吸烟、饮酒与肺结核危险因素的配对病例—对照研究

目的 探讨吸烟、饮酒对成都地区成人肺结核发病危险的影响。进一步确定成人肺结核发病的危险因素。方法 有杉社区病例-对照研究的方法。随意选择社区健康对照174人，按年龄、性别、居住社区与同年收集到的174例成人新发肺结核进行配对，采用问卷面对面调查个人嗜好（吸、饮酒），并在设计中严格控制偏倚，利用Logistic多元回归分析法，排队多种混杂因素（如结核接触史，社会经济地位，BCG接种史，环境因素，体重指数等），以确定吸烟煤、饮酒与肺结核发病的危险关系。结果 单因素分析时本研究病例主动吸烟（OR=2.12,P=0.006)、被动吸烟（OR=1.55,P=0.04）、不同烟种（OR=1.31,P=0.005)和饮酒（OR=1.81,P=0.008)等变量在编译学上与肺结核发病有明显的相关性，进一步多元回归分析则显示，上述各单因素与肺结核发病之间无相关性，只有当吸烟者同时又是饮酒者时，两者的交隔绝作用方显示出与肺结核有密切关系（OR=7.729,P=0.013,95%C.I.=1.5215-39.2634)，并同时存在明显的剂量-效应关系。即病例组每吸一支烟，同时又饮酒时发生肺结核的危险性较对照1.73倍（P=0。0002，95%C.L.I.=1.300-2.3028)。结论 单纯吸烟或饮酒与肺结核的发病无关，而吸烟同时又饮酒时则是成都地区成人患肺结核的危险因素。

Smoking and alcohol consumption as risk factors of pulmonary tuberculosis in Chengdu: a matched case-control study]

OBJECTIVE: The aim of this study was to assess the relationship between personal behaviors (smoking and alcohol consumption) and contracting pulmonary tuberculosis. METHODS: 346 persons (173 cases and 173 controls) were selected from 12 communities of Chengdu area, all the cases were active TB patients (by WHO criteria) from March 1996 to March 1997. Controls were matched for age, sex and living district. Subjects were interviewed face to face by trained interviewers using questionnaires. RESULTS: The results of univariate analysis showed that active smoking (OR = 2.12, P = 0.006), passive smoking (OR = 1.55, P = 0.04), type of cigarettes (OR = 1.31, P = 0.005) and alcohol consumption (OR = 1.81, P = 0.008) were significantly associated with TB. Yet, multivariate logistic regression analysis did not find smoking or alcohol consumption being in independent association with TB, but it showed that persons who were smokers with the addition of alcohol consumption had a higher risk to contract TB (OR = 7.729, 95% C.I. = 1.5215-39.2634). Significant association was noted in the dose-response analysis (OR = 1.73, 95% C.I. = 1.300-2.3028). CONCLUSION: These data indicate that smoking alone or sole alcohol consumption bears no relationship with TB, but smoking plus alcohol abuse is probably a risk factor for pulmonary tuberculosis in Chengdu, and in this connection, a proposal of prospective study to further demonstrate this risk factor is warranted.