影响苯丙酮尿症患儿治疗的因素探讨

An investigation of factors influencing treatment of phenylketonuria in children

目的 探讨促进和妨碍苯丙酮尿症患儿进行正规治疗的主要因素.方法 采用查阅病历与问卷调查的方式,对2000年1月～2008年9月河北省确诊的苯丙酮尿症患儿的治疗情况及各种可能的影响因素进行调查,采用单因素、多因素Logistic逐步回归对数据进行分析.结果 单因素分析显示：患儿性别、母亲生产年龄,治疗组和放弃治疗组之间差异无统计学意义（χ^22.895、4.781,均P〉0.05）;父亲文化程度、母亲文化程度、父亲职业、母亲职业、家庭住址、家庭月收入、父母对疾病的认知程度,以上因素两组间差异有统计学意义（χ^234.000、34.424、46.464、31.034、104.214、7.311、45.498,P均〈0.05）.多因素Logistic逐步回归分析显示：家庭月收入、父母对疾病的认知程度两组间差异有统计学意义（χ^20.243、0.165,P均〈0.05）.结论 家庭收入、父母对疾病的认知程度是影响家庭是否对患儿进行治疗的决定性因素,应针对以上因素,采取有效措施,提高苯丙酮尿症患儿的治疗率,减少残疾的发生.

Objective To investigate main factors that promote and affect regular treatment of chilren with phenylketonuria （PKU）. Methods Treatment process and possible influencing factors of 247 children with PKU confirmed in Hebi Provincial Maternal and Child Health Hospital and Shijiazhuang Municipal Maternal and Child Health Hospital in a period from January, 2000 to September, 2008 were investigated through case record review and questionnaire. All data was analyzed statistically by single factor and multifactorial stepwise logistic regressions. Results Single factor stepwise logistic regression showed that in gender of the children with KPU and mother＇ s childbearing age there were not statistically significant differences between the treatment group and treatment giving-up group 0（2 = 2. 895, 4.781 respectively, both P 〉 0.05）, while in father＇s education background, mother＇s education background, father＇s occupation, mother＇s occupation, residential area of the family, family＇ s monthly income and parents＇ cognition to PKU there were statistically significant differences between the two groups （x^2 = 34.000, 34.424, 46.464, 31. 034, 104.214, 7.311,45. 498 respectively, all P 〈 0.05）. The multifaetorial stepwise logistic regression showed that in family＇ s monthly income and parents＇ cognition to PKU there were statistically significant differences between the two groups （x^2 = 0. 243, 0. 165 respectively, both P 〈 0.05 ）. Conclusion The family＇ s monthly income and parents＇ cognition to PKU are decisive factors that affect whether the family would let their children with KPU receive regular treatment. The effective measures targeting to the factors should be adopted to improve treatment rate of the children with PKU in order to prevent and reduce occurrence of disability.