湖南省湘潭县农村地区肺结核发病情况及影响因素分析

目的 了解农村地区肺结核发病情况及危险因素。 方法 采用巢式病例对照研究方法，对湖南省湘潭县农村地区人群72859名随访观察1年，队列中80例新发肺结核患者作为病例组；从该队列中采用简单随机抽样的方法抽取400名健康人作为对照。对有关暴露因素进行单因素和多因素非条件logistic回归分析。 结果 农村地区肺结核发病率为109.80/10万（80/72 859），男性、女性发病率分别为168.11/10万（63/37 476）、48.05/10万（17/35 383）。单因素分析显示不同年龄（Wald χ²=22251，P<0.001，OR=1.759）、性别（Wald χ²=16.145，P<0.001，OR=0.310）、文化程度（Wald χ²=21.937，P<0.001，OR=0.468）、婚姻状况（Wald χ²=8.320，P=0.004，OR=0.358）、职业（Wald χ²=10.297，P=0.001，OR=0.377）、结核病患者接触史（Wald χ²=7.535，P=0.006，OR=4.166）、结核病病史（Wald χ²=14.637，P<0.001，OR=57.000）、吸烟史（Wald χ²=4.525，P=0.033，OR=1.730）、可疑症状（Wald χ²=46.630，P<0.001，OR=12.758）人群的肺结核发病情况差异均有统计学意义；多因素分析有统计学意义的变量有性别（β=-1.142，Wald χ²=12.904，OR=0.319、95%CI=0.171～0.595）、文化程度（β=-0.743，Wald χ²=14.355，OR=0.476、95%CI=0.324～0.699）、婚姻状况（β=-1.138，Wald χ²=7.537，OR=0.320、95%CI=0.142～0.722）、结核病病史（β=2.852，Wald χ²=5.563，OR=17.329、95%CI=1.619～185.441）、可疑症状（β=1.728，Wald χ²=16.333，OR=5.630、95%CI=2.435～13.016）。 结论 女性、文化程度高和无配偶是肺结核发病的保护因素，有结核病病史和可疑症状是肺结核发病的危险因素。

Pulmonary tuberculosis incidence and its influencing factors in rural areas of Xiangtan county,Hunan province

Objective To study the pulmonary tuberculosis incidence and risk factors among rural areas. Methods A nested case-control study was conducted based on cohort of 72 859 subjects in Xiangtan county of Hunan province. The case group was composed of 80 cases of new tuberculosis patients detected during the 1 year follow-up program. Four hundred non tuberculosis subjects were selected by simple random sampling method from the cohort as controls. Univariate analysis and mutivariate non conditional logistic regression were used to analyze associations between the exposure factors and pulmonary tuberculosis. Results The incidence of pulmonary tuberculosis was 109 80 per 100 000（80/72 859） within one year, the incidence of male and female was 168.11（63/37 476），48.05 per 100 000 （17/35 383） respectively. The results of univariate analysis showed that age (Wald χ²=22.251，P<0.001，OR=1.759), gender (Wald χ²=16.145，P<0.001，OR=0.310), educational level (Wald χ²=21.937，P<0.001，OR=0.468), marital status (Wald χ²=8.320，P=0.004，OR=0.358), occupation (Wald χ²=10.297，P=0.001，OR=0.377), history of TB exposure (Wald χ²=7.535，P=0.006，OR=4.166), history of tuberculosis (Wald χ²=14.637，P<0.001，OR=57.000), smoking history (Wald χ²=4.525，P=0.033，OR=1.730), suspicious symptoms (Wald χ²=46.630，P<0.001，OR=12.758) were significantly associated with TB incidence; multivariate analysis showed that gender (β=-1.142，Wald χ²=12.904，OR=0.319，95% CI=0.171-0.595), education level (β=-0.743，Wald χ²=14.355，OR=0.476，95% CI=0.324-0.699), marital status (β=-1.138，Wald χ²=7.537，OR=0.320，95%CI=0.142-0.722), history of tuberculosis (β=2.852，Wald χ²=5.563，OR=17.329，95%CI=1.619-185.441), suspicious symptoms (β=1.728，Wald χ²=16.333，OR=5.630，95%CI=2.435-13.016) were significantly associated with TB incidence. Conclusion Women, high education level and single were protective factors of TB incidence while history of tuberculosis and suspicious symptoms of tuberculosis were risk factors of TB incidence.