宁波市奉化区肺结核发病危险因素调查

Study on risk factors of pulmonary tuberculosis in Fenghua district of Ningbo city

目的探讨影响宁波市奉化区肺结核发病的危险因素,为肺结核的防治提供科学依据。方法按照1∶1配比进行病例对照研究,使用自行设计的调查问卷进行调查。经χ~2检验及Logistic回归分析,计算OR值。结果单因素分析结果显示,婚姻、文化程度、个人月收入、承担家庭责任、居室类型、工作环境、劳累程度、吸烟、过量饮酒、BMI、睡眠时间、流动人口、肺结核接触史、肺结核疾病认知、现患有其他疾病、发病前遭遇生活负性事件、卡介苗接种等17个变量与肺结核发病关系的差异有统计学意义(P<0.05)。多因素分析结果显示,已婚、文化程度高、个人月收入高和接种卡介苗可降低肺结核发病危险性,OR值分别为0.843、0.782、0.452和0.528;承担家庭主要责任、居室类型差、工作环境差、劳累程度大、吸烟、BMI<18.5、睡眠时间小于8小时、流动人口、合并糖尿病、发病前遭遇生活负性事件和有肺结核接触史等人群易患肺结核,OR值分别为6.253、1.872、2.628、2.825、2.903、6.252、2.848、2.918、2.653、2.028和1.138。结论承担家庭主要责任、居室类型差、工作环境差、劳累程度大、吸烟、BMI<18.5、睡眠时间小于8小时、流动人口、合并糖尿病、发病前遭遇生活负性事件、有肺结核接触史等是肺结核发病的主要危险因素,而已婚、文化程度高、个人月收入高、接种卡介苗是肺结核发病的保护性因素。

Objective To explore the risk factors affecting the TB incidence of young adults in Fenghua district of Ningbo and provide scientific basis for the prevention of pulmonary tuberculosis. Methods Totally 342 cases of new pulmonary TB patients were selected in Fenghua district of Ningbo from Jan 2015 to Dec 2015. A 1： 1 matched case-control study was used. All of people were investigated by unified self-designed questionnaire,22 research factors were analyzed to use the single factor chi-square test,there were 15 factors into the multiple condition logistic regression model. Then use the multivariate conditional logistic regression model was used to analyze and calculate OR values,P values less than 0. 05 were considered as statistically significant. Results Univariate analysis results showed that 17 factors were statistically related（ P〈0. 05） to pulmonary tuberculosis. They were marriage relationship,education level,personal monthly income,bearing responsibility of family,room type,working conditions,exertion degree,smoking,alcohol drinking,BMI,hours of sleep,migrant workers,TB contact history,cognition level of TB,suffering other disease at present stage,encountered negative life events before attack,BCG vaccination. Multivariable conditional logistic regression analysis showed that married,high education level,high personal monthly income and BCG vaccination can reduce the risk of pulmonary tuberculosis. The OR values were0. 843,0. 782,0. 452 and 0. 528. People who were bearing the primary responsibility of family,bad room type,bad working conditions,work fatigue,smoking,BMI 18. 5,fewer than 8 hours of sleep per night,migrant workers,diabetes mellitus,encountered negative life events before attack and TB contact history were all susceptible to pulmonary tuberculosis. The OR values were 6. 253,1. 872,2. 628,2. 825,2. 903,6. 252,2. 848,2. 918,2. 653,2. 028 and 1. 138. Conclusion Bearing the primary responsibility of family,bad room type,bad working conditions,work fatigue,smoking,BMI 18. 5,fewer than 8 hours of sleep per night,migrant workers,diabetes mellitus,encountered negative life events before attack and TB contact history are the main risk factors for pulmonary tuberculosis,while married,high education level,high personal monthly income and BCG vaccination are the protective factors for reducing the incidence.