| 冷泰俊,尹全焕,尹满玉.病因研究中的混杂与交互作用——病毒性肝炎与皮质激素治疗的因果联系[J].Chinese journal of Epidemiology,1993,14(5):279-282 |
| 病因研究中的混杂与交互作用——病毒性肝炎与皮质激素治疗的因果联系 |
| The Confounding Factor and Interaction in Studies of Pathogenesis——An Analysis of the Secondary Infection of Viral Hepatitis with Corticoid Therapy |
| Received:January 28, 1993 Revised:June 14, 1993 |
| DOI： |
| KeyWord: 病毒性肝炎 皮质激素类治疗 感染 混杂因素 交互作用 |
| English Key Word: Viral hepatitis Corticoid therapy Infection Confounding factor Interaction |
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| Abstract: |
本研究以我校两个附属医院传染科住院的肝炎病例762例为调查对象,按使用与未用皮质激素分为两组,用回顾性队列研究的设计方案进行调查分析。结果cRR=6.06,χ2=174.16,P<0.01。提示皮质激素治疗是引起肝炎病人继发医院感染的危险因素。为了分析本调查是否有混杂与交互作用存在,进一步又按病情轻重将全部病例分为重型与中等严重两组进行分层分析。结果aRR(F)=3.05,aRR(F)=1.48,cRR≠aRR,说明病情轻重具有混杂作用。提示引起医院感染的重要因素是病情轻重问题。另一方面因aRR(F)≠aRR(F),提示本研究的两个危险因素之间又有交互作用存在。
通过分层分析明确了引起肝炎继发医院感染的主要危险因素为肝炎本身病情的轻重问题,但皮质激素治疗对继发感染也有一定的促进作用。因此,在治疗中必须十分重视保护与提高患者自身的免疫防御机能,无明确适应症者防止滥用皮质激素。 |
| English Abstract: |
A total of 762 cases of viral hepatitis admitted to the two teaching hospitals of the Third Military Medical College were used for study. They were divided into two groups depending upon whether corticoid treatment was given. As the result of cRR=6.06. χ2=174.16, P<0.01, it is obvious that the corticoid therapy is a risk factor for the secondary infection in patients suffered from viral hepatitis.
For getting rid of the interference of confounding factor and interaction a stratified analysis was performed. These patients were again devided into severe type and moderate type according to the severity of the disease.
The results of stratified analysis were aRR (F)=3.05 and aRR (F)=1.48, cRR> aRR. These findings demonstrated that the degree of severity of patients played a primary role in the secondary infection of hepatitis and showed that the confounding factor was present. On the other hand, the result of aRR (F)≠aRR (F) indicated that the interaction also existed simultaneously.
This study suggests that special attention should be paid to maintain and increase the level of immunological defence function in pateints with hepatitis. And, it is necessary to restrict the indiscriminate usage of corticoids, particularly in severe patients, for preventing nosocomial infection. |
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