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目的:分析云南省先天性心脏病(congenital heart diseases, CHD)发生的危险因素。方法:选择2017年1月至2018年1月在昆明医科大学第一附属医院经心脏彩超、心血管影像学检查确诊并住院治疗的1~10岁CHD患儿作为病例组。另选择同期在儿科住院部、门诊排除CHD和(或)其他先天性疾病的1~10岁儿童作为对照组。对照组母亲孕时年龄、孕期长短与病例组相近。与两组母亲进行面对面问卷访谈,调查家庭情况、居住环境、生活习惯、工作环境、妊娠史、疾病及服药史、负性生活事件及精神状态、饮食营养状况等内容,并进行单因素及多因素logistic回归分析。结果:单因素分析结果显示,母亲孕早期被动吸烟、孕早期接触农药、不良妊娠史、孕前患慢性病、孕早期感冒、孕早期发热、孕早期经历负性生活事件、孕早期服用解热镇痛药物、孕早期服用抗生素是CHD发生的危险因素(P0.05)。多因素logistic回归分析表明,母亲孕早期被动吸烟(OR=2.26, 95%CI 1.12~4.58)、不良妊娠史(OR=2.73, 95%CI 1.31~5.69)、孕早期感冒(OR=4.33, 95%CI 2.15~8.70)、孕早期经历负性生活事件(OR=2.14, 95%CI 1.06~4.32)是CHD发生的主要危险因素;孕期常食用蛋肉鱼虾(OR=0.35, 95%CI 0.15~0.79)、孕前及孕期补充叶酸、维生素及微量元素(OR=0.32, 95%CI 0.16~0.64)是减少CHD发生的保护性因素(P0.05)。结论:母亲孕前及孕期加强蛋白质、维生素、微量元素等合理搭配,同时减少烟雾暴露,减少感冒、负性生活事件及不良妊娠的发生,对预防和降低子代CHD的发生有重要意义。 相似文献
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目的探讨石柱土家族自治县农村地区40岁以上人群慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)的患病情况及相关危险因素。方法整群随机抽取石柱土家族自治县农村地区40岁以上常住居民2 387名,应用统一调查问卷表进行调查,并测定肺功能,记录COPD患病率,logistic回归分析COPD患病的相关危险因素。结果2 387名中配合调查者1 920名,资料完整可用于分析者1 873名,其中175例诊断为COPD,COPD患病率为9.3%;logistic回归分析结果显示,性别(OR=0.174,95%CI:0.107~0.284,P=0.000)、年龄(OR=0.505,95%CI:0.430~0.593,P=0.000)、体质量指数(OR=0.696,95%CI:0.513~0.944,P=0.020)、受教育程度(OR=0.388,95%CI:0.184~0.820,P=0.013)、经济收入(OR=2.082,95%CI:1.418~3.058,P=0.000)、儿时咳嗽史(OR=0.766,95%CI:0.608~0.967,P=0.025)、厨房通风(OR=1.480,95%CI:1.085~2.018,P=0.013)、吸烟(OR=0.82,95%CI:0.687~0.979,P=0.028)、被动吸烟(OR=0.213,95%CI:0.143~0.373,P=0.000)与COPD发病相关。结论石柱土家族自治县农村地区40岁以上人群COPD患病率较高,针对相关危险因素进行早期干预,可降低COPD患病率。 相似文献
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目的 比较2015年和2020年广西壮族自治区(广西)柳州市≥50岁农村居民艾滋病知识知晓情况,为当地制定健康教育计划、实施艾滋病防控工作提供依据。方法 采用多阶段分层随机抽样的方法,于2015年和2020年抽取柳州市≥50岁常住农村居民进行艾滋病相关知识问卷调查。采用多因素logistic回归分析筛选2020年艾滋病知识知晓率的影响因素。结果 2015年和2020年分别抽取柳州市1 298名和1 373名调查对象,艾滋病相关知识知晓率分别为24.7%和69.5%,其中“蚊虫叮咬会传播艾滋病吗”问题的正确率在两次调查中均最低,分别为23.7%和64.5%。2020年调查对象艾滋病知识获取途径主要为电视(60.6%)、医务人员(43.2%)、广播/收音机(41.4%)和报刊(20.8%)。2020年多因素logistic回归分析显示,高年龄者艾滋病知识知晓率较低(OR=0.516, 95%CI:0.441~0.604);个人月收入1 000~元者(OR=1.674, 95%CI:1.173~2.389)、已婚者(OR=2.458, 95%CI:1.715~3.523)和艾滋病知识获取途径... 相似文献
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目的 了解公安司法人员对艾滋病防治知识、态度现状及其影响因素,为减少艾滋病相关歧视宣传教育提供参考依据。 方法 在第五轮中国全球基金艾滋病项目地区7省(自治区、直辖市)的18个市(区),采用整群分层随机方法抽取了6个市(区),抽取不同单位的公安司法人员2374人,进行定量调查,对性别、年龄、婚姻、工作部门、行政级别以及调查对象对艾滋病8个知识点的知晓情况与艾滋病相关歧视进行单因素分析或多因素logistic回归分析。 结果 调查对象中,有39.5%(937/2374)对艾滋病持有歧视态度,不愿意与感染艾滋病的同事、家人交往或不愿意让孩子与HIV感染的同学继续交往;知晓外表健康可携带艾滋病病毒、蚊虫叮咬、共桌吃饭、使用安全套和保持一个性伴可减少艾滋病病毒传播危险或不会传播艾滋等知识的调查对象对艾滋病感染者持正向态度,OR值分别为0.62(95%CI:0.40~0.97), 0.48 (95%CI:0.32~0.74), 0.37 (95%CI:0.40~0.97), 0.40(95%CI:0.22~0.70), 0.45 (95%CI:0.27~0.74);在机关工作或行政级别相对较低的公安司法人员更倾向于对艾滋病持有歧视态度,OR值分别为1.43 (95%CI:1.23~1.66), 1.26 (95%CI:1.02~1.54)。 结论 项目地区公安司法人员中艾滋病相关知识知晓率高,对艾滋病歧视仍一定程度上存在,在艾滋病的反歧视宣传中应重点加强对非传播途径的宣传。 相似文献
