营养状况和人口统计学因素与肺结核关联的病例对照研究

Nutritional status and demographic factors associated with tuberculosis:A case control study

目的了解安徽省淮南地区肺结核发生的现况,探讨肺结核相关危险因素。方法采用病例对照研究的方法,从安徽省淮南市东方集团附属肿瘤医院选取150例确诊肺结核患者,从淮南市体检中心选取260名健康人作为对照,分析结核病发生的相关危险因素。结果年龄及性别构成、家庭经济状况、婚姻状况和是否饮酒者占比在病例组和对照组中差异无统计学意义（P〉0.05）;居住地点和文化程度构成、营养状况、糖尿病、高血压及吸烟者占比在病例组和对照组中差异有统计学意义（χ^2值分别为60.072、6.921、99.464、21.841、6.368、41.478,P均〈0.05）。调整混杂因素后,居住在城市和城镇是肺结核发生的保护因素,其OR值（95%CI）分别为0.703（0.317～0.856）和0.564（0.259～0.724）,患高血压也是肺结核发生的保护因素,其OR值（95%CI）为0.626（0.271～0.784）;重、中、轻度营养不良、糖尿病、吸烟（包括被动吸烟）是肺结核发生的危险因素,其OR值（95%CI）分别为[2.976（0.887～9.989）、2.143（1.069～4.298）、1.703（0.884～4.690）、5.185（1.990～13.511）和1.477（1.087～2.006）]。重、中、轻度营养不良合并患糖尿病增加肺结核发生的危险性,其OR值（95%CI）分别为8.07（4.26～15.29）、3.25（1.51～6.98）、3.07（1.08～8.68）。营养状况正常和超重/肥胖伴高血压,可降低肺结核发生的危险性,其OR值（95%CI）分别为0.64（0.52～0.78）、0.79（0.67～0.92）。重度营养不良伴吸烟增加肺结核发生的危险性,其OR值（95%CI）为3.19（2.05～4.96）。结论居住在农村、营养不良、患糖尿病和吸烟是肺结核发生的危险因素,其中营养不良伴糖尿病或吸烟可使患结核病的危险性增大。

Objectives To investigate the incidence of tuberculosis in Anhui Province and to explore risk factors related to tuberculosis（TB）. Methods One group of potential subjects consisted of 150 patients who were definitively diagnosed with TB at the Orient Group＇s Tumor Hospital in the City of Huainan,Anhui Province,and another group consisted of 260 healthy individuals identified by a local medical examination center to serve as controls.Raw data were analyzed to identify the risk factors for tuberculosis. Results Data on 104 patients and 231 controls were analyzed.There were no significant differences between patients and controls in terms of age,sex,family financial status,marital status,and drinking（P〈0.05）.However,there were significant differences in the place of residence,level of education,nutritional status,diabetes,hypertension,and smoking（χ^2 values were 60.072,6.921,99.464,21.841,6.368,and 41.478;P〈0.05）.After adjusting for confounding factors,living in city or town was found to protect an individual from contracting tuberculosis（OR= 0.703,95%CI：0.317-0.856,OR=0.564,95%CI：0.259-0.724）.In addition,suffering from hypertension protected an individual from contracting tuberculosis（OR=0.626,95%CI：0.271-0.784）,but malnutrition（mild,moderate,or severe）,diabetes,and smoking（including passive smoking）were risk factors for tuberculosis,（OR=2.976,95%CI：1.087-2.006,OR=2.143,95%CI：1.069-4.298;OR=1.703,95%CI：0.884-4.690;OR=5.185,95%CI：1.990-13.511;OR=1.477,95%CI：1.087-2.006）.Malnutrition（mild,moderate,or severe）and diabetes together increased the risk of contracting tuberculosis（OR=8.07,95%CI：4.26-15.29;OR=3.25,95%CI：1.51-6.98;OR=3.07,95%CI：1.08-8.68）.However,a normal nutritional status and being overweight or obese and having hypertension reduced the risk of contracting tuberculosis（OR=0.64,95%CI：0.52-0.78;OR=0.79,95%CI：0.67-0.92）.However,severe malnutrition and smoking together increased the risk of contracting tuberculosis（OR=3.19,95%CI：2.05-4.96）. Conclusion Living in a rural area,malnutrition,diabetes,and smoking are risk factors for contracting tuberculosis.Malnutrition and diabetes together or smoking in particular increased an individual＇s risk of contracting tuberculosis.