因素(OR<1,P<0.05)。病例组和对照组中接触苯的研究对象的苯接触频率差异无统计学意义(P>0.05),而接苯时间差异有统计学意义(P<0.05),病例组的接触时间明显短于对照组。未发现AA发病与恶性肿瘤家族史、结核病史、抗结核药物、中药、汽柴油、润滑油、甲醛、重金属、有机磷杀虫剂、氨基甲酸酯杀虫剂、除草剂、化肥、吸烟、饮酒、染发和高压线100 m范围内的居住史存在明显相关性。结论职业性苯接触、发病1年内家庭或工作场所装修和乙肝病史是AA发病的独立危险因素,而接受过高等教育是AA发病的保护因素。Objective To determine the ris k factors of aplastic anemia（AA）in adult.Methods A 1∶2 case-control study was con ducted,130 AA cases without medical hist ories of cancer,radiotherapy and chemoth erapy were collected as observation grou p,and 260 gender-and age-matched control cases who had other diseases were collected from the same h ospitals.Subjects were surveyed using sa me standard questionnaire including pers onal data,past histories of diseases,fam ily history,drug histories in 5 years,an d histories of occupational and daily ex posure to harmful substances.One-factor and multi-factor analysis were made usin g STATA 7.0 on the dates.Results The res ults showed that t he educated degree of the control group was h igher than that of AA cases,and the occu pational exposure to benzene,house decoration eithe r family or workplace（in one year prior to the onset of AA）and medical history of hepatitis B were the risk factors of AA（OR〉1,P〈0.05）.While the higher education seemed the protection factor of AA（O〈R1,P〈0.05）,but no correlation co uld be found among AA and other factors. Conclusion It was suggested that occupat ional exposure to benzene,house decorati on and medical history of hepatitis B we re the risk factors of AA,higher educati on seemed the protection factor of AA.

关 键 词：再生障碍性贫血 病例-对照研究 成人 危险因素 

分 类 号：R556.5[医药卫生—血液循环系统疾病]