克罗恩病发病相关因素的病例对照研究

Correlated Pathogenetic Factors of Crohn’s Disease: A Case-control Study

背景:近年我国克罗恩病(CD)发病人数明显增多。目的:探讨CD发病的可能相关因素。方法:应用病例对照研究方法,以1∶4的比例纳入51例CD患者和204例非消化系疾病对照者。对研究对象的人口统计学、遗传背景和环境暴露因素方面的信息进行问卷调查,对可能相关因素作单因素筛选后行多因素Logistic回归分析。结果:单因素分析显示有统计学意义(P<0.20)的因素有受教育程度、居住地、冰箱、牙膏用量、结核病、关节痛、精神因素、非甾体抗炎药、牛奶、蛋类、母乳喂养、幼儿期胃肠和呼吸道感染、吸烟、饮酒等18个;多因素分析显示有统计学意义(P<0.05)的因素有7个,包括居住条件(OR=5.937)、冰箱(OR=0.093)、住所周边环境(OR=0.308)、牙膏用量(OR=5.064)、蛋类(OR=3.822)、幼儿期胃肠和呼吸道感染(OR=16.710)和吸烟(曾)(OR=15.889)。结论:本研究结果提示居住拥挤、牙膏用量多、常食蛋类、幼儿期经常胃肠和呼吸道感染以及曾吸烟者罹患CD的危险性可能较高,而家庭不使用冰箱、住所周边环境良好者罹患CD的危险性可能较低。

Background： The incidence of Crohn＇s disease （CD） has been increasing in China in recent years. Aims： To explore the potential correlated pathogenetic factors in the development of CD. Methods： A case-control study of 51 CD patients and 204 non-digestive disease controls was performed. Information concerning demographic data, genetic background, and environmental exposures was collected using questionnaire. The possible correlated factors were analyzed first by univariate analysis and then by multivariate Logistic regression analysis. Results： Univariate analysis showed that 18 variants were statistically correlated with CD （P〈0.20）, including educational level, rural/urban residence, use of refrigerator, amount of toothpaste used, tuberculosis, arthralgia, psychological factors, nonsteroidal antiinflammatory drugs, milk and egg consumption, breast feeding, gastrointestinal and respiratory infection during childhood, smoking, and alcohol drinking etc. Seven statistically significant variables （P〈0.05） were identified by multivariate analysis, including residence condition （OR=5.937）, use of refrigerator （OR=0.093）, neighborhood circumstance （OR=0.308）, amount of toothpaste used （OR=5.064）, egg consumption （OR=3.822）, gastrointestinal and respiratory infection during childhood （OR=16.710） and history of smoking （OR=15.889）. Conclusions： These results suggest that individuals with crowded residence condition, more toothpaste used, more daily consumption of eggs, frequent gastrointestinal and respiratory infection during childhood, and smoking history are of the vulnerable groups of CD, while those having no family refrigerator and good neighborhood circumstance would have lower risk for CD.