目的 了解育龄期乳腺癌患者对子代健康和遗传风险担忧现状及其对癌症诊断前后生育意愿改变的影响。方法 于2019年11月—2020年9月,采用中文版癌症后生育忧虑量表(RCAC)-子女健康亚量表对广州市某三甲医院的230例育龄期乳腺癌患者进行调查,应用SPSS 26.0及PSM插件对结果进行统计分析。在进行子女健康亚量表得分低分组和中高分组患者的生育意愿改变率的比较时,应用倾向性评分匹配法控制混杂因素。结果 育龄期乳腺癌患者对子代健康和遗传风险担忧得分为(11.40±2.99)分;匹配前后不同子女健康亚量表得分分组的患者在癌症诊断前后生育意愿改变率的差异均不具有统计学意义(P>0.05)。结论 育龄期乳腺癌患者对子代健康和遗传风险的担忧虽然没有显著影响其生育意愿的改变,但其对子代健康和遗传风险担忧处于较高水平,临床医护人员应提高对这一现象的重视,可通过多渠道科普相关知识,开展遗传咨询服务以减轻患者的担忧。
Objective To explore the current status of childbearing age breast cancer patients’ concerns about their children’s health and genetic risk and its influence on the change of fertility intention before and after cancer diagnosis.Methods From November 2019 to September 2020,the Chinese version of the Reproductive Concern After Cancer Scale(RCAC)- Children’s Health Sub-scale was used to interview 230 patients with breast cancer of childbearing age in a tertiary hospital in Guangzhou,and SPSS 26.0 and PSM plug-in were used to analyze the results statistically.The propensity score matching method was used to control confounding factors when comparing the change rate of fertility intention of patients with low scores and those with medium and high scores in the children health subscale.Results The score of concern for the health and genetic risk of children in breast cancer patients of childbearing age was(11.40±2.99).There was no statistically significant difference in the change rate of fertility intention before and after cancer diagnosis among patients with different subscale scores of children’s health.Conclusions Despite not significantly impacting fertility intentions,the notably high level of concern regarding children’s health and genetic risks among childbearing-age breast cancer patients necessitates increased clinical awareness.It is recommended that healthcare professionals address this through multi-channel education and genetically focused counseling within a collaborative model to mitigate patient distress.
目的 探讨影响本区肺结核发病的危险因素,为肺结核的防控提供参考依据。方法 采用频数匹配病例对照的研究方法,选自2012—2015年间,在本区居住的肺结核患者为病例组,按1∶1病例对照,在本区选择与病例组同性别、年龄相差<2 a的健康居民为对照组,用单因素Logistic分析及对多因素非条件Logistic 回归分析进行统计学分析。结果 肺结核发病的保护因素有文化程度的高低(OR=0.237,P<0.037),居住环境采光(OR=0.393,P<0.013),蔬菜水果类摄入(OR=0.748,P<0.021),蛋奶类摄入(OR=0.704,P<0.027)。肺结核的危险因素有工作环境是否接触粉尘(OR=2.984,P<0.001)是否吸烟(OR=1.537,P<0.020),是否饮酒(OR=1.110,P<0.041),结核病人接触史(OR=11.052,P<0.001),居住环境潮湿(OR=1.117,P<0.001)。最终被选入回归方程的因素为,文化程度、工作环境是否接触粉尘、结核病人接触史、居住环境潮湿、蔬菜水果类摄入,其OR值分别为0.471、8.945、17.652、14.268、0.234。结论 文化程度及蔬菜水果类的摄入为肺结核保护因素,工作环境接触粉尘、接触过结核病人及居住环境潮湿是肺结核的危险因素。