【作者】 张军；

【导师】 徐希平； 臧桐华； 金永堂；

【作者基本信息】 安徽医科大学 ， 流行病与卫生统计学， 2002， 硕士

【摘要】 目的：为了探讨遗传因素及农药接触对农村双胞胎女性原发性痛经的影响作用。 方法：在安徽省某地进行大规模的横断面调查，由经培训合格的调查员，利用统一的调查表调查其原发性痛经的发生情况以及农药接触情况，并收集双胞胎的一般社会人口学特征以及有关的一些重要的环境因素和职业暴露情况。另外，通过在ABI377DNA测序仪上对十个高多态性遗传标记物进行扫描及基因型分析以综合判断双生子的卵性结果。所有资料是在经EPI INFO软件中双重录入、检错后，利用SAS软件进行分析。结果：在遗传因素对原发性痛经影响的研究中，共收集到合格的双胞胎共1311对，其中同卵双生子908对，异卵双生子403对。应用Logistic多因素回归模型分析在异卵双生子和同卵双生子中，当一个同胞发生原发性痛经，另一个同胞发生同等程度痛经的OR值。结果发现，在同卵双生子中，两同胞均发生痛经的OR值有显著性；在异卵双生子中，除重度痛经外，两同胞均发生同等程度痛经的OR值也有显著性。同时还发现同卵双生子的OR值大于异卵双生子的OR值。在农药接触对原发性痛经影响的研究中，共收集到符合要求的研究对象3286人，对有可能影响原发性痛经的社会人口学因素和环境职业因素分别进行Logistic单因素以及多因素回归分析。在控制混杂因素后，结果显示农药接触对双胞胎人群原发性痛经影响有统计学意义(P＜0.01)，其OR值为1.235(95％CI：1.054-1.446)。同时在研究中还发现年龄和工作紧张对原发性痛经发生与否有显著影响。结论：在遗传因素对原发性痛经影响的研究中，结果提示原发性痛经有一定的遗传倾向，并且痛经程度不同，遗传所起的作用大小也不同。在农药接触对原发性痛经影响的研究中，发现农药接触对双胞胎原发性痛经的发生有影响，农药接触能明显提高原发性痛经的发生率，结果表明农药接触为女性双胞胎原发性痛经的危险因素。更多还原

【Abstract】 Objective: In order to investigate the genetic factor and pesticide exposure on primary dysmenorrhea in twins in rural area. Methods: We carried out a large scale cross-sectional study in Anhui Province. According to the standard questionaire, informations on primary dysmenorrhea and pesticide exposure, sociodemographic and related environmental and occupational variables were obtained by trained interviewers. To identify zygosity of twins, ten highly polymrophic genetic markers were selected and scanned on ABI377 machine. All the data were double entried and checked by EPI INFO and analyzed by SAS. Results: In the Study One, we totally collected eligible 1311 pairs of twins, 908 Monozygotic twins(MZ) and 403 Dizygotic twins(DZ). Logistic regression was applied to analyze the risk of the same degree primary dysmenorrhea in twins with and without adjustment for confounding factors. The results showed that OR value was significant in MZ and OR value was also significant except for severe primary dysmenorrhea in DZ. In additon, OR value of MZ was higher than that of DZ. In the Study Two, we collected 3286 eligible female. Logistic regression was applied to analyze pesticide exposure on primary dysmenorrhea with and without adjustment for confounding factors. The result revealed that pesticide(P<0.01) ()R=1.235 ( 95%CI: 1.054-1.446) was singnificantly associated with primary dysmenorrhea. Meanwhile, age and stress were also singnificantly associated with primary dysmenorrhea. Conclusion: In Study One, the results demonstrated that primary dysmenorrhea was heritable. The effects of genetic factors were different when the degrees of primary dysmenorrhea were different. In study Two, pesticide exposure was singnificantly associated with primary dysmenorrhea in twins, the incidence ofprimary dysmenorrhea increased with pesticide exposure. The results demonstrated that pesticide exposure was the risk factor of primary dysmenorrhea in twins.更多还原