北京市老年人Alzheimer病与痴呆家族史关系研究

目的探讨Alzheimer病(AD)和痴呆家族史的关系.方法采用以人群为基础的病例对照研究设计,通过分层分析和Logistic回归分析估计AD与其痴呆家族史之间的联系强度.结果一级亲属有痴呆病史者,患AD危险性显著高于对照人群(OR值为2.82,P<0.01).同时调整年龄和受教育程度后,一级亲属的痴呆家族史仍和AD的发生有显著联系(调整后的OR值为3.517,P<0.01).结论北京市老年人Alzheimer病存在家族聚集性.     

尿石症危险因素人群病例对照研究

目的 探索尿石症发病的危险因素，为人群预防提供依据。方法 选取深圳市尿石症现况调查发现的334例患者为病例组，721名健康者为对照组，进行尿石症危险因素人群病例对照研究；采用非条件logistic回归对34个变量进行分析，采用Falconer回归法估算遗传变。结果 尿石症病例组和对照组配比条件均衡可比，单因素logistic回归分析共有17个变量有统计学意义，但最终进入模型的因素有10个，其中4个变量为尿石症发病危险因素，OR值大小依次为既往泌尿系慢性炎症史（OR＝4.09,95%CI:1.38-12.14)，一级亲属尿石症史（OR＝2.61,95%CI:1.70-4.01)和多食动物蛋白质（OR＝2．14，95％CI：1．71－2．69），暴露日照时间长（OR＝1．39，95％CI：1．16－1．66）；而较高文化程度（OR＝0．46，95％CI：0．29－0．73），日引水量多（OR＝0．59，95％CI：0．48－0．72），饮果汁（OR＝0．41，95％CI：0．18－0．94），多食奶及奶制品（OR＝0．82，95％CI：0．68－0．99），多食蔬菜（OR＝0．70，95％CI：0．55－0．91）和多食水果（OR＝0．78，95％CI：0．64－0．94）6个变量为尿石症发病的保护因素。一级亲属尿石症患病率病例组高于对照组，尿石症分离比为0．0109，95％CI：0．0050－0．0168，一级亲属尿石症的遗传度为28．48％，男，女分别为32．06％和24．60％。结论 尿石症主要受饮食习惯影响，尿石症家族史和社会经济状况也与发病有关。     

慢性阻塞性肺病与阿尔茨海默病的病例对照研究

目的探讨老年人阿尔茨海默病（AD）与慢性阻塞性肺病（COPD）的关系。方法采用病例对照研究。选择确诊的77例军队AD病人为病例组，在同一医院住院治疗的离退休老干部中按照年龄段分层抽样（按1：2比例）选取154例非痴呆对照。调查方式为电话访谈。结果单因素分析结果显示病例组社会活动情况明显少于对照组，体育锻炼情况、负性生活事件、既往COPD病史、既往癌症病史、痴呆家族史在两组间有显著性差异。在调整相关影响因素后，COPD病史致AD的OR值（95% CI）为2．122（1．007～4．472），负性生活事件、痴呆家族史、社会活动量减少的OR值分别为2．975（1．371～6．457），4．284（1．047～19．392），1．002（1．001～1．004）。结论COPD病史可能是AD的一个独立危险因素。     

过敏性疾病家族史与儿童哮喘发病的相关研究

目的探讨过敏性疾病家族史与儿童哮喘发病的关系。方法采取两阶段分层整群随机抽样调查方法,抽取宝鸡市区1029名0～14岁儿童进行哮喘危险因素调查,利用χ2检验分析过敏性家族史与儿童哮喘的关系。结果按照性别分层,男童中一级亲属哮喘史（OR＝17．83,95％CI：2．36～134．77）、一级亲属其他过敏史（OR＝1．92,95％CI：1．06～3．49）、二级亲属哮喘史（OR＝4．18,95％CI：1．55～11．29）、二级亲属其他过敏史（OR＝3．87,95％CI：1．27～11．79）均与儿童哮喘相关;女童中一级亲属哮喘史（OR＝4．58,95％CI：1．28～16．02）、二级亲属哮喘史（OR＝3．87,95％CI：1．41～10．66）与儿童哮喘相关;根据合并ORM-H,一级亲属哮喘史（ORM-H ＝7．94,95％CI：2．77～22．73）、一级亲属其他过敏史（ORM-H ＝1．80,95％CI：1．14～2．84）、二级亲属哮喘史（ORM-H ＝4．03,95％CI：1．98～8．19）、二级亲属其他过敏史（ORM-H ＝2．36,95％CI：1．11～5．00）也均与儿童哮喘相关。结论过敏性疾病家族史是儿童哮喘的危险因素,有过敏性疾病家族史的儿童应尽量避免其他哮喘危险因素,以降低儿童哮喘的发生概率。     