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目的 探索居民散发诺如病毒感染的潜在危险因素。方法 采用1:2配比病例对照研究方法,选取2015年3月1日至2016年4月30日在上海市宝山区各级医疗机构肠道门诊就诊、实验室确诊为诺如病毒感染的80例患者为病例组,选择2周内无腹泻、呕吐症状的人群作为对照组。利用自行设计的调查表进行问卷调查,应用条件logistic回归进行单因素与多因素分析。结果 80例诺如病毒感染病例,实验室分型G Ⅱ型66例,占82.50%,G Ⅰ型14例,占17.50%。单因素分析显示从事低体力劳动的人群感染诺如病毒的风险是从事高强体力劳动的人群的2.446倍(OR=2.446,95%CI:1.228~4.872);发病前3 d接触呕吐、腹泻患者(OR=8.267,95%CI:2.359~28.975)、发病前3 d有外出就餐史(OR=2.822,95%CI:1.467~5.429)和发病前3 d食用海鲜(OR=3.000,95%CI:1.841~4.888)是诺如病毒感染的危险因素。多因素分析显示:发病前3 d接触呕吐、腹泻患者(OR=6.959,95%CI:1.896~25.537)和发病前3 d食用海鲜(OR=2.283,95%CI:1.336~3.899)为诺如病毒感染的危险因素,饭前洗手(OR=0.609,95%CI:0.408~0.909)为保护性因素。结论 上海市宝山区诺如病毒感染以G Ⅱ型为主。接触患者和食用海鲜是诺如病毒感染的可能危险因素。应加强健康宣传,做好海水产品卫生监测工作。 相似文献
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目的分析全膝关节置换术(TKA)后发生关节假体周围感染(PJI)的相关危险因素。
方法计算机检索由建库至2019年11月的中文数据库中国知网、万方数据库、维普中文科技期刊数据库以及中国生物医学文献服务系统,按拟定的文献纳入与排除标准获取中国人群TKA后发生PJI的相关危险因素的文献,提取有效数据进行Meta分析,绘制森林图,分别采用固定效应模型和随机效应模型计算各相关危险因素(类风湿性关节炎、激素治疗史、糖尿病、手术时间、术中出血量、吸烟、术后放置引流)的合并优势比(OR)值和95%CI,分析各危险因素与TKA后发生PJI的关联强度。
结果共纳入12篇文献,各危险因素合并OR值(95%CI)由高到低依次为类风湿性关节炎(OR=4.84,95%CI:1.87~12.49)、激素治疗史(OR=4.75,95%CI:2.84~7.93)、糖尿病(OR=2.57,95%CI:2.00~3.30)、手术时间(OR=2.19,95%CI:1.57~3.04)、术后放置引流(OR=2.09,95%CI:1.44~3.04)、吸烟(OR=1.76,95%CI:1.26~2.44)、术中出血量(OR=1.34,95%CI:1.06~1.70)。
结论类风湿性关节炎、激素治疗史、糖尿病、手术时间、术后放置引流、吸烟、术中出血量均为TKA后PJI的危险因素,各危险因素与TKA后发生PJI的关系均呈正相关。 相似文献
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目的 了解浙江省舟山海岛地区先天性心脏病(CHD)的相关影响因素,为寻找降低该地区CHD患病率的防治措施提供线索。方法 采用基于人群的巢式病例对照研究设计,从2000-2006年舟山市海岛地区以人群为基础的出生缺陷监测数据库中选择45例先天性心脏病病例,采用1∶3频数匹配随机从数据库中抽取对照135名,进行回顾性分析。结果 多因素logistic回归分析结果显示,丈夫年龄、孕前6个月内服避孕药和梅毒检测试验被纳入最后的模型中。与25岁组相比,孕妇丈夫年龄26~30岁者会显著增高胎儿患CHD的风险性,OR值为9.61(95% CI:1.17~78.94),而31岁组与其比较差异则无统计学意义。孕前6个月内服避孕药和梅毒感染也都具有危险效应,OR值分别为5.48(95% CI:1.48~20.30)、4.36(95% CI:1.26~15.05)。结论 孕前6个月内服用避孕药和梅毒检测阳性对孕妇分娩先天性心脏病患儿的危险性增加,需要采取措施进行干预。 相似文献
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目的 探讨广西壮族自治区(广西)医疗机构法定传染病报告质量影响因素,并比较log-binomial回归与logistic回归模型估计关联强度的差异。方法 采用多阶段分层抽样方法抽取广西县级以上医疗机构为调查对象,开展现场调查收集信息,在R v3.3.3中拟合log-binomial回归和logistic回归模型。结果 共抽查法定报告传染病2 458例,平均报告率为95.08%,及时报告率为97.74%,报告卡填写完整率为77.60%,准确率为61.24%,网络直报录入信息一致率为95.27%,身份证填报完整率为75.59%。多变量log-binomial回归分析结果表明认真开展自查工作(PR=1.03,95%CI:1.01~1.05)和按要求开展培训(PR=1.08,95%CI:1.02~1.15)能有效促进法定传染病报告率的提高;设置项目齐全的门诊日志(PR=1.21,95%CI:1.07~1.37)、认真开展自查工作(PR=1.09,95%CI:1.03~1.14)、建立奖惩制度(PR=2.03,95%CI:1.49~2.78)和按要求开展培训(PR=1.18,95%CI:1.02~1.37)均能有效促进报告卡完整率的提高。在定性判别影响因素对结局事件发生概率影响时,logistic回归和log-binomial回归结果基本一致,但结局发生频率和其在比较组间差值每增加1.00%,logistic回归估计值OR相较于PR分别增加高0.65%(95%CI:0.34%~0.95%)和1.31%(95%CI:0.20%~2.41%)。结论 广西县级以上医疗机构法定传染病报告质量仍有待提高,进一步改进院内自查方法,加强培训工作,落实奖惩制度,规范设置诊疗日志,加强医务人员传染病报告法律意识,是提高报告质量的重中之重。此外,log-binomial回归应被推广应用于横断面或队列研究中定量估计暴露与结局变量的关联强度。 相似文献
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Borgquist R Leósdóttir M Nilsson P Willenheimer R 《International journal of clinical practice》2008,62(2):206-213
