【作者】 马艳春；

【导师】 曲成毅；

【作者基本信息】 山西医科大学 ， 流行病学与卫生统计学， 2008， 硕士

【摘要】 目的:了解1997—2006年山西省非综合征性唇腭裂发生状况及变化规律,分析影响其发生的主要因素,为降低我省非综合征性唇腭裂发生率提供科学的依据。方法:本研究分为两部分,第一部分为描述性研究,收集山西省1997-2006年33所出生缺陷监测医院的非综合征性唇腭裂发生数据进行分析,了解山西省该病发生现状及变化规律,不同年度率的比较用趋势卡方检验。第二部分采用病例对照研究方法进行影响因素的分析,选择2005年1月至2006年12月山西省监测医院内分娩非综合征性唇腭裂患儿的100例产妇以及按照1:2配比条件选择的200例对照进行问卷调查。对调查的25项因素逐一进行Logistic单因素分析,将单因素分析有意义的因素引入Cox多元回归模型进行多因素分析。结果:山西省十年来非综合征性唇腭裂畸形发生率为19.46/万,且十年的年度发生率没有明显变化趋势。总体来说男性发生率高于女性,乡村发生率高于城镇。Logistic单因素分析,P＜0.05的因素包括:常住地、文化程度、家族史、全身疾病、孕早期感冒、孕早期补充叶酸、孕早期用药、孕早期被动吸烟和出生体重共九项。将上述因素引入Cox多元回归模型分析,采用逐步回归法筛选变量(α_λ=0.05,α_出=0.10),进入回归方程的因素有:文化程度、家族史、孕早期用药、孕早期被动吸烟和出生体重。其中家族史、孕早期用药、孕早期被动吸烟、出生体重低为危险因素,OR值分别为15.512(95%可信区间为2.276-105.766)、2.766(95%可信区间为1.406-5.441)、3.011(95%可信区间为1.533-5.914)、2.608(95%可信区间为1.275-5.332)。保护因素有文化程度,OR值为0.264(95%可信区间为0.139-0.499)。结论:山西省属国内非综合征性唇腭裂高发区,且十年的年度发生率没有明显下降趋势。山西省非综合征性唇腭裂发生的危险因素有家族史、孕早期用药、被动吸烟、出生体重低:文化程度为保护因素。更多还原

【Abstract】 Objective:To investigate the situation of non-syndromic Cleft Lip and Palate in Shanxi province from 1997 to 2006 and analyse the possible risk factors.To provide the scientific basis for preventing methods.Methods:The study contains two parts.The first part is descriptive study.To collect the date of nsCLP in 33 hospitals in Shanxi province from 1997 to 2006 and analyse the change trend of nsCLP in ten years by trend chi-square test.The second part is case-control study.We design the questionair and select 100 nsCLP mothers as a case group and 200 mothers with normal newborns as a control group by 1:2 from Jan 2005 to Dec 2006.The 25 factors we investigate were analysed one by one with univariate logistic and those that have meaning in statistics were further analysed with Cox regression.Results The total incidence of nsCLP in Shanxi was 19.46 /10 000.There was no significantly change trend in ten years.The incidence of nsCLP in rural areas is significantly higher than that in urban areas,higher in male than in female births.Univariatee logistic regression showed that permanent residence,education degree,family history,systemic diseases, early pregnancy flu,early pregnancy drug,passive smoking and birth weight have meaning in statistics(P＜0.05).Those factors were analysed further by Cox regression and family history, early pregnancy drug,passive smoking,birth weight are considered risk factors,OR values are 15.512(95%CI for OR:2.276-105.766)、2.766(95%CI for OR:1.406-5.441)、3.011(95% CI for OR:1.533-5.914)、2.608(95%CI for OR:1.275-5.332) respectively,and education degree is prevent factors,OR values is 0.264(95%CI for OR:0.139-0.499)。Conclusion The incidence of nsCLP in Shanxi was higher than other province in china and no significantly decline trend in incidence of nsCLP was observed during 1997～2006.Family history,early pregnancy drug,passive smoking and birth weight are risk factors for nsCLP in Shanxi province,and education degree is prevent factor.更多还原