CAJ | 학술논문

目的：探讨新型隐球菌性脑膜炎发病的相关危险因素，进一步为病因学提供证据。方法采用分层随机抽样方法，按照地理位置分层从我市抽取2个县1个区，再从这3个地区按照比例各分别抽取2个村或社区的居民作为本研究对象，最终确定纳入随访研究的居民共计8348人。于2O11年7月-2O13年7月，将符合入选条件的8348人作为一个队列，进行为期两年的随访。采用1：1匹配的前瞻性巢式病例对照研究方法探究新型隐球菌性脑膜炎发病的相关因素，并采用logistic回归模型逐步筛选出危险因素。结果截止到2O13年7月底，在随访的队列人群中共发现新发新型隐球菌性脑膜炎病例63人（病例组），其中男38人，女25人；年龄5~64岁，中位年龄39.5岁。按照匹配原则共选取同队列中的非新型隐球菌性脑膜炎对照63人，其中男38例，女25例；年龄4~67岁，中位年龄38.7岁。经1：1匹配资料的单因素分析显示，文化程度、单身、无业、接触过鸽子等鸟粪便、糖尿病、艾滋病、接触过死动物几个因素进入回归方程（P<O. O5）。多因素条件logistic回归分析显示，单身（OR=1.3O8）、无业（OR=1. O32）、糖尿病（OR=2. O5O）、艾滋病（OR=3.87O）、接触过鸽子等鸟粪便（OR=3. O82）、接触过死动物（OR=2.812）为新型隐球菌性脑膜炎发病的危险因素；文化程度（ OR=O.9O8）为保护因素。结论单身、无业、糖尿病、艾滋病、曾暴露于鸽子等鸟类粪便和腐生物质是新型隐球菌性脑膜炎发病的危险因素，进一步为新型隐球菌性脑膜炎的病因学提供了依据。
목적：탐토신형은구균성뇌막염발병적상관위험인소，진일보위병인학제공증거。방법채용분층수궤추양방법，안조지리위치분층종아시추취2개현1개구，재종저3개지구안조비례각분별추취2개촌혹사구적거민작위본연구대상，최종학정납입수방연구적거민공계8348인。우2O11년7월-2O13년7월，장부합입선조건적8348인작위일개대렬，진행위기량년적수방。채용1：1필배적전첨성소식병례대조연구방법탐구신형은구균성뇌막염발병적상관인소，병채용logistic회귀모형축보사선출위험인소。결과절지도2O13년7월저，재수방적대렬인군중공발현신발신형은구균성뇌막염병례63인（병례조），기중남38인，녀25인；년령5~64세，중위년령39.5세。안조필배원칙공선취동대렬중적비신형은구균성뇌막염대조63인，기중남38례，녀25례；년령4~67세，중위년령38.7세。경1：1필배자료적단인소분석현시，문화정도、단신、무업、접촉과합자등조분편、당뇨병、애자병、접촉과사동물궤개인소진입회귀방정（P<O. O5）。다인소조건logistic회귀분석현시，단신（OR=1.3O8）、무업（OR=1. O32）、당뇨병（OR=2. O5O）、애자병（OR=3.87O）、접촉과합자등조분편（OR=3. O82）、접촉과사동물（OR=2.812）위신형은구균성뇌막염발병적위험인소；문화정도（ OR=O.9O8）위보호인소。결론단신、무업、당뇨병、애자병、증폭로우합자등조류분편화부생물질시신형은구균성뇌막염발병적위험인소，진일보위신형은구균성뇌막염적병인학제공료의거。
Objective Toinvestigatetheriskfactorsofcryptococcusneoformansmeningitisandprovidefurtherevi-denceforetiology.Methods Thestratifiedrandomsamplingmethodwasused.First,wehadchosen2countriesand1districtin Jingdezhen city based on the stratified geographical position and second,we had chosen citizens from 2 villages in the 2 countries and 1 district according to certain proportion and finally 8 348 citizens were brought into our research. The cohort was followed for two years from July,2O11 to July,2O13. We used the 1:1 matching prospective nested case-control study method to explore the relatedfactorsofcryptococcusneoformansmeningitisandLogisticregressionmodeltodeterminetheriskfactors.Results Until July,2O13,63 cases of cryptococcus neoformans meningitis were found in the follow-up cohort including 38 males and 25 fe-males,aged 5~64 with a median age of 39. 5(case group). According to matching principle,another 63 citizen without the case were selected including 38 males and 25 females,aged 4~67 with a median age of 38. 7(control group). Single factor a-nalysis of the 1:1 matching material indicated that educational background,single,unemployed,dove bird feces,diabetes mel-litus,AIDS,contacting with dead animals factors were into the regression equation(P<O. O5). Multiple factors logistic regres-sion analysis showed that single(OR=1. 3O8),unemployed(OR=1. O32),diabetes mellitus(OR=2. O5O),diabetes mel-litus,AIDS(OR=3. 87O),contacted the dove bird feces(OR=3. O82),contacting with dead animals(OR=2. 812)were the risk factors of cryptococcus neoformans meningitis and educational background was the protective factor(OR=O. 9O8). Con-clusion Single,unemployed,diabetesmellitus,AIDS,onceexposedtothedovebirdfecesandrotofbiomassaretheriskfac-tors related to cryptococcal meningitis. The research findings provide further evidence for the etiology of cryptococcal meningitis.