丹阳市人群结核菌素试验强阳性的影响因素

Influencial factors of strong positive rate of tuberculin skin test among residents in Danyang County

目的探讨结核菌素试验(tuberculinskintest,TST)强阳性的影响因素。方法选取丹阳市导墅镇2个村的所有人群作为研究对象,采用现况调查研究,收集受试者信息,通过构建logistic回归模型,探讨年龄、性别、BMI、吸烟和饮酒情况、卡介苗接种史和糖尿病患病史对TST强阳性率的影响。结果共纳入5405名对象,其中1408名PPD硬结直径≥15mm,TST强阳性率为26.1%,其年龄M(P_(25),P_(75))为50(40,62)岁,集中在30~<60岁(占63.1%),BMI多为正常(占54.2%),吸烟者占69.1%,饮酒者占75.3%,接种过BCG占56.8%,糖尿病占5.7%。TST强阳性率男性(29.0%)高于女性(23.5%)、吸烟者(32.7%)高于不吸烟者(23.9%)、饮酒者(28.7%)高于不饮酒者(25.3%),接种卡介苗者(31.7%)高于未接种卡介苗者(22.9%),差异均有统计学意义(P值均<0.05)。TST强阳性率随年龄增加先升高后降低,40~<50岁组达到峰值(31.4%);强阳性率随BMI值升高先升高后降低,超重组达到峰值(28.1%);不同年龄、BMI对象TST强阳性率差异均有统计学意义(P值均<0.05)。年龄(OR=0.99,95%CI:0.99~0.99)、BMI(OR=1.03,95%CI:1.02~1.05)、吸烟(OR=1.73,95%CI:1.44~2.08)、接种BCG(OR=1.34,95%CI:1.13~1.58)与TST强阳性有统计学关联,低年龄、高BMI、吸烟、饮酒、接种过BCG均为TST强阳性的危险因素(P值均<0.05)。结论低年龄、高BMI、吸烟、饮酒、接种过BCG对象TST的强阳性率较高。

Objective To explore the influencial factors of strong positive rate of tuberculin skin test(TST).Methods The residents in 2 villages of Daoshu Town of Danyang County were selected as the research subjects.A cross-sectional study was conducted, the demographic characteristics of subjects were collected.Logistic regression model was established to explore the influence of age, gender, BMI,smoking status, alcohol consumption status, BCG vaccination history and diabetes history on the strong positive rate of TST among surveyed subjects. Results A total 5 405 individuals were included in the study, among whom 1 408(26.0%) had TST induration of ≥15 mm, resulting TST strong positive rate of 26.1%.For the individuals of strong positive reaction of TST,the age of M(P;,P;) were 50(40,62)years, mainly in the age of 30-60 years(accounted for 63.1%),most of them with normal BMI(accounted for 54.2%);69.1% subjects smoked and 75.3% had alcohol consumption, 56.8% were inoculated with BCG vaccine, 5.7% were suffered with diabetes.Univariate analysis showed that the strong positive rate of TST in males(29.0%),smokers(32.7%),drinkers(28.7%) and those vaccinated with BCG vaccine(31.7%) were higher than those in females(23.5%),non-smokers(23.9%),non drinkers(25.3%) or those not vaccinated with BCG vaccine(22.9%);all above differences were statistically significant(all P<0.05).The strong positive rate of TST first increased and then decreased with age and BMI,and reached the peak in age group of 40-50 years(31.4%) and overweight group(28.1%).There were significant differences in the strong positive rates of TST among subjects of different age and BMI groups(all P< 0.05).Multivariate logistic regression model showed that age(OR=0.99,95%CI: 0.99-0.99),BMI(OR=1.03,95%CI: 1.02-1.05),smoking(OR=1.73,95%CI:1.44-2.08),BCG inoculation(OR=1.34,95%CI:1.13-1.58) were related to the TST strong positive rate;young age, high BMI,smoking, drinking, BCG inoculation were risk factors of TST strong positive rate(all P<0.05). Conclusion Young age, high BMI,smoking, drinking, and BCG inoculation could increase the strong positive rate of TST.