四川省绵阳市肺结核特征及其发现方式的影响因素分析

A Study on Tuberculosis Characteristics and Risk Factors of Case-finding Methods for Tuberculosis in Mianyang City

目的了解四川省绵阳市肺结核的基本特点及临床特征,并探讨'被动发现'和'主动筛查'两种肺结核发现方式可能的影响因素。方法选择2013年6月至2014年3月期间,绵阳市涪城区、江油市共21个乡镇通过居民健康体检筛查出的175例活动性肺结核患者作为研究对象,采用问卷调查、胸部DR检查、实验室检查等方法,收集研究对象肺结核的基本特点和临床特征,运用多因素Logistic回归模型分析肺结核不同发现方式可能的影响因素。结果 175例肺结核患者中60岁以上73例(41.71%),职业以农民为主129例(73.71%);咳嗽、咳痰≥2周为最常见症状102例(58.29%);163例送检合格痰标本,其中痰涂片阳性32例(19.63%);103例行PPD皮试者中阳性73例(70.87%)。多因素Logistic回归分析显示结核病史对肺结核的发现方式有显著影响(OR=15.809,95%CI:6.708~37.258)。结论四川省绵阳市通过居民健康体检筛查出活动性肺结核患者以60岁以上的老年男性、农民为主,以肺部单一症状为主要临床表现;有结核病史的肺结核患者更容易通过'被动发现'筛查出来。

Objective To understand basic characteristics and clinical features of tuberculosis in Mianyang,Sichuan,and to investigate the risk factors of two case-finding methods for tuberculosis: 'passive finding' and 'active screening '. Methods One-hundred and seventy-five active tuberculosis patients screened by physical examination in 21 villages of Fucheng and Jiangyou from June 2013 to March 2014 were included. Information about basic characteristics and clinical features of tuberculosis was collected using questionnaire,chest X-ray and laboratory examinations. We also applied binary logistic regression to explore the risk factors of finding for tuberculosis. Results In all 175 tuberculosis patients,41. 71% were over 60 years old and 73. 71% were farmers. Productive cough over two weeks was the most common symptom,accountting for 58. 29%. 19. 63% were sputum smear-positive while 70. 87% were PPD-positive. Binary logistic regression analysis demonstrated that tuberculosis history significantly influenced the findings for tuberculosis( OR = 15. 809,95% CI: 6. 708 ~ 37. 258). Conclusions Active tuberculosis patients screened by physical examination in Mianyang,Sichuan were mainly elderly male over 60 years old and farmers,with single pulmonary symptom as the primary clinical feature. The patients with tuberculosis history may be found by 'passive finding'.