AIM: To investigate the impact of classical coronary heart disease (CHD) risk factors on the development of future erectile dysfunction (ED). METHODS AND RESULTS: A total of 830 randomly selected subjects were included. Baseline CHD risk factors were evaluated in relation to ED (evaluated by the International Index of Erectile Function-5 questionnaire) 25 years later. At follow-up, 499 men (60%) had some degree of ED. In age-adjusted logistic regression analysis, self-rated health [odds ratio (OR) 1.59, 95% confidence interval (CI): 1.09-2.31], family history of CHD (OR 1.75, CI: 1.17-2.61), fasting blood glucose (OR 1.52, CI: 1.14-2.02), triglycerides (OR 1.25, CI: 1.01-1.54), systolic blood pressure (SBP) (OR 1.19, CI: 1.04-1.35), body mass index (OR 1.08, CI: 1.03-1.13) and serum glutamyl transferase (GT) (OR 1.81, CI: 1.23-2.68), predicted ED. Independent predictors were higher age, low self-rated health, higher blood glucose, higher GT and a family history of CHD. Higher SBP was borderline significantly independent (p=0.05). Furthermore, baseline age-adjusted Framingham risk score for CHD, also predicted future ED (OR 1.20, CI: 1.03-1.38). CONCLUSIONS: Our study supports and expands previous findings that ED and CHD share many risk factors, further underscoring the close link between ED and CHD. Men presenting with ED should be evaluated for the presence of other CHD risk factors. 相似文献
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Joint effects of antibody to heat shock protein 60, hypertension, and diabetes on risk of coronary heart disease in Chinese 总被引:2,自引:0,他引:2
Zhang X He MA Cheng L Zhou L Zeng H Wang J Wang F Chen Y Hu FB Wu T 《Clinical chemistry》2008,54(6):1046-1052
BACKGROUND: Several studies have suggested an association between antibody to human heat shock protein 60 (anti-Hsp60) and coronary atherosclerosis, but the results have been inconsistent. The aim of this study was to investigate the association between anti-Hsp60 and coronary heart disease (CHD) and to determine whether anti-Hsp60, hypertension, and diabetes have joint effects on CHD risk. METHODS: We measured the concentrations of anti-Hsp60 in 1003 CHD patients and 1003 age- and sex-matched control subjects without CHD events. RESULTS: Concentrations of anti-Hsp60 were significantly higher in CHD patients than in controls. Increasing concentrations of anti-Hsp60 were significantly associated with higher risk of CHD (P for trend <0.0001) and with increasing severity of CHD as assessed by number of diseased vessels detected with angiography [odds ratio (OR) 3.67, 95% CI 1.56-8.64, P = 0.003] after multivariate adjustment for traditional CHD risk factors. There were strong joint effects of high concentrations of anti-Hsp60 and hypertension (OR 5.17, 95% CI 3.95-6.75, P < 0.0001) and diabetes (OR 6.49, 95% CI 4.52-9.33, P < 0.0001) on CHD risk; simultaneous occurrence of high anti-Hsp60 concentrations, hypertension, and diabetes conferred a dramatically higher risk of CHD (OR 20.99, 95% CI 12.50-35.24, P < 0.0001) in multivariate analyses. CONCLUSIONS: Anti-Hsp60 is independently associated with CHD risk, and a combination of high anti-Hsp60, hypertension, and diabetes is particularly detrimental for CHD risk. 相似文献
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Olfa Chakroun-Walha Fadhila Issaoui Abdennour Nasri Haifa Bradai Ayman Farroukh Rim Karray Mouna Jerbi Noureddine Rekik 《急性病杂志》2021,10(2):71-77