痛风致病因素的1：3配对病例对照研究

采用1：3配对病例对照研究方法探讨了痛风致因素及其相互关系,病例选自近2年内在山东医科大学附属医院确诊的痛风患者26名,每个病例按1：3配比选择对照,要求对照与病例年龄相同（相差5岁之内）,性别相同,与病例来自同一地区,无自身免疫性疾病和恶性肿瘤病史,按统一调查表询问调查,用Egreat软件分析,单因素分析显示,有11个因素与痛风发病相关,有7个因素在P＝0．05水平被选入多因素模型,它们依次是：食海产品（OR．9．267）,高血压（OR＝6．401）,寒冷与潮湿（OR＝4．558）,肾脏病患（OR＝2．84）,自身免疫性疾病家族史（OR．2．730）,食肉（OR＝2．317）和饮茶（OR＝0．319。     

女性原发性开角型青光眼发病的危险因素分析

摘要:目的　探讨女性原发性开角型青光眼（POAG）发病的主要危险因素。方法　采用问卷调查的方式收集研究118例女性POAG患者及对照人群的一般资料及相关信息,分析女性POAG患者的危险因素。结果　绝经年龄≥50岁（OR＝0.402,95%CI:0.240～0.673,P＜0.05）是女性POAG发病的保护因素;高血压（OR＝2.213,95%CI:1.322～3.712,P＜0.05）、高度近视（OR＝3.893,95%CI:2.319～6.535,P＜0.05）、一级亲属有青光眼家族史（OR＝8.954,95%CI:1.783～45.128,P＜0.05）是女性POAG发病的独立危险因素。结论　高血压、高度近视、一级亲属有青光眼家族史是女性POAG的重要危险因素,而女性雌激素可能是女性POAG的保护因素。     

食管癌人群遗传易感性的流行病学研究

１９９３年３～５月，我们设计了一种遗传流行病学病例对照调查方法，对淮安食管癌高发区人群的遗传易感性进行了研究。结果显示：食管癌家族史与食管癌的发生确有一定关系（Ｘ＾２＝１４．７５ Ｐ〈０．０１、ＲＲ＝２．４２）。进一步分析发现，在病例血缘亲属中食管癌的发病或死亡均显著高于一般人群，且随着与病例关系越接近，其ＳＭＲ和ＲＲ值越大；而病例非血缘亲属ＳＭＲ和ＲＲ接近人群总体水平；对照血缘亲属的ＳＭＲ和ＲＲ     

尿石症危险因素病例对照研究

目的：探讨尿石症发病危险因素和保护因素，为人群预防提供依据。方法：采用基于医院的病例对照研究。选取尿石症新发病人并按1：1配对，应用Foxpro5.0建立数据库，SPSS7．5进行数据分析。结果：67个因素中22个人选单因素条件Logistic回归模型，最终进行多因素条件Logistic回归模型的变量共12个，可划归5类，即社会经济状况，家庭尿石症病史，工作条件，生活和饮食习惯，营养素等，尿石症的危险因素包括家庭年人均收入高（OR＝1.026,OR95%CI=1.010-1.042)，一级亲属尿石症病史（6．429，2．899－14．255）习惯性饮水较水（1．9144，1．272－2．881），口味偏咸（6．948，2．124－22．723），喜吃甜食（8．464，1．821－39．337），高蛋白质（1．752，1．423－2．158），高脂肪（1．236，1．056－1．448）和高磷（1．380，1．184－1．609）尿石症发病的保护因素包括日饮水饮数较多（0．771，0．614－0．967），高碳水化合物（0．640，0．531－0．772）、高膳食纤维（0．722，0．618－0．843）和高维生素C（0．763，0．641－0．907）。结论：尿石症发病主要受饮食习惯和营养因素影响，而社会经济状况和尿石症家族史的作用也不可忽视。     

2型糖尿病患者遗传性病例对照研究

目的通过对2型糖尿病一级亲属患病率和遗传度的分析，探讨遗传因素在2型糖尿病中的作用。方法采用病例对照方法，选择沈阳市2所医院门诊与住院的2型糖尿病患者203例作为病例组，同期选取社区缝康人群201人作为对照组进行调查。采用χ^2检验进行统计分析，并用Falconer法计算遗传度。结果家族史是2型糖尿病的危险因素（OR=5．89）；病例组一级亲属的2型糖尿病患病率为6。76％，显著高于对照组的1.27％，相对危险度为5．32（95％CI=3.54～7．99）；2型糖尿病一级亲属的遗传度为56．88％。结论遗传因素在2型糖尿病的发生中起重要作用，其一级亲属对糖尿病的遗传易感性较高，是糖尿病预防和控制的重点人群。     

