Craig J C, Knight J F, Sureshkumar P, Mantz E, Roy L P
Department of Nephrology, Royal Alexandra Hospital for Children, Sydney, Australia.
J Pediatr. 1996 Jan;128(1):23-7. doi: 10.1016/s0022-3476(96)70423-7.
To determine whether circumcision decreases the risk of symptomatic urinary tract infection (UTI) in boys less than 5 years of age.
A case-control study (1993 to 1995) in the setting of a large ambulatory pediatric service. Case subjects and control subjects were drawn from the same population. One hundred forty-four boys less than 5 years of age (median age, 5.8 months) who had a microbiologically proven symptomatic UTI (case subjects), were compared with 742 boys (median age, 21.0 months) who did not have a UTI (control subjects). The proportion of case and control subjects who were circumcised in each group was compared with the use of the chi-square test, with the strength of association between circumcision and UTI expressed in terms of an odds ratio. To determine whether age was a confounder or an effect-modifier, we stratified the groups by age (< 1 year; > or = 1 year) and analyzed by the method of Mantel-Haenszel.
Of the 144 preschool boys with UTI, 2 (1.4%) were circumcised, compared with 47 (6.3%) of the 742 control subjects (chi-square value = 5.6; p = 0.02; odds ratio, 0.21; 95% confidence intervals, 0.06 to 0.76). There was no evidence that age was a confounder or modified the protective effect of circumcision on the development of UTI (Mantel-Haenszel chi-square value = 6.0; p = 0.01; combined odds ratio, 0.18; 95% confidence intervals, 0.05 to 0.71; Breslow-Day test of homogeneity chi-square value = 0.6; p = 0.4).
Circumcision decreases the risk of symptomatic UTI in preschool boys. The protective effect is independent of age.
确定包皮环切术是否能降低5岁以下男孩出现症状性尿路感染（UTI）的风险。
一项于1993年至1995年在大型门诊儿科服务机构开展的病例对照研究。病例组和对照组来自同一人群。将144名5岁以下（中位年龄5.8个月）经微生物学证实患有症状性UTI的男孩（病例组）与742名未患UTI的男孩（对照组，中位年龄21.0个月）进行比较。使用卡方检验比较每组中接受包皮环切术的病例组和对照组的比例，包皮环切术与UTI之间的关联强度用比值比表示。为确定年龄是混杂因素还是效应修饰因素，我们按年龄（<1岁；≥1岁）对两组进行分层，并采用Mantel-Haenszel方法进行分析。
在144名患UTI的学龄前男孩中，2名（1.4%）接受了包皮环切术，而在742名对照组男孩中，这一比例为47名（6.3%）（卡方值 = 5.6；p = 0.02；比值比，0.21；95%置信区间，0.06至0.76）。没有证据表明年龄是混杂因素或改变了包皮环切术对UTI发生的保护作用（Mantel-Haenszel卡方值 = 6.0；p = 0.01；合并比值比，0.18；95%置信区间，0.05至0.71；Breslow-Day齐性检验卡方值 = 0.6；p = 0.4）。
包皮环切术可降低学龄前男孩出现症状性UTI的风险。这种保护作用与年龄无关。
