摘要：
目的 探讨影响青壮年肺结核发病的危险因素,为肺结核的防治提供更好的科学依据.方法 选取2015年1月至12月奉化市新发肺结核患者238例,按照1:1配比病例对照研究,采用自行设计的调查问卷进行调查,研究因素包括22个变量.对研究因素首先采用单因素x2检验分析,而后对进入多因素模型的14个变量采用多因素条件Logistic回归分析.结果 单因素分析结果显示,婚姻、文化程度、个人月收入、承担家庭责任、居室类型、工作环境、劳累程度、吸烟、饮酒、BMI、睡眠时间、流动人口、肺结核接触史、肺结核疾病认知情况、现患有其他疾病、发病前遭遇生活负性事件、卡介苗接种等17个变量与肺结核发病相关,差异有统计学意义(P＜0.05或P＜0.01).多因素分析结果显示,已婚、文化程度高、个人月收入高、接种卡介苗可降低肺结核发病危险性,OR值分别为0.825、0.685、0.446、0.523;居室类型差、工作环境差、劳累程度大、承担家庭主要责任、吸烟、BMI＜18.5、睡眠时间＜8h、流动人口、有肺结核接触史、发病前遭遇生活负性事件等是肺结核发病的危险因素,OR值分别为6.043、1.882、2.058、2.873、2.981、7.472、2.820、2.978、2.113、1.035.结论 居室类型差、工作环境差、劳累程度大、承担家庭主要责任、吸烟、BMI＜18.5、睡眠时间＜8h、流动人口、有肺结核接触史、发病前遭遇生活负性事件等是肺结核发病的主要危险因素,而已婚、文化程度高、个人月收入高、接种卡介苗是肺结核发病的保护性因素.%Objective To explore the risk factors affecting the TB incidence of young adults in Fenghua City, and provide better scientific basis for the prevention of pulmonary tuberculosis.Methods Totally 238 cases of new pulmonary TB patients were selected in Fenghua City from Jan 2015 to Dec 2015, a l:1 matched case-control study was used.All of people were investigated by unified self-designed questionnaire, which including 22 research factors.First, the single factor chi-square test was used, there were 14 factors in the multiple condition logistic regression model.Then the multivariate conditional logistic regression model was used for analysis, calculate OR values.P values less than 0.05 were considered as statistically significant.Results Univariate analysis results showed that 17 factors were statistically related (P＜0.05 or P＜0.01) to pulmonary tuberculosis.They were marriage relationship, education level, personal monthly income, bearing responsibility of family, room type, working conditions, exertion degree, smoking, alcohol drinking, BMI, hours of sleep, migrant workers, TB contact history, cognition level of TB, suffering other disease at present stage, encountered negative life events before attack, BCG vaccination.Multivariable conditional logistic regression analysis showed that married, high education level, high personal monthly income and BCG vaccination could reduce the risk of pulmonary tuberculosis.The OR values were 0.825, 0.685, 0.446 and 0.523.People who had bad room type, bad working conditions, work fatigue, beating the primary responsibility of family, smoking, BMI＜18.5, fewer than 8 hours of sleep per night, migrant workers, TB contact history and encountered negative life events before attack were all susceptible to pulmonary tuberculosis.The OR values were 6.043, 1.882, 2.058, 2.873, 2.981, 7.472, 2.820, 2.978, 2.113 and 1.035.Conclusions Bad room type, bad working conditions, work fatigue, bearing the primary responsibility of family, smoking, BMI＜18.5,fewer than 8 hours of sleep per night, migrant workers, TB contact history and encountered negative life events before attack are the main risk factors for Pulmonary tuberculosis among local young adults, while married, high education level, high personal monthly income and BCG vaccination are the protective factors for reducing the incidence.
