儿童白血病危险因素的Meta分析

A meta analysis of the relationship between risk factors and childhood leukaemia

目的应用Meta分析系统评价儿童白血病发病与环境危险因素的相关性。方法检索万方医学网,维普数据库,大医医学网,PubMed数据库中关于环境危险因素与中国儿童白血病的相关文章,检索时间从建库截止到2019年8月20日,采用revman5.3软件对提取的数据进行Meta分析,计算合并出优势比(odds ratio,OR)及其95%可信区间(95%confidence interval,95%CI)。结果共纳入25篇关于儿童白血病发病危险因素的病例对照研究,其中病例组共4307例患者,对照组共5159例。Meta分析结果显示儿童环境危险因素与儿童白血病发病关联程度较高的前3位因素的OR及95%CI分别为:油漆接触史OR(5.75),95%CI(3.17,10.44);有毒化学物质接触史OR(3.46),95%CI(2.00,6.00);家族遗传病史OR(3.32),95%CI(2.52,4.38)。母亲孕前或孕期环境危险因素与儿童白血病发病关联程度较高的前3位因素的OR及95%CI分别为:房屋装修或新置家具OR(3.19),95%CI(1.63,6.27);有毒化学物质接触史OR(2.44),95%CI(1.81,3.30);流产史OR(2.15),95%CI(1.28,3.61)。父亲在孕前或孕期环境危险因素与儿童白血病发病关联程度较高因素分别为:吸烟史OR(2.18),95%CI(1.19,4.01);有毒化学物质接触史OR(1.52),95%CI(1.25,1.85)。结论儿童白血病发病与患儿本身、母亲和父亲均密切相关,改善家庭居住环境,营造良好的家庭氛围为预防儿童白血病提供有效的措施。

Objective To evaluate the relationship between risk factors and childhood leukaemia.Methods WanFang database,CNKI,DAYI database,PubMed database were searched to obtain the related articles about the relationship between risk factors and childhood leukaemia,retrieval time until August 20,2019,the research results were analyzed with revman 5.3 software.Results A total of 25 case-control studies on risk factors of childhood leukemia were included,including 4307 cases in the case group and 5159 cases in the control group.Meta-analysis results showed that the OR and 95%confidence interval(CI),of the first three factors with a correlation between childhood environmental risk factors and childhood leukemia:history of paint exposure OR(5.75),95%CI(3.17,10.44);Toxic chemical exposure history OR(3.46),95%CI(2.00,6.00);Family genetic history OR(3.32),95%CI(2.52,4.38).The OR and 95%CI of the first three factors with a correlation between environmental risk factors of mothers before pregnancy or during pregnancy and the incidence of childhood leukemia:house decoration or new furniture OR(3.19),95%CI(1.63,6.27);Toxic chemical exposure history OR(2.44),95%CI(1.81,3.30);abortion history OR(2.15),95%CI(1.28,3.61).The environmental risk factors of fathers association with childhood leukemia were:smoking history OR(2.18),95%CI(1.19,4.01);history of toxic chemical exposure OR(1.52),95%CI(1.25,1.85).Conclusion The incidence of childhood leukemia is closely related to the children themselves,the mother and the father.Improving the family living environment and creating a good family atmosphere provide effective measures for the prevention of childhood leukemia.