广州市肺结核发病危险因素的调查研究  

Risk factors of pulmonary tuberculosis incidence in Guangzhou:a paired case-control study

作　　者：何志青[1] 胡贵方[2] 资青兰[3] 唐惠红[1] 龚芳[1] 陈树忠[4] 雷宇[5] 包婉玲[1] 刘桂丝[1] 

机构地区：[1]广州市胸科医院一分所,510095 [2]南方医科大学公共卫生与热带医学学院流行病与卫生统计教研室 [3]广州市第一人民医院护理部 [4]广州市胸科医院二分所,510095 [5]广州市胸科医院结核病控制科,510095

出　　处：《中国防痨杂志》2012年第7期425-432,共8页Chinese Journal of Antituberculosis

基　　金：广州市科技计划项目(2010Y-C031)

摘　　要：目的探讨影响广州市居民肺结核发病的危险因素,为肺结核的防治提供科学依据。方法采用1∶1配比病例对照研究,对广州市250例涂阳肺结核患者及相同数量的对照(从涂阳肺结核患者的家庭密切接触者人群中选取),使用自行设计的调查表进行调查,调查变量共25个指标,包括受教育程度、职业、个人月收入、承担家庭经济责任、家庭经济状况、吸烟、过量饮酒、运动、婚姻、吸毒、糖尿病史、住房面积、居室的通风、阴暗、潮湿和周围环境质量16个指标和心理应激状况9个指标;心理应激状况选用杨德森生活事件量表(LES)、姜乾金特质应对方式问卷(TCSQ)、肖水源社会支持评定量表(SSRS)。调查表经预调查测其Cronbach’s系数为0.83。调查肺结核患者268例,发出问卷268份,回收有效回卷250份,有效率93.3%,将有效回答的250例患者全部纳入结核病组。调查涂阳家庭密切接触者1206例,发出问卷1206份,回收有效问卷1143份,有效率94.8%;从1143例家庭密切接触者中按照与结核病组患者同性别、年龄相近(≤3岁)原则进行1∶1配对,选取250例纳入非结核病组。对所获资料根据资料的类型采用单因素条件logistic回归分析进行单因素分析,初步筛选出的可能影响肺结核发病的危险因素,再纳入多因素条件logistic回归模型进行多因素分析。计算各变量的Waldχ2值、P值、OR值及其95%CI值。取P值≤0.10有统计学意义。结果单因素分析有统计学意义的变量共15个,多因素分析进入模型的变量有9个,个人月收入(分3个水平,<1000元/月,1000～元/月,≥3000元/月,Waldχ2值分别是13.492、1.379,P=0.000、0.240),承担家庭经济主要责任(Waldχ2=17.820,P=0.000),吸烟(Waldχ2=9.489,P=0.002),过量饮酒(Waldχ2=4.141,P=0.042);生活事件总刺激量(Waldχ2=6.995,P=0.008),消极应对(Waldχ2=14.806,P=0.000)6个因素是结核发病的危险因素,其OR值(95%CI值)分别为[4.17Objective To explore the risk factors affecting the TB incidence in Guangzhou,and provide scientific basis for pulmonary tuberculosis（PTB） prevention.Methods This is a 1∶1 matched case-control study.Two hundreds and fifty smear positive tuberculosis patients in case group and the same number of people selected from household close contacts of smear positive in control group were investigated by unified self-designed questionnaire.A total of 25 indicators were surveyed including level of education,occupation,personal monthly income,the family economic responsibility,family economic status,smoking,excessive alcohol consumption,exercise,marriage,drug abuse,history of diabetes,the housing area,room ventilation,darkness and dampness,the surrounding environmental quality and 9 psychological stress indicators.The psychological stress was investigated by Yang Desen life Event scale（LES）,Jiang Qianjin Trait Coping Style Questionnaire（TCSQ）,Xiao Shuiyuan social support rating scale（SSRS）.Measured by the pre-survey,the Cronbach＇s coefficient of the questionnaire was 0.83.Two hundred and sixty-eight pieces of questionnaire were issued for PTB patients,and 250 valid were returned with the effective response rate of 93.3%.All these 250 patients were enrolled in the case group.1206 pieces of questionnaire were issued for household close contacts,and 1143 valid were returned with the effective response rate of 94.8%.Among these 1143 household contacts,250 controls were selected according to 1∶1 match with cases.The matching principle is same gender,and age gap less than 3 years old.The univariate analysis is made to screen the risk factors that may affect the TB incidence,and then the multivariate conditional logistic regression model is made for analysis.Wald χ^2P values,OR values and their 95% CI is calculated for each indicator.P value ≤ 0.10 is considered statistically significant.Results A total of fifteen indicators are statistically significant in univariate analysis,nine enter into the multivaria

关 键 词：结核 肺 危险因素 病例对照研究 广州市 

分 类 号：R521[医药卫生—内科学]