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中国防痨杂志 ›› 2025, Vol. 47 ›› Issue (12): 1583-1589.doi: 10.19982/j.issn.1000-6621.20250249

• 论著 • 上一篇    下一篇

广州市海珠区65岁及以上老年人结核分枝杆菌潜伏感染状况及影响因素分析

蔡晓婷, 苏碧慧, 何立乾, 邓虹, 伍小英()   

  1. 广州市胸科医院(广州市结核病防治所)二分所管治科,广州 510095
  • 收稿日期:2025-06-11 出版日期:2025-12-10 发布日期:2025-11-28
  • 通信作者: 伍小英,Email:525291832@qq.com
  • 基金资助:
    广州市科技计划项目(2024A03J0588);广州市卫生健康科技项目(20251A011044)

Analysis of latent tuberculosis infection status and influencing factors among elderly aged 65 and above in Haizhu District, Guangzhou City

Cai Xiaoting, Su Bihui, He Liqian, Deng Hong, Wu Xiaoying()   

  1. Department of Governance, the Second Division of Institute, Guangzhou Chest Hospital (Guangzhou Tuberculosis Control Institute), Guangzhou 510095, China
  • Received:2025-06-11 Online:2025-12-10 Published:2025-11-28
  • Contact: Wu Xiaoying, Email: 525291832@qq.com
  • Supported by:
    Guangzhou Science and Technology Plan Project(2024A03J0588);Guangzhou Health Science and Technology Project(20251A011044)

摘要:

目的: 分析广州市海珠区65岁及以上老年人结核分枝杆菌潜伏感染(latent tuberculosis infection,LTBI)状况及影响因素,为老年肺结核精准防控提供科学依据。方法: 采用前瞻性研究和分层随机抽样方法,于2024年1—12月在广州市海珠区18个街道的社区体检现场设置宣传点,按照各街道≥65岁常住居民人口比例分配的入组样本量在各宣传点现场邀请符合入组标准且自愿参与γ-干扰素释放试验(interferon-gamma release assay,IGRA)的老年人现场完成信息登记及血样采集,再将血液样本及时送至广州市胸科医院检验科进行IGRA检测。其他临床资料来源于老年人健康管理记录,包括居民健康体检报告、人口学特征、血常规及肝肾功能等信息。采用单因素和多因素logistic回归模型分析与发生LTBI相关的影响因素。结果: 海珠区共纳入符合入组标准的1987名≥65岁老年人,检出LTBI的感染率为38.70%(769/1987)。多因素logistic回归分析显示,当前吸烟者检出LTBI的可能性是从不吸烟者的1.485倍(OR=1.485;95%CI:1.002~2.201),空腹血糖每升高1mmol/L发生LTBI的风险升高5.5%(OR=1.055;95%CI:1.002~1.110),素食为主者检出LTBI的可能性是荤素均衡者的10.871倍(OR=10.871;95%CI:1.294~91.331);而血尿素氮每升高1个单位,发生LTBI的风险可降低5.8%(OR=0.942;95%CI:0.892~0.995)。结论: 广州市海珠区≥65岁老年人群LTBI感染率较高,需重点关注吸烟、空腹血糖异常、营养不良等高危人群,建议实施戒烟干预、血糖监测及个性化营养支持等综合防控策略。

关键词: 分枝杆菌,结核, 感染, 老年人, 因素分析,统计学

Abstract:

Objective: To analyze the status and influencing factors of latent tuberculosis infection (LTBI) among the elderly aged 65 and above in Haizhu District, Guangzhou City, and to provide a scientific basis for precise prevention and control of pulmonary tuberculosis in the elderly. Methods: A prospective study and stratified random sampling method were adopted. From January to December 2024, publicity points were set up at community health checkup sites in 18 streets of Haizhu District, Guangzhou City. According to the proportion of permanent residents aged 65 and above in each street, the sample size for inclusion was allocated. At each publicity point, elderly people who met the inclusion criteria and were willing to participate in the interferon-gamma release assay (IGRA) were invited on-site to complete information registration and blood sample collection. The blood samples were then promptly sent to the Laboratory Department of Guangzhou Chest Hospital for IGRA testing. Other clinical data were obtained from the health management records of the elderly, including health examination reports, demographic characteristics, blood routine, and liver and kidney function information. Univariate and multivariate logistic regression models were used to analyze the influencing factors related to the occurrence of LTBI. Results: A total of 1987 elderly people aged 65 and above who met the inclusion criteria in Haizhu District were enrolled in the study, and the infection rate of LTBI was 38.70% (769/1987). Multivariate logistic regression analysis showed that current smokers were 1.485 times more likely to be diagnosed with LTBI than non-smokers (OR=1.485, 95%CI: 1.002-2.201), and for each 1 mmol/L increase in fasting blood glucose, the risk of LTBI increased by 5.5% (OR=1.055, 95%CI:1.002-1.110). Those who mainly followed a vegetarian diet were 10.871 times more likely to be diagnosed with LTBI than those with a balanced diet (OR=10.871, 95%CI: 1.294-91.331). On the other hand, for each 1-unit increase in blood urea nitrogen, the risk of LTBI decreased by 5.8% (OR=0.942, 95%CI: 0.892-0.995). Conclusion: The infection rate of LTBI among the elderly aged 65 and above in Haizhu District, Guangzhou City is relatively high. Special attention should be paid to high-risk groups such as smokers, those with abnormal fasting blood glucose, and those with malnutrition. It is recommended to implement comprehensive prevention and control strategies including smoking cessation intervention, blood glucose monitoring, and personalized nutritional support.

Key words: Mycobacterium tuberculosis, Infection, Aged, Factor analysis, statistics

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