非综合征性唇腭裂高危因素的条件Logistic回归分析

目的探讨非综合征性唇腭裂（nonsyndromic cleft lip and palate,NSCL/P）发病的主要危险因素；筛选可能存在的保护因素，为临床预防该病的发生提供理论依据。方法采用1：1配对病例对照研究，病例组（n=76）来源于2006年9月至2007年9月在潍坊医学院附属医院、潍坊市人民医院、菏泽市立医院、烟台毓璜顶医院口腔科进行唇腭裂矫正手术的非综合征性唇腭裂患儿；对照组（n=76）来源于同一医疗机构门诊或病房，符合配对条件的非唇腭裂儿童。对病例组和对照组患儿的父母进行42项可能导致发生唇腭裂因素的问卷调查，使用条件Logistic回归，首先对病例资料进行单因素分析，然后对单因素筛选的变量结合非综合征性唇腭裂相关医学专业知识进行多因素分析，筛选主要危险因素及可能存在的保护因素。结果病例组与对照组作对照分析，进入条件Logistic回归模型的变量包括：母亲孕期感染史（P=0．010）、家族唇腭裂遗传史（P=0．009）、母亲孕期饮食是否规律（P=0．007）、胎次（P=0．004）、母亲孕期异常情绪史（P=0．000）、父亲学历（P=0．000）。结论母亲孕期情绪异常、胎次增加、母亲孕期饮食不规律、家族唇腭裂遗传病史、母亲孕期感染史，是非综合征性唇腭裂发病的促进因素；父亲学历是保护因素。

Conditional Logistic Regression on Risk Factors of Nonsyndromic Cleft Lip and Palate.

Objective To discuss the main risk factors and protecting factors of nonsyndromic cleft lip and palate （NSCL/P） in order to provide theoretical basis for the prevention of the occurrence of the disease. Methods A hospital based 1 ： 1 matched case control study design was applied to this epidemiologieal study. There were 76 cases with nonsyndromic cleft lip and palate children who were selected from Department of Stomatology of Affiliated Hospital of WeiFang Medical College, People＇s Hospital of WeiFang,Heze Municipal Hospital and Yuhuangding Hospital of Yantai from september 2006 to september 2007 as collecting cases, and control cases were chosen from the same medical institution with the matched patients. Parents of patients and control cases were asked some questions about 42 possible influencing factors and the answers were filled in the questionnaire by investigators. To carry on the multivariate stepwise regression analysis in univariate conditional Logistic regression analysis foundation in order to discover risk factors. Results There were 6 risk factors which were related to nonsyndromic cleft lip and palate in the model, maternal infectious （P= 0. 010）, genetic family history （P=0. 009）,maternal disorder diet （P= 0. 007）,birth order（P=0. 004）,maternal stress during the first trimester of pregnancy（P=0. 000） ,father＇s education level（P=0. 000）. Conclusion Maternal infectious, genetic family history, maternal disorder diet, birth order and maternal stress during the first trimester of pregnancy are promoting factors of nonsyndromic cleft lip and palate,while father＇s education level is a protecting factor.