女性农药暴露及生殖因素与乳腺疾病相关性分析  

Association of pesticide exposure and reproductive factors with breast diseases in women

作　　者：张佳琦 曹军英 ZHANG Jia-qi;CAO Jun-ying(Department of Ultrasound,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院超声科,沈阳110016

出　　处：《环境卫生学杂志》2023年第4期275-279,共5页JOURNAL OF ENVIRONMENTAL HYGIENE

基　　金：2020年度辽宁省重点研发计划项目(NO:2020JH2/10300122)。

摘　　要：目的 分析女性某些种类杀虫剂、除草剂、杀菌剂暴露及生殖因素与囊肿、增生结节、纤维腺瘤、导管内乳头状瘤及乳腺癌等乳腺疾病的关系,为乳腺疾病的防治提供流行病学依据。方法 2020年10-12月对辽宁省部分城乡地区(沈阳、辽阳、丹东和朝阳)妇女行乳腺超声筛查,最终纳入1 432人,通过调查问卷收集人口学特征与生殖因素相关信息。单因素分析采用χ2检验,将差异有显著性意义的指标进行多因素Logistic回归分析。结果 筛查结果显示,患病组共纳入416名女性,患病率为29.0%,平均年龄46.46±8.57岁;未患病组共纳入1 016名女性,平均年龄48.48±10.20岁。单因素分析结果显示,BMI、农用杀虫剂、家用杀虫剂、除草剂、杀菌剂、初潮年龄、月经持续天数、闭经年龄、行经年限、绝经后年限、活产次数、流产次数、初产年龄、是否母乳喂养、初潮初产间隔差异与女性乳腺疾病发生的关联有显著性意义(P<0.05)。多因素分析初潮年龄<14岁(OR=2.117,P=0.018),月经持续天数≥7天(OR=1.717,P=0.049),闭经年龄≥50岁(OR=2.375,P=0.007),农用杀虫剂暴露(OR=3.549,P=0.022)是乳腺疾病的危险因素,而母乳喂养(OR=0.437,P=0.014)是保护因素。结论 应加强对女性农药使用及生理生育相关知识的宣教,倡导正确的婚育观念,鼓励母乳喂养,减少农用杀虫剂暴露,减少女性乳腺疾病的发生。Objective To investigate the association of pesticide exposure and reproductive factors with breast diseases such as cysts,hyperplasic nodules,fibroadenomas,intraductal papilloma,and breast cancer in women,and to provide an epidemiological ba-sis for the prevention and treatment of breast diseases.Methods During the period of October to December in 2020,a breast ultra-sound sereening was carried out in various urban and rural areas of Liaoning Province,China(Shenyang,Liaoyang,Dandong,and Chaoyang),and 1432 women were included.A questionnaire was utilized to gather data on their demographic characteristics and reproductive factors.These data were used to investigate the association of pesticide exposure and reproductive factors with breast diseases.We conducted a univariate analysis using the chi-square test as well as a multivariable logistic regression analysis on the indicators with significant differences.Results The screening results showed that 416 women(29.0%out of total)in the disease group with av-erage age at 46.46±8.57.The other 1016 women were selected as the control group with an average age of 48.48±10.20.The univariate analysis showed the following significant indicators(P<0.05):agricultural pesticides,household pesticides,herbicides,fungicides,age of menarche,duration of menstruation,age of amenorrhea,years of menstruation,years after menopause,number of live births,number of abortions,age at first birth,breastfeeding,and interval between menarche and first birth.The multivariate analysis showed that age of menarche<14 years[odds ratio(OR)=2.117,P=0.018],duration of menstruation≥7 days(OR=1.717,P=0.049),age of amenorrhea≥50 years(OR=2.375,P=0.007),and exposure to agricultural pesticides(OR=3.549,P=0.022)were risk factors for breast diseases,while breastfeeding(OR=0.437,P=0.014)was a protective factor.Conclusion In order to reduce the incidence rate of breast diseases,it is necessary to strengthen the education on the knowledge of the use of pesticides and female reproductive physiology,advoca

关 键 词：乳腺疾病 农药暴露 超声 生殖因素 

分 类 号：R173[医药卫生—妇幼卫生保健]