中南地区自杀危险因素的病例对照研究

1995-1999年中国的年平均自杀率为23.23/10万,高于世界其他各地的平均水平,说明自杀是中国重要的公共卫生问题[1].研究表明中部农业地区具有较高的自杀率(21.68/10万)[2,3].为探讨中南地区自杀者的危险因素,本研究从北京回龙观医院与中国疾病预防控制中心合作全国项目"中国意外死亡原因及干预策略的研究"中选出中南地区意外死亡案例数据进行分析.     

湖北农村妇女自杀死亡危险因素的病例对照研究

近年的研究表明中国农村妇女自杀死亡率已达到30·5/10万,远远高于城乡男性和城市女性[1]。本文报道了湖北麻城市农村15岁及以上妇女自杀死亡的影响因素。对象与方法1·1对象资料来源于湖北麻城市(县)“四报”信息管理系统。在湖北麻城市农村抽取分别代表山区、丘陵和平原的龟山、乘马岗和中驿乡,以这3个乡2000~2002年间15岁及以上自杀死亡妇女为研究对象。选择与病例同性别、年龄相差±2~3岁、与病例居住在同一生活环境的妇女1:1配对作为对照。1·2方法:采用自制问卷,由研究者(或经过培训的调查员)逐一入户,寻找知情人(家人、亲属、邻居、…     

医务人员呼吸道感染影响因素的巢式病例对照研究

目的 探索医务人员在院内感染呼吸道传染病的影响因素,针对性的提出院感防范重点及感染控制改进建议.方法 本研究采用巢式病例对照研究的方法.选取北京市东城区和西城区的9家二级以上医院,将符合条件的医务人员作为一个队列,对其医疗行为进行为期一个月的观察.依据咽拭子病原学检测结果判定研究对象的呼吸道感染状况,并将他们分为病例组...     

河南林县Alzheimer病危险因素的巢式病例对照分析

目的 :探讨河南林县阿尔茨海默病 (AD)的危险因素。方法 :采用年龄 (± 2岁 )、性别和乡别匹配的巢式病例对照研究方法分析 15年前的生活习惯、心理社会因素、躯体检查史和疾病史等对AD发生的影响作用。结果 :多因素模型中 ,高血压值OR =1 971、吃发霉蔬菜OR =1 767,皮肤病和贫血的疾病史OR值分别为 0 2 2 7和 0 5 34 ,且均存在显著性意义 ;高血压值的人群归因危险度为 2 8 3% ,与AD之间趋势检验P <0 0 0 0 2。结论 :在林县地区AD的发生中 ,高血压和吃发霉蔬菜为危险因素 ,而皮肤病和贫血的疾病史为保护因素 ;血压值与AD之间存在剂量 -反应关系。吸烟和饮酒未见与AD有显著性联系     

中学生行为问题危险因素的病例对照研究

中学生行为问题危险因素的病例对照研究翟静郭传琴刘贤臣刘同洲曹会龙戴郑生山东省精神卫生中心近年来国内外许多学者对儿童行为问题进行了研究，发现儿童的行为问题与家庭、学校及儿童自身因素等有关［１］。为了探讨中学生行为问题发生的相关因素及各因素的作用，应用山...     

社区阿尔茨海默病危险因素病例对照研究

目的了解社区阿尔茨海默病(AD)可能的危险因素。方法将流行病学调查发现的AD患者以性别、年龄(±3岁)和文化程度按12比例与认知功能正常老人配对,部分高龄老人因无足够正常对照,则按11配对,在同村或同居委会范围内寻找正常对照。患者和正常对照危险因素调查均以询问知情者为主。结果AD患者丧偶或离异者多(OR=3.30,95％CI=1.43-7.63),出生前母亲生育子女数较少(OR=0.78,95％CI=0.62-0.98),吸烟(OR=0.52,95％CI=0.28-0.95),饮酒(OR=0.57,95％CI=0.34-0.97)者较对照组少,各项差异均显著。50岁后很少锻练身体的患者比对照组多(OR=2.56,95％CI=0.89-7.34),但差异无显著性。结论丧偶或离异、出生时母亲生育子女数较少可能是AD的危险因素。50岁后锻练身体、吸烟和饮酒对AD可能有保护作用,须进一步研究。     

