血清双酚A含量与复发性流产的1：2病例对照研究

目的 探讨血清中双酚A含量与不明原因复发性流产的关系。方法 采用以医院为基础的1：2病例对照研究,对62例不明原因复发性流产者按年龄±2岁、同一地区、同一孕周进行匹配。以柱前荧光-高效液相色谱法检测62例不明原因复发性流产者（病例组）和108名正常怀孕妇女（对照组）血清中双酚A的含量。按年龄、体重指数（BMI）、孕周、文化程度、职业分布和吸烟状况进行分组比较。结果 病例组和对照组血清双酚A含量（中位数±四分位数间距）分别是（0.009±0.002）、（0.004±0.012）μg/ml,差异有统计学意义（Z=3.506,P=0.0005）。在调整年龄、职业、文化程度、BMI、被动吸烟等因素后,以双酚A浓度≤0.004 μg/ml为参比,双酚A浓度在0.004~0.012 μg/ml之间的OR值为4.39（95%CI：1.15~16.71）,双酚A浓度≥0.012 μg/ml的OR值为4.95（95%CI：1.77~13.82）,且随着双酚A水平的升高,发生复发性流产的风险也在增加（P=0.0024）;经秩转换方差分析SNK法检验发现,正常妊娠者、复发性流产2次与≥3次者之间差异有统计学意义（双酚A含量分别为0.004、0.008、0.018μg/ml,F=8.92,P=0.0002）。结论 血清中高水平的双酚A含量可能与不明原因复发性流产之间存在关联。     

某石化企业育龄女工自然流产的病例对照研究

目的了解石化企业育龄女工自然流产发生的影响因素,为制定防制措施、减少自然流产的发生提供科学依据。方法采用配对病例对照研究设计,由经培训的调查员选取南京市某大型石化生产企业3年期间发生的156例自然流产者进行回顾性问卷调查。对照组在市疾病预防控制中心进行健康检查的已婚育龄妇女中选择,按年龄进行1∶1配对。对照组与病例组填写相同的调查表。结果多因素条件logistic回归分析显示,家庭月人均收入、月经是否规律、家中是否养动物、劳动强度、接触苯及其同系物、接触重金属、该工种的工龄、接触噪声、接触振动等因素与石化女工自然流产有显著关联,其中家庭月人均收入是保护因素,而月经是否规律、家中是否养动物、劳动强度、接触苯及其同系物、接触重金属、该工种的工龄、接触噪声、接触振动则是石化女工自然流产的危险因素(其OR值分别为1.865,4.603,1.643,11.445,4.114,4.740,3.936,2.765)。结论该项研究发现了多种与自然流产有关的个人因素及职业因素。为此,石化企业女工必须加强优生优育知识的宣传和普及,妊娠期应调离接触有害职业因素的工作岗位,加强孕期保健,以利于维护生殖健康,提高下一代人口素质。     

Association of petrochemical exposure with spontaneous abortion

OBJECTIVES: To assess the association between petrochemical exposure and spontaneous abortion, a retrospective epidemiological study in a large petrochemical complex in Beijing, China was conducted. METHODS: Plant employment records identified 3105 women who were married, were 20-44 years of age, and had never smoked. Of those, 3070 women (98.8%) reported at least one pregnancy. From this group, 2853 (93%) of the women participated in the study. According to their plant employment record, about 57% of these women workers reported occupational exposure to petrochemicals during the first trimester of their pregnancy. Trained interviewers administered a standardised questionnaire to this group of women and their husbands, collecting information on reproductive history, pregnancy outcomes, employment history, occupational exposure, smoking habits, alcohol consumption, indoor air pollution, and demographic variables. The results from the womens' first pregnancies were analysed. RESULTS: There was a significantly increased risk of spontaneous abortion for women working in all of the production plants with frequent exposure to petrochemicals (8.8%; range of 5.8%-9.8%) compared with those working in nonchemical plants (2.2%; range of 0.0%-7.1%). Also, when a comparison was made between exposed and non-exposed groups within each plant, exposure to petrochemicals was consistently associated with an increased risk of spontaneous abortion. The overall odds ratio (OR) was 2.7 (95% confidence interval (95% CI) 1.8 to 3.9) after adjusting for potential confounders. When the analysis was performed with the exposure information obtained from the women' interview responses for (self reported) exposures, the estimated OR for spontaneous abortions was 2.9 (95% CI 2.0 to 4.0). The analysis was repeated by excluding those 452 women who provided inconsistent reports between recalled exposure and work history, and a comparable risk of spontaneous abortion (OR 2.9; 95% CI 2.0 to 4.4) was found. In analyses for exposure to specific chemicals, an increased risk of spontaneous abortion was found with exposure to most chemicals, and the results for benzene (OR 2.5; 95% CI 1.7 to 3.7), gasoline (OR 1.8; 95% CI 1.1 to 2.9), and hydrogen sulphide (OR 2.3; 95% CI 1.2 to 4.4) were significant. CONCLUSION: An increased risk of spontaneous abortion was found associated with the exposure to petrochemicals, including benzene, gasoline, and hydrogen sulphide.

