先天性小耳畸形危险因素的病例对照研究

Case control study on risk factors of congenital microtia

目的探讨导致先天性小耳畸形发生的危险因素，为小耳畸形的预防提供理论依据。方法采用病例对照的研究方法，选取中国医学科学院整形外科医院外耳中心2004年2月到8月期间入院的207例6～11岁的单纯型小耳畸形患者的亲生父母为研究对象；209例无先天性疾病的住院患者的亲生父母为对照，按年龄频数进行1：1的配比。根据自行制定的小耳畸形相关危险因素调查表对病例组及对照组进行问卷调查，调查主要内容包括：①患者及其父母基本信息；②怀孕时母亲的患病及用药情况；③母亲既往妊娠史；④家族史及父母的生活方式。采用卡方检验及非条件Logistic逐步回归法对各个变量进行单因素和多因素分析，并计算出优势比（oddsratio，OR）。结果性别为男性（OR=5．893）、母亲的受教育程度低（OR=2．275）、母亲孕早期患病史（OR=34．496）、怀孕初期用药史（OR=4．299）、多生史（OR=9．52）、母亲流产史（OR=1．723）、父亲吸烟史（OR=4．304）及父亲饮酒史（OR=4．347）为小耳畸形的危险因素；父母长期饮茶史（OR=0．179）为小耳畸形的保护因素。结论小耳畸形的发生是由多种因素相互作用、相互影响综合产生的，预防小耳畸形的发生应从危险因素的各个方面入手。

Objective To identify the risk factors associated with congenital microtia. Methods A case-control, retrospective study was performed. A total of 207 cases of congenital microtia and 209 age-frequently-matched controls were interviewed individually according to the uniform questionnaire. The questionnaire included： （1） Essential information about patients and their parents. （2） First trimester diseases and medication of mother. （3） Past gestation history of mother. （4） Family history and life style of the parent. The available data were analyzed by chi-square test and multivariate Logistic regression model. Results The factors, such as gender （OR = 5.893）, first trimester disease of mother （OR = 34.49） and medication （OR = 4.299）, excessive drinking and smoking of father （OR = 4.347, OR = 4.304）, non-primiparous parity （OR = 9.524）, abortion （spontaneous and induced, OR = 1.723）, low-education of mother （OR = 2.275） were risk factors contributing to microtia in multivariate study. The factors, such as tea （OR = 0.179） were protective factors in multivariate study. Conclusions Multi-risks factors are contributing to microtia. Preventive measures according to risk factors should be put forward.