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中国防痨杂志 ›› 2012, Vol. 34 ›› Issue (11): 731-735.

• 论著 • 上一篇    下一篇

湖南省湘潭县农村地区肺结核发病情况及影响因素分析

张传芳 张贻瑞 陈天柱 龚德华 赵佩安 曾正标 唐益 白丽琼   

  1. 410013 长沙，湖南省结核病防治所结核病控制科（张传芳、张贻瑞、龚德华、唐益、白丽琼）；湖南省湘潭县疾病预防控制中心（陈天柱、赵佩安、曾正标）
  • 收稿日期:2012-05-11 出版日期:2012-11-10 发布日期:2013-02-06
  • 通信作者: 白丽琼 E-mail:liqiong99@126.com
  • 基金资助:

    “十一五”国家科技重大专项（2008ZX10003-008）

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

ZHANG Chuan-fang, ZHANG Yi-rui, CHEN Tian-zhu, GONG De-hua, ZHAO Pei-an, ZENG Zheng-biao, TANG Yi, BAI Li-qiong   

  1. Department of Tuberculosis Control, Hunan Institute of Tuberculosis Control, Changsha 410013,China
  • Received:2012-05-11 Online:2012-11-10 Published:2013-02-06
  • Contact: BAI Li-qiong E-mail:liqiong99@126.com

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摘要： 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。

关键词: 结核, 肺/流行病学, 发病率, 危险因素, 湖南省

Abstract: 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.

Key words: Tuberculosis, pulmonary/epidemiology, Incidence, Risk factors, Hunan province

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