 

     

Tap or bottled water consumption and spontaneous abortion: a 1986 case-control study in California.

To investigate whether drinking tap or bottled water during pregnancy affects the risk of spontaneous abortion, we asked questions about water consumption in a large case-control study (626 cases, 1,300 controls). The study ascertained cases from hospital pathology laboratory reports of pregnancies that began in 1986 and obtained controls from birth certificates. The crude odds ratio for consumption of any vs no cold tapwater at home during the first trimester was 1.2 (95% confidence interval = 1.0-1.5), with no dose-response effect. The crude odds ratio for any bottled water consumption was 0.79 (95% confidence interval = 0.65-0.96), with a downward trend by amount consumed. Adjusting for many potential confounders did not alter these associations appreciably, although some variables appeared to be effect modifiers. The point estimates were stronger among women who were more difficult to contact, suggesting the possibility of bias.     

Tap or bottled water consumption and spontaneous abortion in a case-control study of reporting consistency.

A recent case-control study of 1,926 women found a slightly increased risk of spontaneous abortion associated with reported consumption of tapwater and a decreased risk with reported consumption of bottled water. In a case-control study of spontaneous abortion designed to examine the consistency of prenatal exposure reporting, the association of spontaneous abortion with tap or bottled water consumption was also examined. Cases of spontaneous abortion (N = 100) were ascertained from hospital pathology reports, and pregnant controls (N = 200) were obtained from obstetrical appointment logs. Subjects were first interviewed approximately 24 weeks after their last menstrual period and again approximately 48 weeks after their last menstrual period. Neither an increased risk for spontaneous abortion associated with consumption of tapwater nor a protective effect for consumption of bottled water was observed. Changes in reporting of tapwater consumption from the first to the second interview suggest the possibility of differential reporting in cases and controls. There was no evidence suggesting biased reporting of bottled water consumption.     

HPSE和Syndecan-1与人类早期复发性自然流产关系

目的探讨乙酰肝素酶(heparanase,HPSE)和蛋白聚糖1(syndecan-1)在人类早期复发性自然流产绒毛组织中的表达及两者与复发性自然流产的关系。方法采用实时荧光定量反转录聚合酶链反应(RT-PCR)分别检测山西大同地区非意愿性正常妊娠者(35例)和早期复发性自然流产者(28例)绒毛组织中HPSE和syndecan-1的mRNA表达水平, 分析探讨两者与自然流产关系。结果HPSE mRNA在正常妊娠组表达的阳性率为85.71%(30/35), 明显高于复发性自然流产组的57.14%(16/28), 差异有统计学意义(P<0.05);而在正常妊娠组syndecan-1 mRNA的阳性表达率为54.28%(19/35), 明显低于复发性自然流产组的82.14%(23/28), 差异亦有统计学意义(P<0.05);HPSE和syndecan-1蛋白表达呈负相关(r=-0.386, P<0.01)。结论在复发性自然流产中HPSE的表达降低, 导致降解细胞外基质能力下降, syndecan-1表达增高, 影响胚泡植入, 导致自然流产的发生。     

