云南省地方性猝死危险因素的病例对照研究

A case-control study on the risk factors of Yunnan endemic sudden cardiac death

目的探讨有可能引起云南省地方性猝死(云南地方性爆发性心肌炎)发病的危险因素,为制定确实有效的预防措施提供依据。方法采用1∶4配比的病例对照研究设计,对病例和对照用统一的调查表进行现场询问,对所有研究因素用单因素和多因素条件logistic回归进行筛选,引入交互作用项,建立并评价最优回归模型。结果经过单因素分析,发现有7个可疑危险因素(民族、餐具卫生、食用蕈子、食用酒类、接触农药杀虫剂、爱国卫生运动和食用植物油)进入多因素逻辑回归分析(P<0.10),多因素logistic回归分析显示与云南省地方性猝死有统计相关性的危险因素是发病前是否饮用酒类和是否进行爱国卫生运动。结论饮酒很可能是云南省地方性猝死的发病诱因,在猝死高发季节到来前进行爱国卫生运动可以起到一定的预防作用。

Objective To explore the potential contributing factors to Yunnan endemic sudden cardiacdeath (YESCD, also named Yunnan endemic fulminant myocarditis) in order to provide evidence for prevention.Methods 1 ∶4 matched case-control study was designed, in which cases and controls were interviewed with thesame questionnaires. Univariate conditional logistic regression was conducted to screen all factors. Multivariateconditional logistic stepwise regression was conducted to exam interactions; the optimal regression model wasestablished and evaluated. Results The univariate conditional regression analysis(α= 0.10) revealed 7 significantfactors- nationality, sanitation of dishware, fungus eating, alcohol drinking, exposure to pesticide, patriotic healthcampaign and eating vegetable oil. The analysis of multivariate conditional logistic stepwise regression showed thatdrinking wine and lack of the patriotic health campaign were significantly associated with the risk of YESCD.Whereas no interaction was found between these two factors. Conclusions Alcohol drinking is of high probabilityto cause Yunnan endemic sudden death, and patriotic health campaign before the season of high incidence preventsthe disease in some degree.