湖北省先天性巨结肠症危险因素的病例对照研究

A case-control study on risk factors of Hirschsprung's disease in Hubei province

目的探索HD发病的环境危险因素，为其病因学研究提供线索。方法采用病例对照研究方法，调查80例1990年1月2001年6月在武汉市3家大型教学医院小儿外科住院手术治疗的HD病例及按条件配对的160例对照；用SPSS10．0建立数据库，用SAS6．12进行条件logis—tic回归分析。结果与HD发病有关的因素包括孕期腹痛、孕期有2种以上异常反应（剧烈呕吐、生殖道出血等）、怀孕前半年经期紊乱和孕期曾有不良的精神刺激等4项危险因素以及孕期食用色拉油一个保护因素。结论HD的发病是遗传和环境因素共同作用的结果，母亲在孕期及孕前较短时期内的生理、心理和社会因素可能通过各种途径参与HD的发病。

Objective To investigate environmental risk factors of Hirschsprung＇s disease （HD） and provide evidence for etiology research. Methods 1 ： 2 matched case-control study was used to investigate 80 HD cases with surgical treatment and 160 matched controls from the same three hospitals during Jan 1990 to Jun 2001. Condition logistic regression analysis was used with SPSS 10.0 and SAS 6.12. Resuits Four risk factors were found relevant to HD, including abdominal pain in pregnancy, two or more pregnant responses （violent vomitting, genital tract bleeding ete）, irregular menstruation in half a year anterior to gestation, and harmful mental stimulation during gestation. Taking up salad oil as daily edible oil during pregnancy was one protective factor. Conclusions Hirschsprung＇ s disease was a combination of genetic and environmental factors. Maternal physical, psychological, social factors during pregnancy and the short period prior to gestation might be involved in the pathogenesis of HD through diverse ways.