贵阳市城区老年痴呆患病率调查

目的了解贵阳市城区老年痴呆的患病率及其流行特征。方法采用多级整群抽样方法。随机抽取贵阳市城区26个社区居委会的60岁及以上老年人群作为样本人群，采用二阶段调查方式进行研究。调查60岁及以上老年人3229名。资料比较用Y0检验或计算比值比（OR）。结果共发现痴呆患者64例，其中AD患者41例（占64．06％），VD患者18例（占28．13％），混合性痴呆2例（占3．13％），其他类型痴呆3例（占4．68％）。60岁以上人群痴呆及AD、VD的患病率分别为1．98％，1．27％和0．56％。痴呆、DA和VD的患病率随年龄的增加而显著增高，在男性和女性之间差异无统计学意义；随受教育程度的增高而显著降低；体力劳动者AD患病率显著高于脑力劳动者。丧偶者痴呆、AD的患病明显高于在婚者。结论贵阳市城区痴呆患病率水平接近全国城市人群平均水平。AD是痴呆患病的主要类型，高龄、低教育程度、丧偶的老年人群是痴呆患病的高危人群。     

Risk factors in clinically diagnosed presenile dementia of the Alzheimer type: a case-control study in northern England.

STUDY OBJECTIVE--To investigate the relationship between presenile dementia of the Alzheimer type (PDAT) and family history, medical history, cigarette smoking, and exposure to aluminum. DESIGN--A case-control study in which 109 cases of clinically diagnosed PDAT and 109 controls matched for age and sex were compared for exposure to the risk factors. Odds ratios (ORs) were calculated using McNemar's test. SETTING--The northern health region of England. PATIENTS--Cases comprised those under 65 years diagnosed as having dementia by specialist services, who met clinical algorithm criteria for Alzheimer's disease (AD). Cases were confirmed at interview. MAIN RESULTS--Comparing cases with controls, (ORs) significantly greater than unity were obtained when there was a first degree relative with dementia (OR 2.5, 95% confidence interval 1.05, 6.56), any relative with dementia (OR 2.1, 95% CI 1.01, 4.55), and any relative aged less than 65 with dementia (OR 8.0, 95% CI 1.07, 348). Exposure to moderate levels of cigarette smoking (cumulative) was not significant; nor was exposure to aluminum in drinking water, diet, and medicinal sources. CONCLUSION--In this study of modest statistical power, a family history of dementia was confirmed as a risk factor in PDAT. No significant relationship between exposure to aluminium in water supplies, tea, and antacids was found. What is important, however, is the bioavailability of all dietary aluminium, determined by the concentrations of dissolved silicon in water: this requires further investigation.     

中国老年人群阿尔茨海默病发病危险因素的Meta分析

目的 通过Meta分析探讨我国老年人群阿尔茨海默病发病危险因素。方法 利用Meta分析对国内外公开发表的有关中国老年人群发表危险因素的32篇研究进行定量综合分析。结果 影响阿尔茨海默病发病危险因素包括:年龄OR = 1.38 (95%CI:1.05～1.82)、受教育程度低OR = 2.17 (95%CI:1.68～2.81)、痴呆家族史OR = 3.37 (95%CI:1.90～5.96)、精神病家族史OR = 4.86 (95%CI:2.58～9.18)、负性生活事件OR = 2.13 (95%CI:1.37～3.33)、高血压OR = 1.46 (95%CI:1.14～1.87)、糖尿病OR = 2.20 (95%CI:1.36～3.56)、心血管病史OR = 2.05 (95%CI:1.49～2.80)、脑外伤OR = 2.79 (95%CI:1.66～4.69)和血脂异常OR = 1.71 (95%CI:1.44～2.03)和不参加体育锻炼OR = 1.99 (95%CI:1.58～2.52)。结论 阿尔茨海默病发病受多种危险因素影响,其早期预防应采取有针对性的预防措施,如积极控制相关疾病病情、加强体育锻炼等。     

