重庆市125例儿童白血病发病危险因素的病例对照研究

目的总结和分析与重庆市儿童白血病发病相关的主要因素及特点。方法根据国内外文献研究报道的可能与儿童白血病发病相关的不良因素,结合重庆市的地理及人文特点,设计统一的问卷调查表,采用病例对照的方法,收集2010年10月至2011年9月第三军医大学新桥医院及重庆医科大学附属第一医院、附属第二医院、附属儿童医院血液科住院的125例重庆籍1岁零3个月至18岁儿童白血病患者的资料;根据纳入标准随机选择同期就诊上述医院的139例非遗传病、非先天缺陷、非肿瘤儿童作为对照组。通过问卷调查的方法收集2组人群的一般社会人口学特征、患儿感染史及喂养史、家庭装修史、居住地电磁辐射、父母生育年龄、母孕期感染史及家族肿瘤史等信息,对所得资料进行单因素与多因素非条件Logistic回归分析。结果 36项指标中,11项指标在单因素分析中有意义,其中6项指标也在多因素回归分析中有意义,包括儿童患病前1年居室装修史(OR=3.069),儿童直接接触农药杀虫剂(OR=3.522),母孕期出售配置和喷洒农药及杀虫剂(OR=3.101),孕期居室装修或新置家具(OR=4.868),孕期使用电磁用具(OR=1.786),孕期补充铁剂(OR=5.834)。结论儿童白血病的发病因素错综复杂,儿童患病前1年居室装修及直接接触农药杀虫剂等6个因素可能是重庆地区儿童白血病发生的主要危险因素。

Risk factors of pediatric leukemia in Chongqing:a case control study based on 125 cases

Objective To analyze and summarize the features and risk factors associated with pediatric leukemia in Chongqing and provide the basis for the prevention and control of the disease.Methods A questionnaire was designed based on the associated risk factors reported in domestic and international relative literatures,and geographic and humanistic characteristics of Chongqing.A total of 125 Chongqing native cases of leukemia children(1 year and 3 months old to 18 years old) and 139 matched normal controls were collected from Xinqiao Hospital,Children’s Hospital,First and Second Affiliated Hospital of Chongqing Medical University who were admitted from October 2010 to September 2011.Information was obtained by our designed questionnaire.General social demographic features,infection and feeding histories,house fitting and decoration,surrounding electromagnetic radiation,parental childbearing age,gestational infection,and family histories of cancers.Single factor analysis and multi-factors non-conditional logistic regression analysis were used to analyze the data.Results Among the 36 obtained indexes,11 were of statistical significance in the single factor analysis(P<0.05).While in the multi-factors non-conditional logistic regression analysis,there were 6 of these 11 indexes with significance(P<0.05),which were house fitting and decoration 1 year before onset(OR=3.069),exposure to pesticide before onset(OR=3.522),gestational exposure to pesticide(OR=3.101),gestational house fitting and decoration(OR=4.868),gestational exposure to electromagnetic radiation(OR=1.786) and iron supplements during pregnancy(OR=5.834).Conclusion The etiology of leukemia is complex.House fitting and decoration 1 year before onset and exposure to pesticide before onset and other 4 indexes as listed above are key risk factors of childhood leukemia in Chongqing.