关键词: 结核,肺, 危险因素, 病例对照研究, 广州市

Abstract: Objective  To explore the risk factors affecting the TB incidence in Guangzhou, and provide scientific basis for pulmonary tuberculosis(PTB) prevention.  Methods  This is a 1：1 matched case-control study. Two hundreds and fifty smear positive tuberculosis patients in case group and the same number of people selected from household close contacts of smear positive in control group were investigated by unified self-designed questionnaire. A total of 25 indicators were surveyed including level of education, occupation, personal monthly income, the family economic responsibility, family economic status, smoking, excessive alcohol consumption, exercise, marriage, drug abuse, history of diabetes, the housing area, room ventilation, darkness and dampness, the surrounding environmental quality and 9 psychological stress indicators. The psychological stress was investigated by Yang Desen life Event scale (LES), Jiang Qianjin Trait Coping Style Questionnaire（TCSQ），Xiao Shuiyuan social support rating scale（SSRS）. Measured by the pre-survey, the Cronbach’s coefficient of the questionnaire was 0.83. Two hundred and sixty-eight pieces of questionnaire were issued for PTB patients, and 250 valid were returned with the effective response rate of 93.3%. All these 250 patients were enrolled in the case group. 1206 pieces of questionnaire were issued for household close contacts, and 1143 valid were returned with the effective response rate of 94.8%. Among these 1143 household contacts, 250 controls were selected according to 1：1 match with cases. The matching principle is same gender, and age gap less than 3 years old. The univariate analysis is made to screen the risk factors that may affect the TB incidence, and then the multivariate conditional logistic regression model is made for analysis. Wald χ², P values, OR values and their 95% CI is calculated for each indicator. P value ≤ 0.10 is considered statistically significant.  Results  A total of fifteen indicators are statistically significant in univariate analysis, nine enter into the multivariate analysis. Among which, six are risk factors of TB incidence. They are personal monthly income (three levels, <1000 yuan/month, 1000— yuan/month, ≥ 3000/month, Wald χ² value is 13.492,1.379, P=0.000,0.240), bearing the primary responsibility of family income  (Wald χ² =17.820, P=0.000), smoking (Wald χ² =9.489, P=0.002), excessive alcohol consumption (Wald χ²=4.141, P=0.042); the total amount of stimulation of the life events (Wald χ² =6.995, P=0.008), negative coping (Wald χ² =14.806, P=0.000. Their OR value (95% CI values) are 4.178 (1.948—8.961), 1.475 (0.771—2.821), 6.457 (2.716—15.352), 2.960 (1.484—5.905), 5.048 (1.062—24.004), 1.030 (1.008—1.052), 1.131 (1.062—1.204) respectively. Conclusion  Low personal incomes, bearing the primary responsibility for the family income, smoking, excessive alcohol consumption, life event stimulation and negative response are the risk factors of PTB incidence in Guangzhou.

Key words: Tuberculosis,pulmonary, Risk factors, Casecontrol studies, Guangzhou city