A study of familial aggregation of depression, dementia and Parkinson's disease

Depression is often accompanied by other disorders including Alzheimer's disease and Parkinson's disease. We studied the familial aggregation of these disorders in order to examine the possibility of a shared genetic origin. In a population-based study of 6596 subjects, we studied the association of self-reported depression, which required treatment by a psychiatrist, to family history of psychiatric disease, dementia, and Parkinson's disease. A family history of psychiatric disease was significantly associated with overall depression as well as with unipolar (n = 303 patients) and bipolar (n = 27 patients) depression. The risk of unipolar depression was associated with the presence of two or more demented individuals among their first degree relatives (e.g. parents, siblings and children). Since there was no evidence for familial aggregation in subjects with only one demented relative, our study suggests that unipolar depression may be associated specifically to a strongly familial, form of dementia. The risk of bipolar depression was increased for those with one or more relatives with dementia and, perhaps, for those with relatives with Parkinson's disease. The familial aggregation of depression with dementia and perhaps Parkinson's disease suggests that there may be shared susceptibility gene(s) underlying these diseases. Our study indicates further that there may be differences in the genetic etiology between unipolar and bipolar depression.     

Head trauma and the risk of Alzheimer's disease.

A population-based case-control study of the association between head trauma and Alzheimer's disease was conducted in the Netherlands from 1980 to 1987. The study comprised 198 patients with clinically diagnosed early onset Alzheimer's disease and 198 age- and sex-matched population controls. Adjusted for sex, age, family history of dementia, and education, the odds ratio of a history of head trauma with loss of consciousness was 1.6 (95% confidence interval (CI) 0.8-3.4). The odds ratio for men was 2.5 (95% CI 0.9-7.0), and that for women was 0.9 (95% CI 0.3-2.8). The increase in odds ratio was limited to head trauma that occurred within the period of 10 years prior to the onset of dementia (odds ratio = 10.0; 95% CI 1.0-96.8). There was no evidence of effect modification by family history of dementia as measured on a multiplicative scale. However, the power to show interaction may have been low in this study. The authors' findings are compatible with the view that head trauma may be implicated in Alzheimer's disease, with a short lag time between the head trauma and the first symptoms of disease. The association needs to be confirmed in a prospective follow-up study to fully exclude the possibility of recall bias.     

Family history of coronary heart disease, a strong risk factor for myocardial infarction interacting with other cardiovascular risk factors: results from the Stockholm Heart Epidemiology Program (SHEEP)

We explored the relation between family history of coronary heart disease and the risk of myocardial infarction in a case-control study of subjects, 45 to 70 years of age, living in Stockholm, Sweden. Our cases comprised 1091 male and 531 female first-time acute myocardial infarction patients who had survived at least 28 days after their infarction. Referents were randomly selected from the population from which the cases were derived. The adjusted odds ratio (OR) of myocardial infarction was 2.0 (95% confidence interval [CI] = 1.6-2.6) for men reporting > or = 1 affected parent or sibling, compared with men with no family history of coronary heart disease, and 3.4 (95% CI = 2.1-5.9) for those reporting > or = 2 affected parents or siblings. The corresponding OR for women were 2.1 (95% CI = 1.5-3.0) and 4.4 (95% CI = 2.4-8.1). We found evidence for synergistic interactions in women exposed to family history of coronary heart disease in combination with current smoking and with a high quotient between low-density lipoprotein and high-density lipoprotein cholesterol (>4.0), respectively, which yielded adjusted synergy index scores of 2.9 (95% CI = 1.2-7.2) and 3.8 (95% CI = 1.5-9.7), respectively. Similarly, in men we found evidence for interaction for the co-exposure of family history of coronary heart disease and diabetes mellitus. Our study shows that family history of coronary heart disease is not only a strong risk factor for myocardial infarction in both sexes, but that its effect is synergistic with other cardiovascular risk factors as well.     

Mortality from dementia among gastroduodenal ulcer patients.

STUDY OBJECTIVE--The aim was to examine whether a high intake of aluminium containing antacids is a risk for Alzheimer's disease. DESIGN--The mortality from dementia (1970-87), coded from death certificates as underlying or contributory cause of death, was compared with national rates in a cohort of patients who had surgery for gastroduodenal ulcer disease between 1911 and 1978. SETTING--Patient data were obtained from patient records from major hospitals in western Norway. PARTICIPANTS--4179 patients were identified who met the study criteria, which included having had a documented stomach operation, having a reliably identifiable personal number, and being alive on Jan 1, 1970. MEASUREMENTS AND MAIN RESULTS--The standardised mortality ratio for dementia was 1.10 (95% CI 0.85-1.40, n = 64) for all patients, while for patients operated on in the period 1967-78 it was 1.25 (95% CI 0.66-2.13, n = 13). CONCLUSIONS--As the majority of patients operated on after 1963 have probably been heavy consumers of aluminium containing antacids, the study provides meager evidence that a high intake of aluminium is an important risk factor for Alzheimer's disease, the major cause of dementia. However, the possibility of a raised mortality from Alzheimer's disease cannot be ruled out due to probable misclassification both in diagnosis and exposure. In addition, the observation period may have been too short to detect an effect since the latent period for Alzheimer's disease may be very long.     