新生儿颅内出血病因危险因素的病例对照研究

为了提高新生儿颅内出血的防治水平,采用回顾分析法,对150例确诊为新生儿颅内出血的新生儿患者的影响因素进行病例对照研究。结果显示：脐带绕颈、宫内窘迫、滞产、胎位异常、产钳、负压吸引、窒息、代谢性酸中毒（P均＜0．05,共9个因素对疾病的发生有明显影响。提示加强围产期保健及监护,采用正确的分娩方式是预防本病的关键。     

乙肝疫苗免疫预防效果影响因素的巢式病例对照研究

目的 研究影响乙肝免疫效果的因素,探讨提高乙肝免疫预防效果的方法 .方法 使用巢式病例对照研究方法 ,以2006年全国乙肝等疾病血清流行病调查河北现场的1734名1-15岁儿童作为研究对象,按其HBsAg是否阳性分为病例组和对照组,分析造成儿童HBsA9阳性的危险因素.结果 母亲HBsAg阳性和儿童年龄、出生医院是影响乙肝疫苗预防效果的主要因素(P<0.0001).结论 当前乙肝免疫预防的工作重点在于发现HBsAg阳性孕妇,同时改进农村地区的新生儿乙肝免疫预防条件.     

大学生神经症影响因素的病例对照研究

目的；探讨大学生神经症发病的主要危险因素。方法：采用非条件Ｌｏｇｉｓｔｉｃ回归方法对１２１例神经症患者和５１６名健康者按性别分组分析。结果：性别不同，神经症发病的主要危险因素也不同。男生：与神经质、母亲文化偏低，娱乐体育等能力不良，经济物质基础较差相关。女生与神经质，内外倾，得到社会支持系统（保护因子），母亲拒绝否认，丧失社会支持系统相关。结论：研究神经症危险因素，要控制性别影响。     

A case-control study on risk factors of breast cancer in China

Introduction

To screen the risk factors associated with breast cancer among Chinese women in order to evaluate the individual risk of developing breast cancer among women in China.

Material and methods

A case-control study on 416 breast cancer patients and 1156 matched controls was conducted in 14 hospitals in 8 provinces of China in 2008. Controls were age- and region-matched to the cases. Clinicians conducted in-person interviews with the subjects to collect information on demographics and suspected risk factors for breast cancer that are known worldwide. Conditional logistic regression was used to derive odds ratios (OR) and 95% confidence intervals (CI) for the associations between risk factors and breast cancer.

Results

Compared with matched controls, women with breast cancer were significantly more likely to have higher body mass index (BMI, OR = 4.07, 95% CI: 2.98-5.55), history of benign breast disease (BBD) biopsy (OR = 1.68, 95% CI: 1.19-2.38), older age of menarche (AOM) (OR = 1.41, 95% CI: 1.07-1.87), stress anticipation (SA), for grade 1-4, OR = 2.15, 95% CI: 1.26-3.66; for grade 5-9, OR = 3.48, 95% CI: 2.03-5.95) and menopause (OR = 2.22, 95% CI: 1.50-3.282) at the level of p < 0.05. Family history of breast cancer (FHBC) in first-degree relatives (OR = 1.66, 95% CI: 0.77-3.59) and use of oral contraceptives (OC) (OR = 1.59, 95% CI: 0.83-3.05) were associated with an increased risk of breast cancer at the level of p < 0.20.

Conclusions

Our results showed that BMI, history of BBD biopsy, older AOM, SA and menopause were associated with increased risk of breast cancer among Chinese women. The findings derived from the study provided some suggestions for population-based prevention and control of breast cancer in China.     

地震受灾人群创伤后应激障碍危险因素的病例对照研究

目的:探讨地震3年后受灾人群中创伤后应激障碍(PTSD))的危险因素。方法:采用病例对照研究的方法,分析地震3年后云南省鲁甸县龙头山镇重灾区受灾群众155人的调查资料,以PTSD筛查阳性人群为病例组,阴性人群为对照组,对自编人口学基本信息调查表、创伤后应激障碍自评量表(PCL-C)的问卷数据进行单因素分析,采用非条件logistic回归分析探讨年龄、性别等人口学资料及灾难暴露程度、参与现场救援、地震中失去亲人与否等对创伤后应激障碍的影响。结果:病例组与对照组单因素分析比较显示,性别(χ²=4.65,P<0.05)、受教育程度(χ²=9.63,P<0.01)、灾难暴露程度(χ²=7.15,P<0.01)有统计学意义。非条件logistic回归分析显示女性(OR=4.89,P<0.01)、非文盲(OR=6.30,P<0.01)、高暴露者(OR=17.44,P<0.05)是发生PTSD的危险因素。结论:地震三年后重灾区受灾人群中女性、非文盲、高暴露者发生PTSD的危险性大,提示应当重点对这类...     