结直肠癌与膳食纤维相关饮食因素病例对照研究

目的 探讨膳食纤维相关饮食因素与结直肠癌发病风险之间的关系。方法 2013年12月-2015年12月以福建省肿瘤医院、福建医科大学附属协和医院和附属第一医院确诊的结直肠癌患者200例为病例组,同时选择与之在年龄、性别、地区等相匹配的健康居民200人作为对照组。运用1：1匹配病例对照研究,采用半定量食物频率调查问卷对调查对象进行面对面流行病学调查。结果 最近1年摄入甘薯纤维量（0.030~0.313 g/d OR=0.159,95%CI=0.042~0.608）、10年前摄入甘薯膳食纤维量（0.091~0.904 g/d OR=0.050,95%CI=0.009~0.269;>0.904 g/d OR=0.186,95%CI=0.043~0.809）、地瓜干膳食纤维量（>0.002 g/d OR=0.336,95%CI=0.177~0.628）、豆制品膳食纤维量（0.966~1.481 g/d OR=0.233,95%CI=0.079~0.681;>1.481 g/d OR=0.043,95%CI=0.011~0.169）、性格类型（非A非B型性格OR=0.089,95%CI=0.025~0.319;B型性格OR=0.253,95%CI=0.080~0.800）是结直肠癌发病的保护因素;牛羊肉（1.645~14.247 g/d OR=10.025,95%CI=1.970~51.020;>14.247 g/d OR=9.178,95%CI=1.386~60.791）、静态时间长（6~10 h OR=7.968,95%CI=1.901~33.402;>10 h OR=21.225,95%CI=3.966~113.600）是结直肠癌发病的危险因素。结论 膳食纤维具有预防结直肠癌的作用,在日常生活中应注意调整饮食结构和生活方式。     

异硫氰酸酯水平与肺癌关系病例对照研究

目的探讨异硫氰酸酯(ITC)水平与肺癌的关系,为肺癌的防治提供参考依据。方法采用以医院为基础病例对照研究方法对河南省南阳市中心医院2012年5月—2014年11月收治的88例肺癌患者及同期在该医院进行健康体检的84名健康体检者进行问卷调查,并采用高效液相色谱法检测人尿液中ITC代谢量。结果病例组患者十字花科蔬菜摄入量、膳食中ITC摄入量和尿液中ITC代谢量分别为(94.7±6.4) g/d、(11.7±1.0)μmol/d和(0.93±0.2) μmol/g,均低于对照组体检者的(105.6±8.9) g/d、(12.6±1.2)μmol/d和(1.63±0.3) μmol/g,差异均有统计学意义(均P<0.05);多因素logistic回归分析结果显示,在调整了性别、年龄、体质指数、肺癌家族史及吸烟、饮酒、饮茶情况等混杂因素后,膳食中ITC摄入量≥15.305 μmol/d者患肺癌风险为ITC摄入量<9.173 μmol/d者的0.70倍(OR=0.70,95%CI=0.51~0.96),尿中ITC代谢量0.825~3.342和≥3.343 μmol/g者患肺癌风险分别为ITC代谢量<0.825 μmol/g者的0.68倍(OR=0.68,95%CI=0.50~0.93)和0.48倍(OR=0.48,95%CI=0.32~0.72)。结论增加日常饮食中十字花科蔬菜的摄入量可能会将低肺癌的患病风险。     