2011-2013年新安县住院精神病患者自杀行为及其危险因素分析

目的分析住院精神病患者自杀的相关因素,为预防和制订有效的安全措施提供参考。方法对2011年1月至2013年7月在新安县第二人民医院精神病科住院的146例精神病患者相关资料进行分析。结果调查的146例住院精神病患者中,有自杀行为者36例,发生率为24．66oA。自杀行为发生率分别是：病程〈5年的为32．35％,≥5年的为17．95％（P〈0．05）;感觉药物反应难受的为37．70％,不难受的为15．29％（P〈0．01）;有被控制体验的为35．85％,无此体验的为18．28％（P〈0．05）;有幻听的为42．86％,无幻听的为21．60％（P〈0．05）;有无价值感／罪恶感的为33．78％,无此感觉的为15．28％（P〈0．01）;有自杀史的为39．22％,无自杀史的为16．84％（P〈0．01）;有自杀家族史的为35．29％,无自杀家族史的为18．95oA（P〈0．05）;有自杀“效仿”心理的为35．82％,无此心理的为15．19％（P〈0．01）。多因素非条件Logistic回归分析结果,病程、药物反应难受、自杀史、自杀家族史、自杀“效仿”心理是影响患者自杀行为的因素,其OR值依次为0．386、2．434、3．150、2．273、2．734。结论病程短、感觉药物反应难受、有自杀史、有自杀家族史、有自杀“效仿”心理的精神病患者容易发生自杀行为。     

Cognitive disorders appearing before the age of 65 in patients of the Alzheimer Centre of the VU Medical Centre: diagnoses and clinical characteristics

OBJECTIVE: To obtain a profile of the causes and clinical characteristics of cognitive disorders in patients referred to a memory clinic before the age of 65 years. DESIGN: Retrospective case-note study. METHOD: Data were collected from 127 subjects with objective cognitive disorders who visited the Alzheimer Centre of the VU Medical Centre in Amsterdam, the Netherlands, in the period from 1 January 2001 to 31 December 2003 with an onset of complaints before the age of 65. Besides the diagnoses, we investigated the clinical presentations, the occurrence of cardiovascular risk factors, the family history, and the presence of noncognitive neurological signs. RESULTS: The most common causes of cognitive decline under the age of 65 were Alzheimer's disease (46%) and frontotemporal dementia (23%). Vascular dementia was seen in 5% and dementia with Lewy bodies in 2%; 9% had mild cognitive impairment but no dementia. Hypertension and a positive family history for dementia were each present in 40% of the patients. Non-cognitive neurological abnormalities were found only in cases of non-Alzheimer dementia. During the period under investigation, the number of patients with objective cognitive disorders increased more than did the number without a cognitive disorder. CONCLUSION: Within the population of a memory clinic, Alzheimer's disease was the most frequent cause of cognitive decline under the age of 65, followed by frontotemporal dementia. The distribution differed from causes of dementia at an older age, where vascular dementia had the second place.     

军队老年人阿尔茨海默病危险因素的病例对照研究

目的 探讨军队老年人阿尔茨海默病(AD)的危险因素,初步分析早年电磁暴露与AD的关系。方法 采用病例对照研究。选择解放军总医院近年来确诊的62例军队AD患者为病例组,在同一医院住院治疗的离退休老干部中按照年龄段分层抽样(按1:2比例)选取124例对照。调查方式为电话访谈。结果 单因素分析结果显示,病例组社会活动情况明显少于对照组,早年电磁暴露、体育锻炼情况、负性生活事件、慢性阻塞性肺病病史、既往癌症病史、痴呆家族史在两组间差异有显著性。在调整相关影响因素后,负性生活事件、痴呆家族史、社会活动量的OR值(95％CI)分别为3.27(1.53～6.97)、5.78(1.39～24.10)和0.81(0.72～0.92),早年电磁暴露的OR值(95％CI)为2.49(0.96～6.45),而既往癌症病史和吸烟似与AD呈负相关。结论 负性生活事件、痴呆家族史、社会活动减少是AD的独立危险因素,早年电磁暴露是其可能的危险因素;吸烟和既往癌症病史与AD呈负相关的原因可能与该老年人群的“生存偏性”有关。