Lancet Oncol:肠道病毒感染的儿童患白血病的风险降低

2015-08-28 崔倩 译 MedSci原创

肠道病毒感染的患儿和患白血病的风险的关系目前尚不清楚。该研究的目的是评估儿童感染肠道病毒后患白血病的风险。研究人员做了一个全国性的回顾性队列研究来分析台湾国民健康保险研究数据库(NHIRD)的数据。研究人员对年龄未满18岁的肠道病毒感染的儿童进行了鉴定。使用计算机生成的随机数字,按性别,年龄,城市化水平,父母职业和感染肠病毒的指数年将没有感染肠道病毒的儿童和感染了肠道病毒的儿童进行了随机选择和频率

肠道病毒感染的患儿和患白血病的风险的关系目前尚不清楚。该研究的目的是评估儿童感染肠道病毒后患白血病的风险。

研究人员做了一个全国性的回顾性队列研究来分析台湾国民健康保险研究数据库(NHIRD)的数据。研究人员对年龄未满18岁的肠道病毒感染的儿童进行了鉴定。使用计算机生成的随机数字,按性别、年龄、城市化水平、父母职业和感染肠病毒的指数-年将没有感染肠道病毒的儿童和感染了肠道病毒的儿童进行了随机选择和频率匹配(1:1)。该研究只包括那些年龄和性别有完整的基线数据,并且至少有三次临床就诊确诊为肠道病毒感染的孩子。第一次临床诊断为肠病毒感染的诊断日期被定义为指数日期为随访人-年评估和参与者的起始指数日期。研究人员对所有参与者进行了随访,直到他们患上了白血病,或失去了随访,或从NIH项目退出,或没有患白血病直到研究结束(审查)。主要终点是随访期间白血病的诊断。

3054336名年龄小于18岁的儿童的保险理赔数据是从NHIRD中所有参保儿童中随机选择的。研究人员2000年1月1日和2007年12月31日之间确定了282360名感染肠道病毒的儿童和282355名没有感染肠道病毒的儿童。白血病的发病密度率分别为,肠道病毒感染的儿童为每100000人年3.26例,没有肠道病毒感染的儿童为每100000人年5.84例。白血病的风险在肠道病毒感染的人群中比非肠道病毒感染的人群中显著降低(调整后的亚风险比[SHR] 0.44,95%Cl 0.31-0.60,P<0.0001)。感染了肠道病毒的儿童有同时减少了淋巴细胞白血病(调整后SHR 0.44,0.30-0.65,P<0.0001)和急性髓系白血病(调整后SHR 0.40,0.17-0. 97;p=0.04)的风险。疱疹性咽峡炎和手足口病是白血病的风险降低相关的主要疾病。

肠道病毒感染和白血病发展的风险降低之间的关联支持了儿童白血病原因的Greaves假说。

原始出处:

Jiun-Nong Lin,Cheng-Li Lin, Ming-Chia Lin, Risk of leukaemia in children infected with enterovirus, Lancet Oncology,2015.8.27

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    2015-09-16 howi
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    2016-02-19 minlingfeng
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