前列腺癌发病的危险因素研究现状

前列腺癌是一种老年性疾病，其发病与多种因素有关，本文就影响前列腺癌发病的危险因素作一综述，为预防及筛选前列腺癌提供参考。     

前列腺癌发病的危险因素研究现状

前列腺癌是一种老年性疾病 ,其发病与多种因素有关 ,本文就影响前列腺癌发病的危险因素作一综述 ,为预防及筛选前列腺癌提供参考。     

胰腺癌发病危险因素的研究现状

在北美洲和欧洲 ,胰腺癌分别占因癌症死亡原因的第4位和第 6位[1] ,在我国为前 10位[2 ] 。胰腺癌发病隐匿 ,病程进展快 ,诊断后平均生存时间为 3个月。适合手术治疗者低于 15 % ,术后 5年生存率低于 4 % [3 ] 。现就胰腺癌发病危险因素的国内外研究现状综述如下。一、生理因素流行病学研究提示 ,5 0岁以上人群发生胰腺癌的危险性大约是年轻人的 2 0倍。在西方国家 ,胰腺癌患者就诊时的年龄多为 6 5～ 70岁 ,而已经患有慢性胰腺炎的患者 ,发病年龄可提前 10～ 2 0年。在东亚 ,一组资料显示中国人胰腺癌发病年龄在 (5 5 7± 11 5 )岁 ,日本…     

膀胱癌发病及影响预后的危险因素

膀胱癌是我国泌尿系统最常见的恶性肿瘤.我国膀胱癌的发病率虽然远低于西方国家,但近年来有逐渐增高趋势.与大多数恶性肿瘤一样,膀胱癌的发生是一个多因素、多步骤的病理变化过程.除膀胱癌的分级分期之外,目前环境暴露对于膀胱癌进展复发及预后的影响还知之甚少.明确并控制膀胱癌发病及影响预后的危险因素,对降低膀胱癌的发病率和提高膀胱癌的生存率具有重要意义.     

尿道下裂发病相关危险因素的研究

目的　研究可能引起尿道下裂发病率增高的危险因素。　方法　采用病例 对照研究 ,调查 30个可能的暴露危险因素 ,病例组 2 10例 ,同期对照组 4 2 0例。对患儿和正常儿童的母亲采用问卷式调查 ,数据进行单因素非条件Logistic分析和多因素非条件Logistic逐步回归分析。　结果　本组病例均为汉族 ,有家族史者 5例 (2 .4 % ) ;危险因素 :怀孕年龄 (OR :38.6 3)、先兆流产 (OR :4 .71)、黄体酮 (OR :3.6 4 )、雌激素 (OR :5 .4 1)、杀虫剂 (OR :2 .39)、有机溶剂 (OR :2 .12 )、怀孕季节 (OR :1.86 )和洗洁精 (OR :1.87) ,而OR值 <1的有 :流产次数 (OR :0 .81)、足月儿 (OR :0 .2 7)、正常胎儿体重 (OR :0 .0 0 5 ) ,其余 17项调查因素无阳性意义。　结论　先兆流产、胎儿未足月、低体重儿和外界环境中一些影响内分泌干扰剂 (杀虫剂、洗洁精、有机溶剂、黄体酮、雌激素 )可能是尿道下裂发生的危险因素 ,可能促进了近年来尿道下裂发病率的增加。     

