CAJ | 학술논문

目的研究成人急性髓细胞白血病(AML)发病相关的环境及生活危险因素.方法以上海市白血病协作组29家二级、三级医院血液科为研究现场,采用1∶2配对病例对照研究设计,选取2003年6月至2007年4月间确诊的206例住院成人AML患者,均符合2001年WHO AML诊断标准,有明确肿瘤放射治疗及化学治疗史者AML除外.对照组选自该院其他科室的非血液系统患者,年龄、性别为主要配对条件.用统一的调查表进行危险因素问卷调查,内容包括家族史、疾病既往史、用药史、职业有害因素和生活有害因素接触史,采用条件logistic回归进行单因素和多因素分析.结果单因素及多因素logistic回归分析发现,服用中草药为可能的保护因素(OR=0.39,95%CI:0.16～0.98);糖尿病史及服用降糖药(OR=1.39,95%CI:0.67～2.87),金属类职业接触史(OR=1.73,95%CI:0.77～3.91),职业接触其他物质包括胶水、油漆、涂料等(OR=1.72,95%CI:0.93～3.2),从事饲养家禽家畜(OR=1.33,95%CI:0.79～2.24)等为成人AML患病的可疑危险因素.未发现居住在距离高压输电线100 m内、1年内装修、染发、吸烟、饮酒与成人AML患病有相关性.结论上述危险因素如金属类接触史、职业接触胶水、油漆、涂料等可能增加了罹患AML的风险,而服用中草药为可能的保护因素.
목적 연구성인급성수세포백혈병(AML)발병상관적배경급생활위험인소.방법 이상해시백혈병협작조29가이급、삼급의원혈액과위연구현장,채용1∶2배대병례대조연구설계,선취2003년6월지2007년4월간학진적206례주원성인AML환자,균부합2001년WHO AML진단표준,유명학종류방사치료급화학치료사자AML제외.대조조선자해원기타과실적비혈액계통환자,년령、성별위주요배대조건.용통일적조사표진행위험인소문권조사,내용포괄가족사、질병기왕사、용약사、직업유해인소화생활유해인소접촉사,채용조건logistic회귀진행단인소화다인소분석.결과 단인소급다인소logistic회귀분석발현,복용중초약위가능적보호인소(OR=0.39,95%CI:0.16～0.98);당뇨병사급복용강당약(OR=1.39,95%CI:0.67～2.87),금속류직업접촉사(OR=1.73,95%CI:0.77～3.91),직업접촉기타물질포괄효수、유칠、도료등(OR=1.72,95%CI:0.93～3.2),종사사양가금가축(OR=1.33,95%CI:0.79～2.24)등위성인AML환병적가의위험인소.미발현거주재거리고압수전선100 m내、1년내장수、염발、흡연、음주여성인AML환병유상관성.결론 상술위험인소여금속류접촉사、직업접촉효수、유칠、도료등가능증가료리환AML적풍험,이복용중초약위가능적보호인소.
Objective To determine risk factors of environment and lifestyles involved in acute hematology departments of 29 secondary-care and tertiary-care hospitals in Shanghai. There were 206 hospitalized patients with de novo AML during June 2003 to April 2007 meeting the diagnostic criteria for AML by the World Health Organization, excluding those with definite history of radiotherapy or chemotherapy, and 412 age- and gender-matched controls with non-hematological other diseases from the same hospitals. All the participants were interviewed face-to-face using a standard structured questionnaire,including personal medical history, family medical history, history of medications, traditional Chinese herb medicines, exposure to occupational hazards, lifestyle factors, etc. in the past five years prior to onset of the disease. Conditional univariate and multivariate logistic regression analyses were performed to identify risk factors for AML. Results Logistic regression analysis showed that taking traditional Chinese herb medicine might be a protective factor for AML, with an odds ratio (OR) of 0. 39 and its 95% confidence interval (CI) of 0. 16-0. 98. Potential risk factors for AML included history of diabetes and taking hypoglycemic agents ( OR: 1.39, 95% CI: 0.67 -2. 87), occupational exposure to metal ( OR: 1.73, 95% CI: 0. 77 -3. 91 ), glue, paint and other coating materials, etc. ( OR: 1.72, 95% CI: 0. 93 - 3.2), raising animals (OR: 1.33, 95% CI: 0. 79 -2. 24). No association of living within a distance of 100 meters from high voltage power transmission lines, home renovation and decoration in the past year, hair dyeing, smoking,alcohol drinking with AML in adults was found. Conclusions Factors mentioned above such as occupational exposure to metal, glue, paint and other coating materials potentially increase risk for AML in adults,however taking traditional Chinese herb medicine is possibly a protective factor for it.