不同流产次数的复发性流产患者血栓弹力图比较研究

目的探究血栓弹力图(thrombelastograph,TEG)在不同流产次数的复发性流产(recurrent spontaneous abortion,RSA)患者凝血功能中的变化趋势,为早期不同流产次数RSA患者的诊断和治疗提供有效的检测指标。方法选取2018年1月至2019年1月湘潭市中心医院不孕不育科治疗的147例不同流产次数的RSA已孕患者为研究对象,设为观察组,根据不同孕周将其分为早孕组(平均妊娠6^+6周)35例,早中孕组(平均妊娠13^+6周)47例,中孕组(平均妊娠18^+6周)65例;并根据不同流产次数将流产≥4次者分为流产4组(31例),流产3次者分为流产3组(69例),流产2次者分为流产2组(47例)。从同时期于我院建立生产档案的健康孕妇中随机抽取160例为健康对照组。观察两组孕妇TEG检测5项参数变化情况,并对比不同RSA患者TEG变化情况。结果经TEG检测后,凝血指数(coagulation index,CI)均值都在3以上,观察组和对照组孕妇均呈血液高凝状态,观察组各项指标更偏向高凝状态,R值和K值缩短,α角和MA值增大,CI值升高,与对照组比较差异有统计学意义(P<0.05)。在不同孕周患者中,R、MA及CI值比较差异无统计学意义(P>0.05);K值随孕周的增加而降低,α值随孕周的增加而升高,3组比较差异有统计学意义(P<0.05);流产4组的MA值高于流产3组、流产2组(P<0.05);R、K、α角及CI值比较,差异无统计学意义(P>0.05)。结论在不同流产次数的RSA患者中应用TEG检测,可在早期准确反映出患者RSA的倾向,且患者既往流产次数越多(≥4次),TEG的参数MA增加得越明显,其主要表现为血小板聚集功能增强的凝血功能异常。     

膜拜成员健康水平与自我和谐、焦虑关系

目的 了解膜拜成员健康水平及其与自我和谐、焦虑关系,为膜拜成员的教育转化提供参考依据。方法 于2014年3-5月采取随机抽样方法在陕西省西安市教育转化学习班抽取63名膜拜成员作为膜拜组,并在西安市招募69名与膜拜组性别、年龄、文化程度相近的非膜拜人员作为对照组,采用自编一般情况调查表及自测健康评定量表（SRHMS）、自我和谐量表（SCCS）、状态-特质焦虑量表（STAI）对2组人员进行调查。结果 膜拜组人员生理健康、心理健康、社会健康得分和自测健康总分分别为（119.11±23.96）、（89.17±18.55）、（74.68±16.70）和（310.33±45.65）分,均低于对照组人员的（131.86±21.51）、（104.80±24.26）、（86.00±20.52）和（353.36±60.02）分（均P<0.01）;膜拜组人员自我与经验的不和谐得分、自我和谐总分分别为（49.85±10.16）和（100.73±13.14）分,均高于对照组人员的（46.32±8.41）和（95.95±10.53）分,自我的灵活性得分为（41.96±4.66）分,低于对照组人员的（44.62±7.88）分（均P<0.05）;膜拜组人员特质焦虑得分为（48.98±7.46）分,高于对照组人员的（40.87±8.97）分,差异有统计学意义（t=5.618,P<0.001）;多元线性逐步回归分析结果显示,影响膜拜成员生理健康的因素为特质焦虑,影响膜拜成员心理健康的因素为特质焦虑,影响膜拜成员社会健康的因素为自我和谐总分和自我的灵活性,影响膜拜成员自测健康总分的因素为特质焦虑。结论 膜拜成员的健康水平较低,其健康水平与低自我和谐程度和高特质焦虑有关。     

A case-control study to investigate the role of recent spontaneous abortion in the aetiology of neural tube defects

Summary. Clarke et al.¹ suggested that women who have had a spontaneous abortion are at an increased risk in their next pregnancy of producing an offspring with a neural tube defect (NTD). A matched case-control study was carried out to test the related hypothesis that a spontaneous abortion occurring in the 6-month period prior to the conception of a pregnancy (recent spontaneous abortion) is a risk factor for the development of an NTD in that pregnancy. The cases were 177 singleton pregnancies to non-primigravida Leicestershire women, which were affected by non-syndromal NTDs between 1976 and 1989. Two control pregnancies were matched with each case on intended place of delivery and date of maternal last normal menstrual period (LNMP). After adjusting for potential confounders, recent spontaneous abortion was found to be associated with a decreased relative risk of neural tube defect, odds ratio 0.46, 95% confidence interval 0.20, 1.07. The result provided little evidence in favour of the hypothesis, suggesting instead that prior spontaneous abortion has a protective effect in relation to subsequent NTD development rather than being a major risk factor in the aetiology of NTDs.     