合并原发性高血压肾结石的危险因素及与结石成分的关系

目的观察合并原发性高血压的肾结石患者的临床资料及血生化结果,筛查其肾结石的危险因素,分析与结石成分的相关性。方法选取在2015年8月到2017年12月我院收治的685例肾结石患者,统计其性别、年龄、BMI及血生化指标的结果,筛查其相关危险因素;进一步分组为合并原发性高血压并且无高血糖、高尿酸、高甘油三酯的泌尿系结石组185例,无合并高血压、糖尿病、高血脂、高尿酸血症的单纯结石组203例,利用红外光谱法对结石标本行结石成分分析,比较两组结石成分的差异性,利用SPSS软件进行统计分析,χ~2检验分析两组分类资料,t检验分析两组计量资料,采用Pearson相关性分析原发性高血压分级与结石成分之间的相关性。结果合并原发性高血压肾结石BMI、血尿酸、空腹血糖、血甘油三酯、血尿素氮、血肌酐指标较单纯结石组明显升高,血白蛋白表达水平下降(P0.05);分组对照结果:合并高血压肾结石组结石成分构成分布与对照组比较不全相同,差异具有统计学意义(P0.05),成分为草酸钙类(32.97%)、尿酸类(23.78%)成分增多,而碳酸钙结石、磷酸钙结石、磷酸镁氨结石则减少。高血压不同分级与肾结石成分两者间,Pearson相关性分析,χ~2=27.578,P=0.016;r=0.100。尿酸性结石与高血压分级Pearson相关性分析r=0.270,P0.05;具有一定的正相关性。结论合并原发性高血压、高血尿酸、高血糖、高甘油三酯、低蛋白血症、血尿素氮肌酐升高是肾结石的危险因素,合并原发性高血压肾结石常见的结石成分为草酸钙结石及尿酸性结石,高血压分级程度与尿结石成分两者之间存在一定的相关性,尤其与尿酸性结石存在一定正相关。     

内蒙古西部地区蒙古族骨质疏松症的发病及其危险因素分析

目的：探讨内蒙古西部地区蒙古族骨质疏松症（ OP）的发病及其危险因素,以便针对性地进行干预。方法连续抽取内蒙古医科大学附属医院体检中心300名蒙古族健康人群进行OP患病率调查,发现OP 43例,为病例组,未发生OP的257名中随机抽取86名为对照组。对2组的年龄、身高、体重指数和性别等17项予以比较分析。所得资料在单因素分析的基础上,又做多因素logistic回归。结果 OP的患病率为14．33％。 OP发生的相关因素分析,排除进入模型的其他作用因素后,年龄每增加1岁和体重指数每增加1个单位,促使OP发生的危险性分别是原来的1．10倍和1．21倍（ OR分别是1．10和1．21,其95％可信区间内均不包含1, P均＜0．05）;城市居住和进食蔬菜少促使发生OP的危险性分别是农牧区居住和进食蔬菜多的3．85倍和3．82倍（OR分别是3．85和3．82,其95％可信区间内均不包含1, P均＜0．05）,促进发病。而男性和饮酒多促使发生OP的危险性分别是女性和饮酒少或无的0．41倍和0．11倍（ OR分别是0．41和0．11,其95％可信区间内均不包含1, P均＜0．05）,女性更易发生OP,饮酒多可阻止发病。结论增龄、体重指数增高、城市居住、进食蔬菜少和女性是发生OP的危险因素,而饮酒多为其保护因素。     

中国人群尿道下裂发病相关危险因素的研究

采用病例对照研究,分析中国人群尿道下裂发病的可能危险因素。所有病例均来自安徽省各地区的三级甲等医院。研究采取调查问卷的形式。病例组193例,对照组835例。结果显示合并其他先天性畸形的例数占病例组的13．0％,以隐睾为主（9．8％）。10例（5．1％）有泌尿生殖系统畸形家族史,其中5例（2．6％）为尿道下裂。尿道下裂发病的高危因素包括孕妇年龄〉35岁（OR：1．47）、年龄〈18岁（OR：2．95）,以及母亲在怀孕期间饮酒（OR：27．6）、服用药物（OR：1．53）、感染（OR：1．87）。父母从事农业生产亦为患儿尿道下裂发病的高危因素之一（母亲OR：1．68、父亲OR：1．74）。其余研究因素差异无统计学意义。     

慢性移植肾肾病的危险因素及发病机理

随着免疫抑制剂的不断研发,慢性移植肾肾病(chronic allograft nephropathy)已经取代急性排斥成为威胁移植物存活的主要病因.慢性移植肾肾病发病机理复杂,涉及免疫及非免疫因素,而强效免疫抑制剂的使用并不能明显降低慢性移植肾肾病的发生率.本文拟就慢性移植肾肾病的发病机理作一综述,以理清各种因素在慢性移植肾肾病的发病过程中的作用.     

