Wientjens D P, Davanipour Z, Hofman A, Kondo K, Matthews W B, Will R G, van Duijn C M
Department of Epidemiology & Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.
Neurology. 1996 May;46(5):1287-91. doi: 10.1212/wnl.46.5.1287.
To review the evidence for risk factors of Creutzfeldt-Jakob disease (CJD), we pooled and reanalyzed the raw data of three case-control studies. The pooled data set comprised 178 patients and 333 control subjects. The strength of association between CJD and putative risk factors was assessed by computing the odds ratio as estimate of the relative risk. The risk of CJD was statistically significantly increased for subjects with a family history of CJD (odds ratio = 19.1; 95% CI 1.1 to 348.0). Further, there was a significant association between the risk of CJD and a history of psychotic disease (odds ratio = 9.9; 95% CI 1.1 to 86.1). Although not significantly increased, there was an elevated risk of CJD for subjects with a family history of dementia, a history of poliomyelitis, subjects employed as health professionals, and subjects ever exposed to cows and sheep. No association could be shown with organ meat consumption, including brain. The negative results of this reanalysis reassures the absence of a common risk factor in all CJD patients. However, the ongoing epidemiologic surveillance of CJD in several European countries may provide more evidence to exclude any environmental exposure early in childhood.
为了回顾克雅氏病(CJD)危险因素的证据,我们汇总并重新分析了三项病例对照研究的原始数据。汇总数据集包括178例患者和333名对照对象。通过计算比值比作为相对风险的估计值,评估CJD与假定危险因素之间的关联强度。有CJD家族史的受试者患CJD的风险在统计学上显著增加(比值比=19.1;95%置信区间1.1至348.0)。此外,CJD风险与精神病史之间存在显著关联(比值比=9.9;95%置信区间1.1至86.1)。虽然没有显著增加,但有痴呆家族史、脊髓灰质炎病史、从事卫生专业工作的受试者以及曾接触牛和羊的受试者患CJD的风险有所升高。未发现与食用包括脑在内的动物内脏有任何关联。此次重新分析的阴性结果证实了所有CJD患者不存在共同危险因素。然而,几个欧洲国家正在进行的CJD流行病学监测可能会提供更多证据,以便尽早排除儿童期的任何环境暴露因素。