嘉兴市中小学生肺结核危险因素病例对照研究

A case-control study on risk factors for tuberculosis among students in primary and middle schools

目的探索影响中小学生肺结核发病的主要危险因素,为开展学校肺结核病防控工作提供借鉴。方法选择2008年1月至2009年12月间,嘉兴市中小学生中经结核病定点医院确诊的现患肺结核患者,进行1∶1病例对照研究。结果单因素分析中,体重、体质量指数、家庭经济条件、学习强度、文体活动强度、母亲文化程度、结核病接触史对中小学生结核患病的影响有统计学意义(P<0.05或P<0.01)。多因素分析中,体质量指数<20 kg/m2(OR=8.406),家庭经济条件差(OR=5.781),学习强度大(OR=3.083),有结核病接触史(OR=13.698)是患肺结核病的危险因素;文体活动强度大(OR=0.385)和母亲文化程度高(OR=0.136)是保护因素。结论中小学生结核病的患病危险因素复杂,自身抵抗力、家庭经济条件、结核病接触情况等与肺结核发病密切相关。

Objective To explore main risk factors of tuberculosis（TB） among students in primary and middle schools,and to provide fundamental basis for TB prevention and control in school settings.Methods A case-control study was carried out in the primary and middle schools students,a total of 104 TB cases and 104 controls were selected.Results Univariate analysis showed that weight,body mass index,family economic status,academic intensity,participation in entertainment and exercises,maternal educational level,exposure to tuberculosis had significant effect on tuberculosis.Multinomial Logistic regression analysis showed that body mass index 20 kg/m2（OR=8.406）,poor family economic status（OR=5.781）,strong academic intensity（OR=3.083）,exposure to TB（OR=13.698） were significant risk factors for TB.Frequent participation in entertainment and exercises,high maternal educational level were protective factors for TB.Conclusion There are several risk factors for tuberculosis among students in primary and middle schools.It should be noted that innate immunity,family SES and exposure to TB played an important role in TB infection among junior and high school students.