Risk factors for female and male infertility: results of a case-control study.

In order to evaluate male and female risk factors for infertility in a case-control study, we have compared all couples in a French administrative region consulting for primary or secondary infertility (of more than one year's duration) with couples in which the woman had given birth during the year of the study. For any one couple, a history of varicocele, male genital infections or testis damage multiplies the risk of primary infertility by a factor of 28, 3 and 4 respectively, and previous female infections (salpingitis) multiply the risk by 45. Similarly, a history of ectopic pregnancy, sexually transmitted diseases or salpingitis multiplies the risk of secondary infertility by a factor of 5, 4 and 7 respectively, and a history of varicocele multiplies this risk by 4.     

A case-control study of presentations in general practice before diagnosis of coeliac disease.

BACKGROUND: Delay in the diagnosis of coeliac disease prolongs morbidity and may increase mortality. Little is known about presentations in general practice that may predict a subsequent diagnosis of coeliac disease. AIM: To examine presentations in general practice during the 5 years prior to diagnosis of coeliac disease. DESIGN OF STUDY: A case-control study with each biopsy-proven coeliac disease case matched by age, sex, and general practice to an average of two controls. SETTING: Thirty-seven general practices in south-east Wales. METHOD: Cases were identified via a secondary care clinic and controls recruited from the general practices of cases. General practice clinical records of both cases and controls were analysed to determine frequency of consultations, presenting symptoms, diagnoses, referrals, and investigations during the 5 years prior to diagnosis. RESULTS: Cases (n = 68) had an increased number of consultations compared with controls (n = 160) during the 5 years prior to diagnosis (mean difference five consultations, P = 0.001). Three clinical features were independently associated with subsequent diagnosis of coeliac disease: depression and/or anxiety (odds ratio [OR] = 2.5, 95% confidence interval [CI] = 1.1 to 5.7, P = 0.031); diarrhoea (OR = 4.5, 95% CI = 2.0 to 10.0, P <0.001); and anaemia (OR = 26.3, 95% CI = 5.7 to 120.6, P <0.001). Both diarrhoea and anaemia remained associated even when data for the year prior to diagnosis was excluded from the analysis. CONCLUSION: [corrected] GPs should consider testing for coeliac disease when patients present often, especially with diarrhoea and/or who are discovered to be anaemic. Further research is required to clarify the role of depression and/or anxiety in the diagnosis of coeliac disease.     

Risk factors for infection with carbapenem-resistant Klebsiella pneumoniae: a case-case-control study

Objetive:

To evaluate the association between quinolone exposure and the emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) and to estimate CRKP-specific mortality.

Methods:

Case-case-control study implemented in a tertiary care institution. Three groups of patients were analyzed: 61 consecutive cases of infection with CRKP (Group I); 61 randomly chosen cases of patients infected with carbapenem-sensitive Klebsiella pneumoniae (CSKP; Group II); and 122 randomly chosen controls without CRKP or CSKP infection. Matching was based on the length of stay in intensive care unit and the date of bacterial isolation. An active search was performed for patients with CRKP and CSKP infection, and prospective cases were included in the study. We compared the results for Groups I and II against those for the controls by using two conditional logistic regression analyses that included infection as the dependent variable and controlled for time at risk and comorbidities.

Results:

Exposure to quinolones was not associated with CRKP infection: no association was found in the analysis of CRKP with the controls (OR= 1.7; 95% CI: 0.2-6.5) or in the analysis of CSKP against the controls (OR= 0.6; 95% CI: 0.2-1.6). Use of carbapenems (OR= 3.3; 95% CI: 1.2-9.3) and colonization with CRKP (OR= 3.3; 95% IC: 1.2-9.3) were specific risk factors for infection with CRKP. Mortality associated with CRKP was 61.3%.

