江苏省部分地区社区人群结核病发病风险及危险因素分析  

The risk and influencing factors of tuberculosis among community population in Jiangsu

作　　者：钱姣 姜洁[1] 朱立国[1] 翟祥军[1] 姜伟[2] 殷文华[3] 季明[4] 竺丽梅[1] 陆伟[1] 彭红[1] QIAN Jiao;JIANG Jie;ZHU Li-guo;ZHAI Xiang-jun;JIANG Wei;YIN Wen-hua;JI Ming;ZHU Li-mei;LU Wei;PENG Hong(Jiangsu Provincial Center for Disease Control and Prevention,Nanjing,Jiangsu 210009,China;Zhangjiagang Provincial Center for Disease Control and Prevention,Zhangjiagang,Jiangsu 215600,China;Danyang Provincial Center for Disease Control and Prevention,Danyang,Jiangsu 212310,China;Taixing Provincial Center for Disease Control and Prevention,Taixing,Jiangsu 225499,China)

机构地区：[1]江苏省疾病预防控制中心,江苏南京210009 [2]张家港市疾病预防控制中心,江苏张家港215600 [3]丹阳市疾病预防控制中心,江苏丹阳212310 [4]泰兴市疾病预防控制中心,江苏泰兴225499

出　　处：《中国热带医学》2022年第5期400-405,411,共7页China Tropical Medicine

基　　金：国家科技重大专项(No.2018ZX10715002)。

摘　　要：目的 了解江苏省部分地区社区人群结核病发病风险及危险因素,为制定结核病防控策略提供依据。方法 以国家科技重大专项江苏省重大传染病综合防治示范区项目开展的大规模结核病筛查工作为基础,建立结核病发病风险及危险因素研究队列,对队列成员开展胸部X线检查、结核病可疑症状筛查和流行病学调查等工作。在主动筛查的基础上,通过将随访人员信息与国家结核病管理信息系统比对获取研究对象的发病情况,进行结核病发病风险及危险因素的分析。结果 队列共随访211 210人,2018—2020年三年随访期内共发生结核病224例,累计发病率106.06/10万。多因素Cox回归分析结果显示,男性、年龄≥65岁、有结核病既往史、糖尿病史、外出史以及出现结核病可疑症状为结核病发病的独立危险因素(P<0.05),BMI<18.5的人群结核病发病风险为BMI≥28人群的11.8倍(P<0.01)。结论 江苏省部分地区社区人群年均发病率虽处于偏低水平,但仍应加强对男性、≥65岁老年人、有结核病既往史、糖尿病史、外出史、低BMI以及出现结核病可疑症状的人群的管理和干预,以降低结核病发病率。Objective Jiangsu province, and to provide evidence for the formulation of tuberculosis prevention and control strategies.MethodsWe established a cohort to study the risk and influencing factors of tuberculosis in Jiangsu Province, based on the large-scale tuberculosis screening supported by the Demonstration Area Project of Comprehensive Prevention and Treatment of Major Infectious Diseases in Jiangsu, which is one of the National Science and Technology Major Projects. Chest X-ray examination,screening of tuberculosis suspected symptoms and epidemiological investigation were carried out for the cohort members. On the basis of active screening, the incidence of the study objects was obtained from the National Tuberculosis Management Information System during the follow-up period to ensure that no cases were missed, and the risk and influencing factors of tuberculosis were analyzed.Results occurred during the 2018-2020 follow-up period, with a cumulative incidence of 106.06/100 000. Multivariate Cox regression analysis showed that male, older than 65 years old, previous history of tuberculosis, history of diabetes mellitus, migrant work history and suspicious symptoms of tuberculosis were independent risk factors for the incidence of tuberculosis(P<0.05). Those with a BMI of less than 18.5 were 11.8 times more likely to develop tuberculosis than those with a BMI of 28 or more(P<0.01).Conclusions intervention should be strengthened for men, people over 65 years of age, people with a history of tuberculosis, diabetes or migrant work, people with a low BMI and people with suspected TB symptoms to reduce the incidence of tuberculosis.

关 键 词：结核病 队列研究 发病风险 危险因素 筛查 

分 类 号：R521.1[医药卫生—内科学]