Adequacy of a single stone risk analysis in the medical evaluation of urolithiasis

PURPOSE: We tested the hypothesis that a single 24-hour urine sample for stone risk analysis would be sufficient for the simplified medical evaluation of urolithiasis. MATERIALS AND METHODS: We retrospectively analyzed stone risk profile data on 24-hour urine samples obtained during random and restricted diets in 225 patients with recurrent urolithiasis. RESULTS: In 2 random samples we noted no significant difference in urinary calcium, oxalate, uric acid, citrate, pH, total volume, sodium, potassium, sulfate or phosphorus. For these risk factors there was a highly significant positive correlation in the 2 random samples (r > or = 0.68, p <0.0003) and the value of each was abnormal or normal in at least 81% of patients. Urinary magnesium and ammonium were significantly lower in random sample 2 than 1, the former by 4%. After calcium, sodium and oxalate dietary restriction mean urinary calcium and sodium plus or minus standard deviation decreased significantly by 25% from 251 +/- 125 to 187 +/- 98 mg. daily and by 38% from 183 +/- 87 to 113 +/- 57 mEq. daily, respectively. Other risk factors had a slight or no significant change. Correcting random urinary calcium for the excessive urinary excretion of sodium brought urinary calcium to 210 +/- 108 mg. daily, similar to the value on the restricted diet. CONCLUSIONS: The reproducibility of urinary stone risk factors is satisfactory in repeat urine samples. A single stone risk analysis is sufficient for the simplified medical evaluation of urolithiasis.     

新疆南部维吾尔族尿石症患者病例对照研究

目的探讨新疆南部维吾尔族泌尿系结石发病的危险因素。方岳采用问卷调查的方式，研究了阿克苏地区90例维吾儿族泌尿系结石患者一般情况及生活习惯、饮食习惯，并对其结石成分进行分析。结果21—50岁为尿结石高发年龄组（74．4％），男性略多于女性，结石患者较对照组多口味偏咸，饮水量较少，差异有统计学意义（P〈0．001）；结石成分以草酸钙为主者81例（90．0％），磷酸钙结石1例（1．1％），尿酸结石5例（5．6％），磷酸镁铵结石2例（2．2％），胱氨酸结石1例（1．1％）。结论泌尿系结石发病主要受饮食习惯和饮水量的影响。     

重庆地区尿石症危险因素的研究

目的　探讨尿石症患者的发病年龄、发病诱因及发病季节等因素与家族史的关系。　方法　采用问卷调查形式对 36 0例有家族史和 12 0 0例无家族史尿石症患者及 10 0 0例正常对照组进行调查。　结果　① 36 0例有家族史尿石症者中 ,一级亲属和二级亲属的患病率分别为 10 .71% (14 7/1372 )、1.6 8% (5 4 / 32 14 ) ;而对照组一级亲属和二级亲属的患病率分别为 0 .6 6 % (2 3/ 3480 )、0 .12 % (9/7345 )。②有家族史尿石症者中 ,男性平均发病年龄 (2 6 .35岁 ) ,女性 (36 .4岁 ) ,两组比较差异有显著性意义 (t=1.75 ,P <0 .0 5 )。有家族史男性发病年龄 (2 6 .35岁 )早于无家族史男性 (2 9.31岁 ,t =2 .2 15 ,P <0 .0 5 ) ,女性患者有家族史者平均发病年龄 34.9岁 ,无家族史者平均发病年龄 35 .2岁 ,二者比较差异无显著性意义 (t=0 .739,P >0 .0 5 )。③发病诱因、发病季节在有家族史和无家族史间无统计学意义 ,但环境因素两组比较差异均有显著性意义 (χ2 =0 .2 3,P <0 .0 5 )。　结论　尿石症是一种多因素的且可能与遗传因素有关的疾病。     

Urinary stone risk factors in the siblings of patients with calcium renal stones

PURPOSE: We determined which, if any, urinary stone risk factors accurately discriminate stone forming and nonstone forming siblings of patients with calcium renal stones. MATERIALS AND METHODS: A total of 252 siblings of stone formers provided 2, 24-hour urine samples, which were sent overnight and analyzed at a central laboratory. Standard stone risk factors were measured and the supersaturation of calcium oxalate, calcium phosphate and uric acid was calculated. RESULTS: Discriminant functions were derived for each gender by multivariate analysis. In stone forming sisters higher urinary calcium and pH discriminated with a success rate of 70%. In stone forming brothers higher urinary calcium, lower urinary potassium and older age discriminated with a success rate of 79%. CONCLUSIONS: Select urinary measurements as well as age classify siblings into those with and without stones with fair accuracy. Calcium excretion and urinary pH in females, and calcium excretion, urinary potassium and age in males are feasible identifiers of stone forming siblings. To determine whether these measurements can be used to predict new stone onset may require years of observation of our current cohort.     