Conclusion:

No association was found between exposure to quinolones and infection with CRKP; however, colonization by CRKP and use of carbapenems are risk factors for infection with CRKP.     

神经症危险因素的病例对照研究

目的:广泛筛选与神经症发生有关联的人格障碍、生活事件、父母养育方式等可疑危险因素并分析其关联程度。方法:通过成组病例对照研究,用生活事件量表、父母养育方式问卷,人格诊断问卷对100名就诊于北京两家三甲精神病专科医院的神经症患者(病例组)和按照性别、年龄(±3岁)成组匹配的无精神障碍的200名上述医院的工作人员(对照组)进行自评问卷调查。结果:(1)单因素分析显示,病例组的负性生活事件得分、父亲拒绝因子得分、父亲过度保护因子得分、母亲拒绝因子得分、总体人格障碍得分均高于对照组[22.5vs.2.5,(40.4±14.1)vs.(35.4±7.9),(29.1±7.5)vs.(28.2±5.6),(40.4±13.7)vs.(36.8±8.5),(29.8±14.1)vs.(17.1±13.0);均P0.05]。(2)非条件Logistic回归分析显示,神经症发生的保护因素是正性事件(OR=0.92,95%CI:0.87～0.98);危险因素是负性事件(OR=1.06,95%CI:1.04～1.08)及总体人格障碍(OR=4.84,95%CI:2.24～10.49)。结论:正性生活事件是神经症发生的保护因素,负性生活事件和人格障碍是神经症发生的危险因素。     

Duration of sleep and breast cancer risk in a large population-based case-control study

One important function of sleep may be its contribution to the maintenance of the immune system and regulation of the circadian rhythms by melatonin. Researchers have speculated that disruption of immune functions involving cortisol levels and natural killer cell activity may increase breast cancer risk whereas increased melatonin exposure may protect against breast cancer. We conducted a multistate population-based case-control study of 4,033 women with invasive breast cancer and 5,314 community women without breast cancer in which we inquired about women's sleep habits in the recent past and during adult lifetime. Relative to women who slept 7.0-7.9 h/night, the multivariate odds ratio for developing breast cancer among women who slept an average of 9 h or more per night approximately 2 years prior to interview was 1.13 (95% CI 0.93-1.37). The multivariate-adjusted odds ratio for the continuous term was 1.06 (95% CI 1.01-1.11), suggesting a 6% increase in risk for every additional hour of sleep. Similar patterns were observed for average lifetime adult sleep duration. We found little evidence that sleeping few hours per night was associated with breast cancer risk. The results of this study suggest that increasing sleep duration is modestly associated with an increased breast cancer risk. In contrast, short duration of sleep (<7 h/night) is not substantially associated with increased risk. Further research in this area is warranted.     

Identification of new risk factors for pneumonia: population-based case-control study

Background

Certain conditions are established as risk factors for community-acquired pneumonia. There are a number of other conditions that may also be risk factors, but information on these is limited.

Aim

To determine new independent risk factors for community-acquired pneumonia using a very large primary care database.

Design of study

Nested case-control study.

Setting

Four hundred and forty-three general practices in the UK contributing to the QRESEARCH database.

Method

A total of 17 172 incident cases of all ages diagnosed with pneumonia between 1996 and 2005 were matched with up to five controls by age, sex, general practice, and calendar year. Associations between pneumonia and each established condition and potential risk factors were determined with odds ratios (ORs), using multiple conditional logistic regression analysis adjusted for smoking, socioeconomic status, and use of influenza and pneumococcal vaccines.

Results

The analysis confirmed the higher risk of pneumonia among patients with at least one of the established risk factors; the adjusted OR was 2.29 (95% confidence interval [CI] = 2.20 to 2.39). In addition, patients with the following conditions had a higher risk of pneumonia despite adjustment for known risk factors and confounders: stroke or transient ischaemic attack, rheumatoid arthritis, Parkinson''s disease, cancers, multiple sclerosis, dementia, and osteoporosis. The adjusted OR for pneumonia among patients without an established risk factor but with at least one of the new conditions was 2.44 (95% CI = 2.24 to 2.65).

Conclusion

As well as confirming some established risk factors, this study has determined seven new independent risk factors for community-acquired pneumonia.