被动吸烟与舌癌的病例对照研究

目的 探讨被动吸烟与舌癌发病的关系。方法 采用病例对照研究方法,收集2010年9月～2015年1月经病理确诊的舌癌新发病例190例,并选取同期686例社区健康人群作为对照。应用非条件Logistic回归模型估算仅18岁前、仅18岁后、18岁前后均被动吸烟与舌癌发病风险的调整OR（95%CI）值,并进一步对性别、年龄进行分层分析。结果 与无被动吸烟者相比,仅18岁前被动吸烟可增加舌癌的发病风险为2.813（OR=2.813,95%CI：1.581～5.005）,仅18岁后被动吸烟可增加舌癌的发病风险为1.666（OR=1.666,95%CI：1.055～2.631）;18岁前后均被动吸烟可增加舌癌的发病风险为2.690（OR=2.690,95%CI：1.674～4.322）。而且每日暴露时间越长、开始暴露年龄越小、被动吸烟年限越长,患舌癌的危险性就越大（均有P_趋势<0.05）。分层分析结果显示在被动吸烟人群中,女性或年龄≥60岁者比男性或年龄<60岁者患舌癌的风险更高。结论 被动吸烟是舌癌发病的危险因素,减少被动吸烟可在一定程度上降低舌癌的发生。     

Association of thromboangiitis obliterans with cigarette and bidi smoking in Bangladesh: a case-control study

BACKGROUND: In addition to cigarettes, bidi, made of unprocessed and low-grade tobacco, is being smoked widely in Bangladesh and in other south Asian countries. The cause-and-effect relationship is established between thromboangiitis obliterans (TAO) and smoking. However, type of smoking material(s) most strongly related to TAO is not yet determined. METHODS: We conducted a hospital-based case-control study in Rajshahi, Bangladesh, to examine the relationship of type of smoking materials (cigarette versus bidi) with TAO on 103 pairs of cases and controls matched by age and sex during the period 1995 to 1996. The inclusion criteria for cases were newly diagnosed TAO and current smoker, while those for controls were current smokers admitted to the hospital due to non-cardiovascular diseases. RESULTS: Among the cases 35.0% and 65.0% were cigarette and bidi smokers, while among the controls 69.9% and 30.1%, respectively. Using logistic regression approach, considering cigarette smoking approximately 10 per day as reference, bidi smoking >20 per day (odds ratio [OR] = 34.76, 95% CI: 6.11-197.67) and 11-20 per day (OR = 7.12, 95% CI: 2.35-21.63) had greater risk of TAO after adjusting confounding factors. Respective OR for bidi smoking approximately 10 per day, cigarette smoking 11-20 per day and cigarette smoking >20 per day, were 2.18 (95% CI: 0.64-7.51), 3.81 (95% CI: 1.37-10.57) and 6.88 (95% CI: 1.87-25.30). CONCLUSION: Within the limits inherent to case-control study, our findings suggest that bidi smoking may well play a more important role in causing TAO than cigarettes. It leads to the speculation that unprocessed and low-grade tobacco used for producing bidi might play a more potent role to initiate TAO than cigarettes.     

