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目的探讨环境因素对儿童恶性淋巴瘤的影响,了解儿童恶性淋巴瘤的可能危险因素。方法采用1:2匹配的病例-对照流行病学研究设计,选择由宁夏医科大学附属医院儿科确诊的62例儿童恶性淋巴瘤患者为病例;同时选择124例该院与病例同期住院的其他非血液系统性疾病、非肿瘤疾病患者为对照。通过问卷调查的方法收集两组人群的一般社会人口学特征、既往病史、儿童母亲孕期有害物质接触史、室内外环境状况及家族史等信息。对资料进行单因素与多因素条件Logistic回归分析。结果单因素分析结果显示,确诊前两年感冒史、既往感染史、X线接触史、母亲孕期化肥及农药接触史、父母油漆接触史、父母化工厂工作史、父亲开始吸烟的年龄、患儿住房类型、儿童卧室地面装修、居住环境电离辐射、居室与高压电距离、家里养宠物均与儿童恶性淋巴瘤有关。多因素分析结果表明,既往感染史(OR=7.782,95%CI=1.366～44.316)、居住环境电离辐射(OR=6.206,95%CI=1.086～35.470)、母亲孕期化肥及农药接触史(OR=10.329,95%CI=2.217～48.132)、父母油漆接触史(OR=3.023,95%CI=1.094～8.352)、家中养宠物(OR=3.888,95%CI=1.293～11.696)、患儿住房类型(OR=20.886,95%CI=3.515～124.090)是儿童恶性淋巴瘤的重要危险因素。结论既往感染史、居住环境电离辐射、母亲孕期化肥及农药接触史、父母油漆接触史、家中养宠物、患儿住房类型是儿童恶性淋巴瘤发生的共同的危险因素。
Objective To investigate the influence of environmental factors on children with malignant lymphoma and to understand the possible risk factors of children with malignant lymphoma. Methods A case-control study of 1: 2 matched controls was designed. Sixty-two cases of pediatric patients with malignant lymphoma diagnosed by pediatric department of Ningxia Medical University Affiliated Hospital were selected as the cases. At the same time, 124 cases of other non- Systemic disease, non-tumor patients as a control. The general socio-demographic characteristics, past medical history, contact history of harmful substances during pregnancy of pregnant women, indoor and outdoor environmental status and family history were collected by questionnaire. Data were analyzed by single factor and multivariate logistic regression. Results The results of univariate analysis showed that the incidence of cold, past infection history, history of X-ray exposure, mother’s history of chemical fertilizers and pesticide exposure, parental paint exposure history, working history of parent chemical factory, father’s smoking age, Housing types, children’s bedroom floor decoration, living environment, ionizing radiation, living room and high-voltage distance, home pets are associated with children with malignant lymphoma. Multivariate analysis showed that the incidence of previous infection (OR = 7.782, 95% CI = 1.366 ~ 44.316), ionizing radiation in living environment (OR = 6.206, 95% CI = 1.086-35.470) = 10.329,95% CI = 2.217 ~ 48.132), the history of parental paint exposure (OR = 3.023,95% CI = 1.094 ~ 8.352), domesticated pets (OR = 3.888, 95% CI = 1.293 ~ 11.696) Type (OR = 20.886,95% CI = 3.515 ~ 124.090) is an important risk factor for children with malignant lymphoma. Conclusion The history of previous infections, ionizing radiation in living environment, mother’s history of chemical fertilizers and pesticides during pregnancy, history of parental paint exposure, domesticated pets and children’s housing types are common risk factors for the development of malignant lymphoma in children.