云南省地方性不明原因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

目的探讨可能引起云南省地方性不明原因猝死的危险因素，为制订确实有效的预防措施提供依据。方法在猝死病区选择病例22人，在非病区选择对照24人，对病例和对照采用统一的调查表进行现场询问，应用SPSS 13．0统计软件进行单因素Х^2检验及多因素logistic回归筛选可疑危险因素，建立并评价最优回归模型。结果经单因素Х^2检验，发现餐具存放位置、家中有无牲畜圈、发病前是否食用蕈子、发病前是否接触农药杀虫剂、发病前是否气候骤变5个可疑因素具有统计学意义（Х^2值分别为12．206、4．779、5．741、6．120、10．754，P〈0．05）；经多因素logistic回归筛选出食用蕈子为保护性因素[比值比（OR）=0．115，P〈0．05）]，气候骤变为危险因素（OR=36．592，P〈0．01）。结论气候骤变可能是云南省地方性不明原因猝死的发病诱因．在猝死高发季节到来前食用蕈子可以起到一定的预防作用。

Objective To explore the potential risk factors to Yunnan endemic sudden cardiac death （YESCD） and provide evidence for prevention. Methods Twenty-two cases and 24 controls were randomly selected from YESCD areas and non-YESCD areas, respectively. Both cases and controls were interviewed with unified questionnaires. Univariate Х^2 test and multivariate conditional logistic stepwise regression was conducted with SPSS 13.0. The optimal regression model was established and evaluated. Results The univariate Х^2 test revealed that presence or absence of 5 potential factors might possibly be associated to YESCD ： appropriate places for storing dining utensils, pens for livestock, consumption of mushrooms, exposure to any pesticides, and sudden climate changes before onset （Х^2 = 12.206,4.779,5.741,6.120, 10.754, P 〈 0.05）. Multivariate conditional logistic stepwise regression demonstrated that consumption of mushrooms was a protective factor（OR = 0.115, P 〈 0.05） and sudden climate change was a risk factor（OR = 36.592, P 〈 0.01 ）. Conclusions Sudden climate change might be a risk factor contributing to YESCD, and eating mushrooms before the prevalence seasons may provide some protection.