TAP1基因多态性与结核病易感关联性的家系病例对照研究

目的 分析结核病多发家系中TAP1基因rs1135216和rs1057141位点单核苷酸多态性和环境因素与结核病患病的关联,为结核病防治提供理论依据。方法 从广东省结核病防治单位纳入结核病多发家庭患者,同病例组有血缘关系的作为家庭密切接触者,另取同期体检的健康人群作为健康对照,共413人纳入本次研究。采用家系病例对照研究方法,通过自行设计的问卷,收集研究对象的一般人口学特征、行为危险因素以及环境因素。采用χ2检验进行单因素分析及Hardy - Weinberg遗传平衡检验,多因素条件logistic回归模型用于分析各因素与结核病患病的关联。应用Haploview软件对两位点进行连锁不平衡分析和单倍型构建。采用GMDR分析基因 - 基因、基因 - 环境交互作用对结核病患病的影响。结果 共纳入413名研究对象,其中结核病患者（TB）133人,健康对照者（HC）173人,家庭密切接触者（HHC）107人。显性模型分析结果显示,携带CT - CC基因型是结核病患病的危险因素,在HHC组和HC组中,其患病风险分别是携带TT基因型的2.409倍（95%CI:1.377～4.214）和2.014倍（95%CI:1.249～3.247）。单体型分析结果显示,C - T单体型可能是肺结核患病的保护因素。GMDR分析结果显示,基因 - 基因交互作用在TB组和HC组间的最优模型是rs1135216单因子模型（P＜0.05,CVC = 10/10,TA = 0.579）;基因 - 环境交互作用在TB组和HHC组中,最优模型为rs1135216位点、性别、年龄和文化程度四因子模型（P＜0.05,CVC = 10/10,TA = 0.651）;在TB组和HC组中,最优模型为rs1135216位点、文化程度、BMI、居住环境潮湿与否和环境卫生五因子模型（P＜0.05,CVC = 8/10,TA = 0.655）。结论 TAP1基因rs1135216位点与结核病患病风险相关,且宿主 - 环境因素对结核病的发生发展起着重要的作用。     

Assessment of reporting consistency in a case-control study of spontaneous abortions

Reporting consistency was examined in a case-control study of spontaneous abortion in Santa Clara County, California. Each case (n = 100) and two pregnant controls (n = 200), frequency-matched by last menstrual period, were interviewed twice: first after the case's spontaneous abortion (on average, 24 weeks after the last menstrual period) and again after completion of the controls' pregnancies (on average, 48 weeks after the last menstrual period). Because of concern about differential reporting of water consumption in regions with publicized water contamination, interviews included detailed questions about consumption of tap water and bottled water during pregnancy, as well as other exposures. Most factors such as caffeine consumption, cigarette smoking, employment, and pregnancy history were consistently reported between interviews and did not appear to be subject to differential reporting between cases and controls. When variables were examined by univariate analysis, controls deleted reports of tap water consumption (any vs. more) more often than did cases. There was also a suggestion of differential reporting of up to two glasses per day for tap water and bottle water consumption when they were examined as continuous variables. However, the degree of differential reporting was not sufficient to appreciably alter the measures of association between water consumption during pregnancy and spontaneous abortion.     

Characteristics of women undergoing induced abortion: Results of a case-control study from northern Italy

In order to identify subgroups of women at elevated risk of induced abortion, personal characteristics and habits, selected medical histories and contraceptive practices of 873 women undergoing legal abortion in various areas of Northern Italy were compared with those of 504 control subjects identified in family planning clinics of the same hospitals or area health authorities. When age was allowed for, the risk of induced abortion was not strongly influenced by marital status, education or other indicators of social class. However, women who were employed, independently from the type of occupation, showed markedly lower abortion risks than housewives. Among various indicators of sexual habits investigated, the strongest determinant of legal abortion was the frequency of sexual intercourses over the previous six months, women with less frequent intercourses showing a markedly elevated risk estimate (RR = 2.82). Induced abortion was less frequent among ex-smokers and more frequent in heavy smokers, but was not appreciably influenced by several other indicators of lifestyle habits and history of gynaecological or psychiatric complaints. The risk of abortion was not influenced by the number of livebirths, but was lower for women with later age at first birth. Less than 5% of case and control subjects reported more than two previous induced abortions, thus indicating that abortion is more of an “accidental” event rather than a widespread contraceptive practice. However, over three-quarters of abortions occurred in women reporting no contraception at all or coitus interruptus, thus underlining the scope for family planning education in this population.     

Association of spontaneous abortion and other reproductive effects with work in the semiconductor industry

This study tested the hypothesis that fabrication room (fab) work in the silicon-based semiconductor industry is associated with an increased risk of spontaneous abortion (SAB). The study was conducted nationwide at 14 companies representing a spectrum of large to small manufacturers. A small increase in risk of SAB was observed among fab workers compared with nonfabrication room (nonfab) workers in two cohorts, historical (adjusted RR = 1.43, 95% confidence interval [CI] 0.95–2.09) and prospective (adjusted RR = 1.25, 95% CI = 0.63–1.76). Analysis of specific fab exposures in the historical cohort showed a consistent, dose-response association of SAB with photoresist and developer solvents, whose major component was ethylene-based glycol ethers. The consistency of our findings and the toxicological data for these agents suggest that this is a causal association. Independent associations of SAB with self-reported stress and with etching fluorides were observed and require further research. No significant decrease in fertility was observed among men or women working in fabs, but reduced fecundability was suggested for some women fab workers.     

