分娩方式与儿童急性白血病关系的病例对照研究  

Case-control study on the correlation between methods of delivery and childhood acute leukemia

作　　者：郭宏湘[1] 程欣茹[1] 白松婷[1] 张建营[2] 王凯娟[2] 杨文杰[2] 

机构地区：[1]郑州大学第一附属医院儿科,河南郑州450052 [2]郑州大学公共卫生学院流行病学教研室,河南省肿瘤流行病学重点实验室

出　　处：《现代预防医学》2013年第18期3401-3403,3414,共4页Modern Preventive Medicine

摘　　要：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。Abstract： OBJECTIVE This study aimed to explore the correlation between methods of delivery and childhood acute leukemia （CAL）. METHODS A total of 177 newly diagnosed CAL patients under the age of 15 who visited the children＇s hematology department of an affiliated hospital of an university in Henan between October of 2011 and September of 2012 were selected as the case group; patients with down syndrome were excluded. Meanwhile, 177 patients who visited the children＇s healtheare clinic or hospitalized at the pediatrics department of the same hospital during the same period were selected as the control group by 1 ： 1 matching with the case group according to their residence location, gender, and age （± 1 year） ; patients with blood and immune system disorders or other malignant tumors were excluded. Face-to-face interviews with parents of the patients in both groups were conducted and the questionnaire surveyed demographic data of the research subjects, methods of delivery, and 21 other CAL-related factors. Conditional logistic regression analyses of the results were performed by the SAS 9.1 software. RESULTS Among the 177 CAL cases, 134 cases, including 82 males and 52 females, were diagnosed with acute lymphoblastic leukemia, and 43 cases, including 27 males and 16 females, were diagnosed with acute nonlymphocytic leukemia. Median age of the case group and the control group was 4.3 and 4.5 years old, respectively; and quartile of the two groups was 4.7 and 4.4 years old, respectively. 31 and 146 of the CAL cases resided in cities/towns and rural areas, respectively. Conditional logistic regression analysis showed that factors related to CAL included methods of delivery （OR = 2.497, 95%CI： 1.115-5.594）, family interior decoration history （OR = 3.047, 95%CI： 1.271-7.304）, family history of malignant tumors （OR = 2.148, 95%CI： 1.087-4.242）, radiation exposure history （OR = 1.810, 95%CI： 1.005-3.261）, mother＇s occupational exposure history to harmful or toxic substances �

关 键 词：儿童白血病 病例对照研究 分娩方式 剖宫产 

分 类 号：R733.71[医药卫生—肿瘤]