结核感染人群肺结核发病危险因素的研究

A study of risk factors of tuberculosis in tuberculosis infected population

目的了解影响结核菌感染人群肺结核发病的各种危险因素,评估危险因素的相对危险程度,为人群干预提供科学依据。方法选择广州市某区2015年11月~2017年5月登记的367例初治肺结核病人,对同性别、最近一天到区结核病门诊求诊的PPD阳性的非肺结核病人进行1∶1的病例对照研究,同时采用单因素和多因素logistic回归分析。结果单因素分析中有27项因素与结核感染人群肺结核发病有关联,经多因素分析8项因素有关联,其中体重过低、住房阴暗、住房不通风、被动吸烟频繁、经常饮酒、劳动或工作强度大、经常担心自身健康状况是肺结核发病危险因素,其OR值(95%CI)分别为42.930(7.683~239.862)、40.154(12.589~128.080)、88.469(8.936~875.847)、606.787(6.400~57 530.413)、16.988(1.651~174.846)、140.368(9.080~2 169.907)、254.842(4.195~15 482.897),而已婚是肺结核保护因素,其OR值(95%CI)为0.088(0.032~0.244)。结论体重过低、住房阴暗、住房不通风、被动吸烟频繁、经常饮酒、劳动强度大、经常担心自身健康状况是结核感染人群肺结核发病的危险因素,已婚可降低肺结核发病风险。应针对主要危险因素采取相应的干预措施,减少已感染人群肺结核发病。

Objective To investigate the risk factors of pulmonary tuberculosis in tuberculosis infected people,to evaluate the relative risk of risk factors,and to provide scientific basis for popu-lation intervention. Methods 367 cases of new tuberculosis patients were selected from November 2015 to May 2017 in a district of Guangzhou,and non-tuberculosis patients with same sex as well as a dianosis of positive PPD in recent day to Huangpu District tuberculosis outpatient service,were enrolled in a 1∶ 1 case-control study,with both single factor and multivariate logistic regression analysis. Results Among the univariate analysis,27 factors were associated with the incidence of pulmonary tuberculosis in tuberculosis group. Eight factors were associated with tuberculosis infection in tuberculosis patients,among which underweight,dark housing,no ventilation,frequent passive smoking and drinking,labor or work of high intensity and often worrying about their own health status were factors of the incidence,and the OR value（ 95% CI） were 42. 930（ 7. 683 - 239. 862）,40. 154（ 12. 589 - 128. 080）,88. 469（ 8. 936 - 875. 847）,606. 787（ 6. 400 - 57 530. 413）,16. 988（ 1. 651 - 174. 846）,140. 368（ 9. 080 - 2 169. 907）,254. 842（ 4. 195 - 15 482. 897） respectively. While marriage is a protective factor for tuberculosis,the OR value（ 95% CI） being 0. 088（ 0. 032 - 0. 244）. Conclusion Underwei,dark housing,no ventilation,frequent passive smoki-ng,often drinking,intense labor or work and often being worried about their own health status are the risks of TB infection in people with tuberculosis risk factors,and getting married may reduce the risk. Corresponding intervention measuresshould be taken for the major risk factors to reduce the incidence of pulmonary tuberculosis in the infected population.