社会经济地位、环境因素及个人行为对肺结核发病危险的研究

目的：探讨社会经济地位、个人行为（吸烟、饮酒）、环境因素（居住和工作环境）、体重指数（BMI）等对成都地区成人肺结核发病危险的影响，以确定该地区肺结核的主要危险因素。方法：采用群体病例－对照研究、多变量多指标测量、多因素分析得出结论。结果：由职业、教育程度和家庭收入测量的社会经济地位、吸烟、饮酒等与肺结核发病无关；而吸烟合并饮酒者，肺结核发病危险显著增加（OR=6.12，95％CI＝1.15－32.49)；其他与肺结核发病相关的因素，按危险度顺位排列是暴露于化学气雾（OR＝5.15，95％CI＝1.44－18.40）、低BMI（OR＝4.72，95％CI＝2.68－8.33）、室内潮湿（OR＝4.06，95％CI＝2.25－7.33）和暴露于大量粉尘（OR＝2.35，95％CI＝1.18－4.70）。结论：不良个人行为（吸烟＋饮酒），拥挤、阴暗潮湿和卫生状况差的环境，长期暴露于大量粉尘或化学气雾与成都地区成人肺结核发病有密切关系。

Social economical status, behaviors and environment as the risk factors of tuberculosis in ChengduChina

Objective To study the risk factors of pulmonary tuberculosis in Chengdu, Southwest China. Methods A population based case control study was used which included 174 cases selected from 12 communities in Chengdu and 174 controls selected from registered population with normal chest radiograph.Cases were active TB patients which were matched for age,sex with controls,then interviewed by trained interviewers using a standardized questionnaire. Results Social economic status measured by education, occupation and income did not show obvions influence to TB; It found that the active smoking, passive smoking,type of cigarettes and alcohol consumption had no significanct effects on TB during logistic regression analysis. The study showed that a person who was smoking and also alcohol intake had a higher risk to get TB ( OR = 6.12 , 95%CI= 1.15 32.49 ). Significant association was showed in the Dose Response Analysis ( OR = 1.37 , 95%CI= 1.30 2.30 ). Crowded living space ( OR = 1.14 , 95%CI= 1.05 1.25 ), degree of darkness ( OR = 2.18 , 95%CI= 1.11 4.27 ) and moisture ( OR = 4.06 , 95%CI= 2.25 7.33 ), poor sanitary ( OR = 3.03 , 95%CI= 1.22 4.44 ), airpollution of working environment, which were filled with dusts ( OR = 2.35 , 95%CI= 1.18 4.70 ) and chemical fumes ( OR = 5.15 , 95%CI= 1.44 18.40 ) were strongly associated with pulmonary tuberculosis. BMI also had strong relationship with TB ( OR = 4.72 , 95%CI= 2.68 8.33 ). Conclusion Poor environment and exposure to dust and chemical fume under working condition, low BMI, smoking combining alcohol consumption were the risk factors of adult pulmonary tuberculosis in Chengdu, China.