孕期父母环境危险因素暴露与儿童急性淋巴细胞性白血病风险关系分析

Association between parental exposure to environmental risk factors and the risk of childhood acute lymphoblastic leukemia

目的 探讨孕期父母接触可能引起儿童急性淋巴细胞性白血病（ALL）的环境危险因素。方法 选取2015年在天津市血液病医院就诊的179例ALL儿童为病例，同时选取136例正常儿童作为对照，进行病例对照研究；设计ALL发病的危险因素调查表，对所得的资料进行单因素和多因素非条件logistic回归分析。结果 单因素非条件logistic回归分析发现，儿童ALL发病与性别（OR=1.934，95% CI：1.225-3.054，P=0.005）、母亲既往流产史（OR=2.378，95% CI：1.437-3.934，P=0.001）、孕期二手烟暴露史（OR=1.837，95% CI：1.098-3.071，P=0.020）、患感冒（OR=1.728，95% CI：1.082-2.762，P=0.022）、服用解热镇痛药（OR=4.858，95% CI：1.824-12.944，P=0.002）、接触空气净化剂（OR=1.731，95% CI：0.972-3.082，P=0.043）、父亲职业性接触石油类产品（OR=2.007，95% CI：1.110-3.629，P=0.021）、怀孕期间居所装修（OR=2.506，95% CI：1.414-4.439，P=0.002）有关；多因素非条件logistic回归分析，ALL发病与性别（OR=2.037，95% CI：1.254-3.308，P=0.004）、母亲既往流产史（OR=2.078，95% CI：1.232-3.503，P=0.006）、怀孕期间居所装修（OR=1.689，95% CI：1.046-2.726，P=0.032）、母亲孕期感冒（OR=1.677，95% CI：1.018-2.764，P=0.043）、父亲职业性接触石油类产品（OR=1.988，95% CI：1.069-3.696，P=0.030）有关。结论 性别、母亲孕前流产史、怀孕期间装修史、母亲孕期感冒史、父亲职业性石油类产品接触史5项指标可能为引起儿童ALL的危险因素。

Objective To investigate the association between parental environmental risk factors exposure and the risk for childhood acute lymphoblastic leukemia （ALL）. Methods A total of 179 ALL children cases were selected in Tianjin Blood Disease Hospital and 136 healthy children matched by age, gender and living place were selected in 2015 for a case control study. The data were analyzed with univariate and multivariate non conditional logistic regression models. Results The results of multivariate logistic regression analysis indicated that sex, history of abortion, exposure in a smoking environment during pregnancy, catching a cold, taking antipyretic analgesics, maternal exposure to air purifying agent, father＇s occupational exposure to petroleum products and home decoration during pregnancy were associated with the risk of childhood ALL （P〈0.05） and the results of multivariate logistic regression analysis indicated that sex, history of abortion, catching a cold, father＇s occupational exposure to petroleum products and home decoration during pregnancy were associated with the risk of childhood ALL （P〈0.05）. Conclusion The five factors including sex, history of abortion, catching a cold, father＇s occupational exposure to petroleum products and home decoration during pregnancy were risk factors for childhood ALL.