A study of the etiology of idiopathic calcium urolithiasis in children: hypocitruria is the most important risk factor

PURPOSE: To determine the association of metabolic risk factors with pediatric calcium urolithiasis we compared metabolic evaluation data on children with idiopathic calcium stones and those on healthy children. MATERIALS AND METHODS: Metabolic evaluation was done in 78 calcium stone formers 1 to 15 years old (mean age 7.2) who were free of urinary tract infection, anatomical abnormalities, and metabolic, endocrinological and intestinal disorders, and in 24 healthy children. Evaluation included serum biochemistry, and measurement of daily excretion of urinary calcium, oxalate, urate, phosphorus, citrate and magnesium. RESULTS: Demographic characteristics, serum parameters, and daily excretion of calcium, urate, phosphorus and magnesium did not differ statistically in the 2 groups. However, urinary oxalate was significantly higher and urinary citrate was significantly lower in stone formers than in controls (p = 0.002 and 0.028, respectively). Hypocitruria and hyperoxaluria were 4.3 and 3-fold more common in stone formers than in controls, respectively. Multivariate analysis using logistic regression showed that hypocitruria was the only significant risk factor for idiopathic calcium stones (p = 0.008). CONCLUSIONS: Hypocitruria was the most important risk factor in our patients. Hyperoxaluria was also common and accompanied hypocitruria in many stone formers. In contrast to many previous reports, we failed to show that hypercalciuria is an important metabolic defect for idiopathic calcium stones, possibly because our study evaluated a different population.     

Prostate cancer in Mexican-Americans: identification of risk factors

BACKGROUND: There is a paucity of information regarding prostate cancer (PCa) risk factors among Hispanics, the fastest-growing ethnic group in the United States. METHODS: This population-based case-control study included 176 Texas men of Mexican descent with PCa and 174 age- and ethnicity-matched controls. Demographic, lifetime occupational history, family history of cancer, lifestyle (e.g., smoking, alcohol, diet, and recreational physical activity) and anthropometric information were collected by personal interviews. Chemical exposure and physical activity were determined using job-exposure matrices for each reported job. RESULTS: Logistic regression models adjusted for relevant covariates were used to evaluate their independent effects. Compared to controls, cases were three times more likely to work in jobs with high agrichemical exposure (OR = 3.44, 95% CI 1.84-6.44), and 54% less likely to work in jobs with moderate/high occupational physical activity (OR = 0.46, 95% CI 0.28-0.77). In analyses stratified by stage, cases with organ-confined PCa were three times more likely to have high agrichemical exposure (OR = 3.39, 9%CI 1.68-6.84), and 56% less likely to have moderate/high levels of occupational physical activity (OR = 0.44, 95% CI 0.26-0.76). Increased risk of being diagnosed with advanced PCa was associated with obesity at time of diagnosis (OR = 2.50, 95% CI 1.20-5.20) and high levels of agrichemical exposure (OR = 4.65, 95% CI 1.97-10.97), but not with occupational physical activity. CONCLUSIONS: This case-control study, the first conducted in a homogeneous Hispanic population, identified modifiable PCa risk factors, such as physical activity and agrichemical exposure, which may be useful in developing interventions for this understudied population.     

Upper urinary tract recurrence after radical cystectomy for bladder cancer: incidence and risk factors

