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目的探索儿童环境危险因素对儿童急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)发生风险的影响。方法采用病例-对照研究的流行病学方法,收集2015年在天津市血液病医院就诊的儿童ALL作为病例组,选取同期同地区的健康儿童作为对照组。通过一对一问卷调查的方式收集研究对象的相关信息。通过单因素x~2检验和多因素非条件Logistic回归模型,分析儿童环境危险因素与ALL发生关联情况,并计算相关危险因素的人群归因危险度百分比(population attributable risk percent,PARP)。结果单因素分析结果显示,病例组中接触油漆涂料(x~2=7.146,P=0.008)、不爱吃蔬菜和水果(x~2=47.070,P<0.001)以及出生后居室装修(x~2=9.030,P=0.003)的儿童发生ALL的比例均高于对照组。多因素分析结果显示,接触油漆涂料(OR=2.174,95%CI:1.031~4.583)、不爱吃蔬菜和水果(OR=4.990,95%CI:3.017~8.253)和出生后居室装修(OR=2.831,95%CI:1.361~5.889)与儿童ALL的发生相关。上述三种危险因素的PARP分别为11.2%、25.2%和11.7%。结论油漆涂料接触史、不爱吃蔬菜和水果及出生后居室装修可能是儿童患ALL的危险因素。
Objective To explore the impact of children’s environmental risk factors on the risk of childhood acute lymphoblastic leukemia (ALL). Methods A case-control study of epidemiological methods was used to collect childhood ALL patients treated in Tianjin Hematology Hospital in 2015 as a case group, and healthy children in the same period were selected as control group. Through one-on-one questionnaire to collect information about the research object. The association between children’s environmental risk factors and ALL was analyzed by single factor x2 test and multivariate non-conditional Logistic regression model, and the population attributable risk percentage (PARP) was calculated for the relevant risk factors. Results The results of univariate analysis showed that there was no significant difference between the cases treated with paint and paint (x ~ 2 = 7.146, P = 0.008), no eating vegetables and fruits (x ~ 2 = 47.070, 2 = 9.030, P = 0.003) were higher in children than in controls. The results of multivariate analysis showed that there were no significant differences between the two groups (OR = 2.174, 95% CI: 1.031 ~ 4.583), no eating vegetables and fruits (OR = 4.990, 95% CI: 3.017-8.253) 2.831, 95% CI: 1.361 ~ 5.889) were associated with the occurrence of childhood ALL. PARP for the three risk factors were 11.2%, 25.2% and 11.7%, respectively. Conclusions The history of paint coating exposure, not eating vegetables and fruits and post-natal decoration may be risk factors for children with ALL.