影响肺结核密切接触者发病的因素分析

目的 探讨肺结核密切接触者患病的相关危险因素,为高危人群的结核病防治提供科学依据.方法 对越秀区2011年至2013年涂阳肺结核患者及其密切接触者登记随访的资料中选取符合条件的密切接触者发病患者289例为病例组,未发病者595例为对照组;分析影响其发病的相关因素.结果 单因素logistic回归分析显示卡介苗接种史、住房通风情况、室内卫生情况、食用肉蛋类、吸烟、慢性支气管炎病史、糖尿病史、每天工作时间及工作环境情况等因素与密切接触者肺结核发病相关.多因素logistic回归模型筛选后的结果表明,吸烟、有慢性支气管炎病史、糖尿病史及每天工作时间≥12小时是密切接触者患病的危险因素;有卡介苗接种史、良好的住房通风环境、经常食用肉蛋类食物及露天开放的工作环境是密切接触者发病的独立保护因素.结论 密切接触者肺结核的发病与其个人体质、生活及工作环境密切相关;加强个体戒烟的宣教行为,改善住房和公共场所等环境通风、卫生情况,有利于肺结核的预防与控制.

A case-control study on risk factors of tuberculosis close contacts

Objective To investigate the risk factors of tuberculosis close contact and provide scientific clues for tuberculosis prevention.Methods 289 tuberculosis patients as cases and 595 disease-free as controls,were selected according to registered data and follow-up system of smear-positive pulmonary tuberculosis patients and their close contacts in our hospital from 2011 to 2013.Results Univariate analysis demonstrated that factors such as history of Bacillus Calmette Guerin （BCG） vaccination,housing ventilation,interior hygiene,meat and eggs consumption,smoke,history of chronic bronchitis or diabetes,working hours per day,and the work environment conditions had significant association with pulmonary tuberculosis.Furthermore,multivariate logistic analysis showed that smoke,history of chronic bronchitis or diabetes and working hours ≥ 12 per day offered an adverse role on tuberculosis risk,while history of BCG vaccination,favorable housing ventilation or work environment,and meat and eggs consumption （＞4 times/week） contributed an protective effect on tuberculosis.Conclusion Tuberculosis incidence of close contacts were closely related to their personal health quality,and their living and working environment.Individual giving-up smoking education should be strengthened,and improving environmental ventilation and health in housing and public places could be effective for pulmonary tuberculosis prevention and control.