Objectives: To examine the incidence of and the risk factors for upper urinary tract recurrence in patients undergoing a radical cystectomy for bladder cancer, and to examine the clinical course of patients harboring upper urinary tract recurrence. Methods: This retrospective study included 362 patients who underwent radical cystectomy for bladder cancer. Patients with a history of upper urinary tract recurrence and concomitant upper urinary tract recurrence at cystectomy were excluded. Results: After a median follow up of 48 months (range 0–214) after radical cystectomy, 11 patients (3.0%) developed upper urinary tract recurrence. The median time to upper urinary tract recurrence was 48.4 months (range 11.6–78.6). The overall probability of upper urinary tract recurrence was 3.3% at 5 years. The median overall survival period after upper urinary tract recurrence was 23.5 months (range 4.3–53.9), with a better overall survival for patients who received a radical operation than for those who did not (38.6 months vs 11.9 months, respectively; P = 0.03). At multivariable analysis, the presence of carcinoma in situ (P < 0.01) and invasion of the urethra (P = 0.02) were independent risk factors for upper urinary tract recurrence. The 5‐year upper urinary tract recurrence was significantly higher for patients positive for either of these risk factors than for those without risk factors (12.0% vs 0.9%, respectively; P < 0.001). Conclusions: This study shows that the presence of carcinoma in situ and cancer invading the urethra are risk factors for upper urinary tract recurrence. Close follow up is needed for early detection of upper urinary tract recurrence in patients at higher risk.     

广西南宁市体检人员尿石症患病情况及影响因素

目的了解南宁市人群尿石症的流行现状和分布特征,探索尿石症的影响因素。方法采用整群抽样方法,随机抽取南宁市6所体检机构为研究现场,对抽中机构2011年1~12月进行体检的企事业单位职工计33 639人进行问卷调查和泌尿系B超、血生化等检测。结果①该人群尿石症的患病率为5.96%,有随年龄增加而上升的趋势(χ2=143.459,P0.05);男性尿石症患病率为7.80%,女性为3.88%,不同性别之间患病率差异有有统计学意义(χ2=229.776,P0.05)。②多因素Logistic回归分析提示男性(OR=3.318)、吸烟(OR=2.902)、血尿酸高(OR=2.152)是尿石症的主要危险因素,而经常饮水(OR=0.610)是尿石症的保护因素。结论南宁市人群尿石症高发,应从优化饮食结构和改善生活习惯上加以重视尿石症的预防。     

Ureteroscopy for the treatment of urolithiasis in children

PURPOSE: Ureteroscopy for treating urolithiasis in prepubertal children has become more common with the advent of smaller instruments. We reviewed our experience with ureteroscopy for urolithiasis in this cohort of patients as well as the literature using this treatment modality in children. MATERIALS AND METHODS: Between 1994 and 2000 we performed 27 ureteroscopic stone extractions in 25 children. Ureteroscopy was done in a manner similar to that in adults. Ureteral dilation was performed when necessary to access the ureter. A stent was placed postoperatively if there was significant ureteral trauma. RESULTS: Of the 25 children 13 were male and 12 were female. Average age was 9.2 years (range 3 to 14). Stones were 2 to 12 mm. in greatest diameter (average 6). Of the 27 procedures the ureteral orifice was dilated before stone treatment in 15 (56%), while in 19 (70%) a stent was placed afterward. No intraoperative and 2 postoperative complications were identified. Overall 92% of the children were rendered stone-free after 1 procedure and 100% were stone-free after 2. CONCLUSIONS: Ureteroscopy for urolithiasis in prepubertal children is safe and effective. Routine ureteral dilation and ureteral stent placement are not always necessary in these patients.     

重庆市渝东南地区成年女性压力性尿失禁发病率和危险因素调查

目的调查重庆市渝东南地区成年女性压力性尿失禁（SUI）的发病率和危险因素,为SUI的预防、治疗提供参考。方法随机抽取重庆市渝东南地区20岁以上女性675例,采用自填问卷和调查员向被调查者一对一当面问卷相结合的方法调查SUI的发病率和危险因素。问卷内容包括是否患SUI、人口学特征（年龄、职业、BMI等）、慢性疾病、月经状况、生育史等12个问题。结果重庆市渝东南地区成年女性SUI发病率为20．27％,40岁以前患病率随年龄的增加而上升,30-40岁年龄段是SUI发病高峰,工人、农民易患SUI,BMI、盆腔手术史、高血压、糖尿病、便秘、慢性咳嗽等慢性疾病及围绝经期、多次妊娠流产、分娩次数、顺产、会阴裂伤、会阴切开等妇产科因素是SUI的易患因素。结论重庆市渝东南地区成年女性SUI患病率较高,需引起医务人员和广大群众的高度重视,应进行早期宣传、早期预防、早期治疗。