医用诊断X射线工作者冠心病危险因素研究

Risk factors of coronary heart disease among medical diagnostic X-ray workers

目的 研究医用诊断X射线工作者冠心病发病的危险因素 ,探讨职业受照与冠心病的关系。方法 采用 1∶2配比的病例对照研究 ,在全国范围内选取 112名医用诊断X射线工作的冠心病患者及相应对照 ,问卷调查心血管疾病影响因素及职业因素 ,归一化工作量法估算个体累积受照剂量。SAS软件单因素条件Logistic回归筛选出主要影响因素 ,逐步回归法拟合条件Logistic模型。结果 超重 (OR =2 6 79,P =0 0 15 0 )、体育锻炼 (OR =0 4 2 1,P =0 0 333)、糖尿病史 (OR =7 82 3,P =0 .0 2 0 0 )、高血压史 (OR =6 172 ,P =0 .0 0 0 3)、冠心病家族史 (OR =17 2 98,P =0 0 0 0 1)、防护条件差(OR =3 992 ,P =0 0 0 2 7)、累积剂量 (OR =1 6 12 ,P =0 0 45 4) ,最终保留在模型中。结论 高血压、超重、糖尿病及冠心病家族史是X射线工作者冠心病主要的危险因素 ,经常参加体育锻炼为冠心病的保护性因素 ,较大剂量受照 (>30 0mGy)可能与冠心病发病相关。

Objective To investigate risk factors of coronary heart disease (CHD) in medical diagnostic X-ray workers in China, especially the relationship of CHD with occupational irradiation. Methods A 1∶2 matched case-control study was carried out. The study subjects consisted of 112 pair-matched cases and controls coming from different hospitals in China. Information about occupational and non-occupational risk factors obtained by interviewing every subjects personally. Individual doses were estimated by normalized work load method. SAS 6.12 software conditional Logistic regression method was applied to data analysis. Results Variables such as family history of CHD (OR= 17.298,P=0.0001), history of hypertension (OR=6.172,P=0.0003), overweight (OR=2.679,P=0.0150), physical exercises (OR=0.421,P=0.0333),diabetes (OR= 7.823,P=0.0200), radiation protection condition(OR=3.992,P=0.0027),and accumulated radiation dose(OR=1.612, P=0.0454) were included in the last model. Conclusions For the medical diagnostic X-ray workers, family history of coronary heart disease ,history of hypertension, diabetes, etc. are the main risk factors of CHD, and occupational exposure may be a potential risk factor. As for the mechanism, further studies are needed. ;