肺结核危险因素病例对照研究  

Case Control Study on Risk Factors of Pulmonary Tuberculosis

作　　者：王欣[1] 翁少凡[1] 祖爱华[2] 郭雁飞[1] 周婷[1] 陈卫红[1] 

机构地区：[1]华中科技大学同济医学院,湖北武汉430030 [2]深圳市南山区疾病预防控制中心,广东深圳518000

出　　处：《工业卫生与职业病》2011年第4期208-213,共6页Industrial Health and Occupational Diseases

基　　金：国家863项目(2006AA02Z347)

摘　　要：目的探讨影响肺结核发病的危险因素,为预防肺结核的发病采取有效的措施提供依据。方法采用病例对照研究,选取951例7~90岁肺结核病患者作为病例组,每个病例选取1名与其同性别、同年龄的正常人作为对照。通过询问调查收集调查对象信息,用单因素分析和多因素非条件logistic回归模型分析。结果调查的951名肺结核患者中,男性患者73.4%,女性患者26.6%;单因素分析显示固定接触人数（OR=1.349,P〈0.05）,日常共同居住人数（OR=1.623,P〈0.05）、吸烟情况（OR=1.568,P〈0.05）、患病前接触过结核患者（OR=2.923,P〈0.05）、患糖尿病（OR=1.957,P〈0.05）,是肺结核患病危险因素;从事职业与肺结核患病相关,与非接尘工人比较,农民患肺结核危险升高（OR=1.921,P〈0.05）,接触粉尘工人肺结核患病率是非接尘者3.6倍（P〈0.05）,商人、白领职员患肺结核的危险性低（OR=0.630,P〈0.05）。多因素分析进入模型有统计学意义（P〈0.05）的变量为文化程度、日常中固定接触人数、累计吸烟量、饮酒、患病前接触过肺结核患者、体重指数（BMI）、工作暴露粉尘环境,其OR值分别为0.693、1.432、1.633、0.443、3.432、2.824和2.242。结论日常中固定接触人数多、累计吸烟量大、接触过肺结核病人数多、体重指数低是肺结核病的危险因素,文化程度高、饮酒是肺结核病的保护因素;在肺结核病控制工作实践中,采取相应的针对性措施有助于肺结核病的疫情控制。Objective To explore the risk factors of pulmonary TB and to find out criteria for its effective preventive and controlling measures.Methods Case control study was conducted.951 pulmonary TB patients with 7-90 years of age were selected and registered from TB prevention institutions of three counties.One healthy person with the same gender and age was selected to match each case and grouped as the controls.Interviews were carried out with a uniformly designed questionnaire.Unconditional mono-and multivariable logistic regression models were used for analysis.Results In a total of 951 TB patients investigated,73.4% were males and 26.6% were females.The results of mono-variable analysis showed that exposure to TB during working（OR=1.349,P0.05）,resided in same place（OR=1.623,P0.05）,smoking habit（OR=1.568,P0.05）,exposure to TB patients prior to his/her suffering（OR=2.923,P0.05）,and diabetes complication（OR=1.957,P0.05）were significantly associated with pulmonary TB prevalence.In occupational factors,peasants had higher risk（OR=1.921,P0.05）.Workers with dust exposure had higher risk than those without dust exposure（OR=3.577,P0.05）.Meanwhile business persons and white collar clerks had lower risk（OR=0.630,P0.05）.Multiple unconditional logistic regression analysis turned out that education levels,the number of persons daily contacted,cumulative amount of cigarettes smoked,drinking habit,whether or not exposed to TB patients prior to suffering,BMI,and occupational exposure to dust were also associated with pulmonary tuberculosis（P0.05）,and the OR values were 0.693,1.432,1.633,0.443,3.432,2.824 and 2.242 respectively.Conclusions More people contacted in daily life,more cigarettes smoked,more chances in contact with TB patients and low BMI were risk factors of pulmonary TB.Higher education level and drinking habit were the protective factors.In the preventive practices for TB,relevant measures aimed at those above-mentioned factors should be taken in order to control the epidemic of TB.

关 键 词：肺结核 危险因素 病例对照研究 

分 类 号：R135.2[医药卫生—劳动卫生]