Objective: To identify the early predictors of severe envenomation in the southern region of Tunisia. Methods: It was a retrospective monocentric study including consecutive patients admitted to the emergency department for snakebite envenomation. Snakebite envenomation was defined by a history of snakebite. Predictors of severe envenomation were determined by univariate and multivariate analyses. Results: Our sample consisted of 109 patients aged 30 (20-44) years with a 1.1:1 sex-ratio (56 males and 53 females). During the 24-hour surveillance period, 25 patients developed severe envenomation (22.9%). The in-hospital mortality rate was 4.6% (n=5). The independent predictors of severe snakebite envenomation were leucocyte count over 11550/mm3 (OR: 18.7, 95% CI: 3.3-107.8), creatine kinase over 155 IU/L (OR: 6.16, 95% CI: 1.1-35.6), and/or tourniquet before arrival to the ED (OR: 32.14, 95% CI: 3.5-295.9). Conclusions: This study emphasizes the importance of early evaluation of snakebite envenomation. Further studies are required to approve a severity scale proper to snakebite envenomation in Tunisia. 相似文献
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A common substitution (Asn291Ser) in lipoprotein lipase is associated with increased risk of ischemic heart disease. 总被引:4,自引:1,他引:3
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H H Wittrup A Tybjaerg-Hansen S Abildgaard R Steffensen P Schnohr B G Nordestgaard 《The Journal of clinical investigation》1997,99(7):1606-1613
Lipoprotein lipase degrades triglycerides in plasma and as a byproduct produces HDL particles. Genetic variation in lipoprotein lipase may therefore affect cardiovascular risk. We tested 9,214 men and women from a general population sample and 948 patients with ischemic heart disease for the Asn291Ser substitution in lipoprotein lipase. The allele frequency in the general population was 0.024 and 0.026 for women and men, respectively. In comparison with noncarriers, female heterozygous probands had increased plasma triglycerides (delta = 0.23 mmol/liter), while HDL cholesterol was reduced in both female and male carriers (delta = 0.18 mmol/liter and delta = 0.11 mmol/liter, respectively). A similar phenotype was found in six homozygous carriers. On multiple logistic regression analysis, plasma triglycerides and HDL cholesterol were independent predictors of ischemic heart disease in both genders. On univariate analysis, odds ratios for ischemic heart disease in probands were 1.89 in women (95% CI: 1.19-3.01) and 0.90 in men (95% CI: 0.62-1.31), and on multivariate analysis were 1.98 in women (95% CI: 1.11-3.53) and 1.02 in men (95% CI: 0.65-1.60). This study demonstrates that a single common mutation in the lipoprotein lipase gene is associated with elevated plasma triglycerides and reduced HDL cholesterol levels, whereby carriers, in particular women, seem to be predisposed to ischemic heart disease. It cannot be excluded, however, that male carriers of this substitution may represent a subset of low-HDL individuals without raised triglycerides not predisposed to ischemic heart disease. 相似文献
