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目的研究与成人再生障碍性贫血(AA)发病有关的危险因素。方法采用医院内1∶2病例-对照研究方法。病例组130例,符合AA诊断标准,无肿瘤病史和放化疗史;对照组260例,为病例组同一医院的其他病种患者,性别、年龄、住院日和居住地均与病例组配对。问卷调查内容包括个人一般情况、既往病史、家族史、发病前5年内用药史、发病前职业性和生活性有害物质接触史。采用STATA7.0统计软件对调查结果进行1∶2配对资料单因素和多因素分析。结果对照组的文化程度明显高于病例组。单因素和多因素分析均发现,职业性苯接触、发病1年内家庭或工作场所装修和乙肝病史是AA发病的独立危险因素(OR>1,P<0.05),接受过高等教育是AA发病的保护因素(OR<1,P<0.05)。病例组和对照组中接触苯的研究对象的苯接触频率差异无统计学意义(P>0.05),而接苯时间差异有统计学意义(P<0.05),病例组的接触时间明显短于对照组。未发现AA发病与恶性肿瘤家族史、结核病史、抗结核药物、中药、汽柴油、润滑油、甲醛、重金属、有机磷杀虫剂、氨基甲酸酯杀虫剂、除草剂、化肥、吸烟、饮酒、染发和高压线100 m范围内的居住史存在明显相关性。结论职业性苯接触、发病1年内家庭或工作场所装修和乙肝病史是AA发病的独立危险因素,而接受过高等教育是AA发病的保护因素。
Objective To study the risk factors associated with the development of adult aplastic anemia (AA). Methods The hospital 1: 2 case-control study was used. The patients in the case group were 130 cases, meeting the diagnostic criteria of AA, no history of tumor and the history of radiotherapy and chemotherapy. The control group of 260 cases were matched with other cases in the same hospital in the case group, gender, age, hospitalization day and place of residence. Questionnaire survey includes the general situation of individuals, past medical history, family history, history of medication within 5 years before onset, history of exposure to occupational and live-hazardous substances before onset. STATA7.0 statistical software was used to analyze the survey results by 1: 2 paired data of single factor and multivariate analysis. Results The education level of the control group was significantly higher than that of the case group. Both univariate and multivariate analyzes showed that occupational benzene exposure was associated with an AA risk (OR> 1, P <0.05), family history or workplace decoration and hepatitis B history within 1 year of onset, and higher education was associated with AA Protection factors (OR <1, P <0.05). There was no significant difference in the frequency of benzene exposure between the benzene exposure group and the control group (P> 0.05), but the difference was significant (P <0.05). The contact time of the benzene group was shorter than that of the control group group. No history of AA and family history of malignancy, history of tuberculosis, antituberculosis drugs, traditional Chinese medicine, gasoline and diesel, lubricants, formaldehyde, heavy metals, organophosphorus insecticides, carbamate insecticides, herbicides, chemical fertilizers, smoking, There was a clear correlation between drinking, coloring and residence history within a 100 m high voltage line. Conclusion Occupational benzene exposure, home or workplace decoration and hepatitis B history within one year of onset are independent risk factors for AA, while having received higher education is a protective factor in the pathogenesis of AA.