被动吸烟与神经管缺陷关系的病例对照研究

目的 探讨妇女怀孕前后被动吸烟与神经管缺陷（NTDs）的相关性。方法 采用1[DK]∶1配对病例对照研究,选取2010-2014年山西省“削峰工程”监测医院登记的生育NTDs患儿的妇女411例作为病例组,同时选择怀孕前后居住在同一个县（或区）、民族相同、末次月经与病例妇女相差3个月以内的生育健康儿童的妇女411例作为对照组进行问卷调查。用单因素和多因素条件logistic回归模型探究妇女怀孕前后被动吸烟与NTDs的关系。结果 妇女怀孕前后被动吸烟增加生育NTDs患儿的风险（aOR=1.209,95%CI:1.043～1.401,P=0.012）。且随着被动吸烟的频次增加,生育NTDs患儿的风险增加,与未被动吸烟的妇女相比,每周被动吸烟4～6次的妇女和每周被动吸烟大于6次的妇女生育NTDs患儿的OR值分别为2.113和2.903（趋势〖XC小五号.EPS;P〗=13.381,P＜0.001）。妇女被动吸烟的主要场所是家中（71.6%）,且妇女被动吸烟程度与丈夫吸烟情况相关（r=0.405）。结论 妇女怀孕前后被动吸烟会增加生育NTDs患儿的风险,且随着被动吸烟频次的增加,生育NTDs患儿的风险增加。     

Investigation of a spontaneous abortion cluster: Lessons learned

An investigation of a reported spontaneous abortion excess in an office environment was undertaken employing a multidisciplinary approach, including (1) an epidemiologic/ validation step; (2) an industrial hygiene survey, including electromagnetic field measurements and indoor air quality determinations; and (3) a risk perception/risk communication component. This approach was needed because there are numerous chemical and physical agents and psychosocial stressors that may potentially impact the reproductive status of female office workers. Although video display terminals (VDTs) are typically the focus of spontaneous abortion (SAB) investigations, one cannot ignore other stressors in the environment. Magnetic field exposures within a payroll area were determined using a hand-held survey meter and data logging dosimeter. On average, the full shift time-weighted average exposures of workers to extremely low frequency (ELF) magnetic fields in the payroll office area ranged from 1.0 to 5.6 mG. Influencing the investigation's protocol design were the Centers for Disease Control's (CDC's) recent Guidelines for Investigating Clusters of Health Events. Although these guidelines grew primarily out of cancer cluster investigations, we applied them in this instance and found them to be generalizable to reproductive hazards investigations. A spontaneous abortion excess was validated over a 2-year period among 26 women with 32 reproductive events, with rates 1.5–2.5 times the expected, depending on comparison figures used. Lessons learned in the investigation, including the applicability of the CDC's Cluster Investigation Protocol and the enormous importance of risk perception and risk communication, are described. © 1994 Wiley-Liss, Inc.     

血清C反应蛋白升高与慢性脑供血不足风险关系的病例对照研究

目的 探讨血清C反应蛋白(C-reactive protein,CRP)与慢性脑供血不足(chronic cerebral circulation insufficiency,CCCI)的相关性.方法 纳入黑龙江省中医院门诊确诊的新发病例142例,正常对照组142例.该病例对照研究将年龄、性别作为匹配因素进行1:1个体匹配,比较病例组、对照组CRP水平的组间差异;将CRP水平四分位分组,采用条件Logistic回归分析相对危险度.结果 病例组的CRP水平高于对照组(Z=-3.69,P＜0.001);在校正了多种混杂因素之后,结果表明血清CRP水平最高四分位组的CCCI患病风险是低水平组的3.08倍(OR =3.08,95％CI:1.27～7.46).结论 血清CRP升高与CCCI患病风险之间可能存在相关性.