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目的 探讨改进的ABCD2评分法对短暂性脑缺血发作(transient ischemic attack,TIA)后7d内发生脑梗死风险的预测价值.方法 本研究纳入了2014年7月至2015年12月在南通大学第二附属医院就诊的133例TIA患者,记录其TIA后7d内脑梗死的发生情况.使用单因素和多因素Logistic回归分析可能导致脑梗死的危险因素.采用ABCD2联合颈动脉超声(carotid ultrasound)的改良评分法(ABCD2-CU评分法)给TIA患者进行评分.绘制受试者工作特征曲线(ROC)曲线,观察曲线下面积(AUC),评估ABCD2评分及ABCD2-CU评分对TIA后脑梗死风险的预测价值及其差异.结果 133例TIA患者7d内有35例(26.3%)进展为脑梗死.单因素分析提示入院时血压≥140/90 mmHg(1 mmHg =0.133 Kpa)、单侧肢体无力、言语障碍、持续时间≥10 min、糖尿病史、高血压病史、颈动脉斑块形及颈动脉狭窄等8项危险因素与TIA后早期脑梗死密切相关(均P< 0.05).多因素Logistic回归分析提示单侧肢体无力[OR(95% CI),3.52 (1.76~12.34)]、持续时间≥10min [2.45 (1.06~9.27)]、糖尿病史[3.37 (1.27~ 10.94)]、高血压病史[4.15 (1.71~13.34)]、颈动脉斑块[6.32 (2.46 ~ 19.40)]及颈动脉狭窄[12.73(2.67 ~44.35)]是TIA后早期进展脑梗死的独立危险因素(均P<0.05).ABCD2-CU评分(AUC =0.802,95% CI:0.717 ~0.888,P=0.000)对脑梗死的预测价值高于ABCD2评分(AUC=0.614,95%CI:0.511~0.717,P=0.036).结论 ABCD2-CU评分较ABCD2评分在判断TIA后早期脑梗死风险方面有更高的临床价值,可帮助医生鉴别高危患者,以早期采取及时预防措施. 相似文献
18.
Determinants of functional independence and quality of life in children with spina bifida 总被引:4,自引:0,他引:4
Schoenmakers MA Uiterwaal CS Gulmans VA Gooskens RH Helders PJ 《Clinical rehabilitation》2005,19(6):677-685
OBJECTIVE: To investigate determinants of functional independence and study which functional abilities were determinants for 'health-related quality of life' in children with myelomeningocele. DESIGN: Cross-sectional study by means of clinical assessment, 'disability' measurement and questionnaires. Uni- and multivariate logistic regression models were used to investigate factors that were determinants for these outcomes. Results were expressed as odds ratios (OR) and 95% confidence intervals (95% CI). SETTING: Outpatient spina bifida clinic at a university hospital. SUBJECTS: One hundred and twenty-two children with myelomeningocele. Mean age 7.9; range 1-18 years. MAIN MEASURES: Functional independence as measured by the Pediatric Evaluation of Disability Inventory (PEDI), and quality of life as measured by the Spina Bifida Health Related Quality of Life Questionnaire. RESULTS: Lesion level below L3 (OR 0.4, 95% CI 0.1-1.0), mental status of IQ > or =80 (OR 4.2, 95% CI 1.2-14.9), having no contractures in lower extremities (OR 3.4, 95% CI 1.3-8.8), and having normal strength of knee extensor muscles (OR 4.1, 95% CI 1.4-11.5) were most strongly associated with independence in self-care. Mental status (OR 16.1, 95% CI 2.8-93.9), having no contractures in lower extremities (OR 1.5, 95% CI 1.4-5.3), and normal strength in knee extensors (OR 11.0, 95% CI 1.3-97.0) were the most important determinants for independence in mobility. Concerning functional abilities, being independent with regard to mobility was the most important determinant for 'health-related quality of life' (OR 5.3, 95% CI 1.6-17.4). CONCLUSIONS: In children with myelomeningocele, good muscle strength, mental ability and being independent in mobility appeared to be much more important for daily life function and quality of life than other medical indicators of the disorder. 相似文献