目的 探讨社区采用不同方式发现肺结核患者的临床特征.方法 对2019年1月1日-2019年12月31日在广州市越秀区登记肺结核患者临床特征进行分析.根据就诊方式分为主动发现组和被动发现组.结果 主动发现组301例(47.55％),被动发现组332例(52.45％).主动发现组患者年龄22.5～53.0岁,中位数34.0岁;被动发现组患者年龄28.0～57.0岁,中位数44.0岁,主动发现组患者平均年龄低于被动发现组年龄,差异有统计学意义(U=39 754,P=0.000).病原学痰涂片抗酸杆菌阳性率方面,主动发现组患者(19.46％)低于被动发现组(43.60％),差异有统计学意义(x2=41.721,P=0.000).影像学上,肺部病灶范围≥3个肺野,主动发现组98例(32.56％)低于被动发现组168例(50.61％),两组患者病灶范围差异有统计学意义(x2=22.467,P=0.000).主动发现组肺部有空洞者(21.60％)低于被动发现组(34.04％),差异有统计学意义(x2=12.090,P=0.001);在既往治疗史上,肺结核复治主动发现组7例(2.33％)低于被动发现组25例(7.53％),两组患者肺结核患者登记差异有统计学意义(x2=8.909,P=0.003).结论 主动发现肺结核患者痰涂片阳性率低,病灶范围较小,病情较轻.采用主动发现方式,可对肺结核患者早期诊断和早期治疗,有助于提高肺结核的治愈率.

目的 分析无症状肺结核病人的临床特点,为肺结核发现方式采取策略提供依据.方法 633例确诊为肺结核的病人,分为结核症状组和无症状组,对这两组病例的特征,包括年龄、性别、职业、病灶范围、病灶是否含有空洞、确诊时间、诊断类别、治疗转归等因素进行比较,分析其特点及差异.结果 症状组有356例,占56.2％,无症状组有277例,占43.8％.症状组与无症状组在年龄≥60岁、职业为家政家务待业、病灶范围≥2个肺野、病灶含有空洞、确诊时间≥14天、诊断为初治病例、涂片阳性、确诊病例与临床诊断病例等方面比较两者差异有统计学意义(P<0.05),而在性别、治疗转归方面比较,差异无统计学意义(P>0.05).结论 在结核病疫情还相当严峻的今天,对无症状病人亦应高度警惕肺结核病,应采取在高危人群中筛查结核的主动发现病人的策略.

目的:调查2018—2021年广州市越秀区学校肺结核患者密切接触者的筛查情况，为开展学校结核病防控工作提供依据。方法:按照《关于印发学校结核病防控工作规范（2017版）的通知》的要求，对学校密切接触者进行结核可疑症状、结核菌素试验和/或胸部X线等检查。结果:2018—2021年广州市越秀区学校共发现学生肺结核患者161例（2018年42例，2019年50例，2020年38例，2021年31例）。大学生73例（45.34%），中专及高中学生74例（45.96%），初中生8例（4.97%），托幼机构6例（3.73%）。其中男性患者83例（51.55%），女性患者78例（48.45%）。发现的161例学生肺结核患者中，病原学阳性患者48例（29.81%），病原学阴性患者113例（70.17%）。通过对161例确诊患者进行流行病学调查，共筛查密切接触者7 698例，其中7 667例密切接触者结核菌素皮肤试验（PPD试验）结果中，强阳性326例；有6 193例进行胸片筛查，胸片表现为异常者38例，在7 698例密接者中共发现活动性肺结核患者8例。结论:通过对学校肺结核患者密切接触者的筛查，可及早发现结核患者并杜绝传染源，从而防止学校结核疫情的发生。

目的 探讨2型糖尿病(type 2 diabetes mellitus,T2DM)并发肺结核(pulmonary tuberculosis,PTB)患者继发肺部感染时外周血中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)变化情况.方法 采用回顾性研究方法,收集2013年1月至2018年1月首次在广州市胸科医院结核科住院治疗的951例T2DM并发初治菌阳PTB患者的临床资料,包括年龄、性别、临床症状、糖尿病史、糖化血红蛋白A1c(glycosylated hemoglobin A1c,HbA1c)、外周血白细胞(WBC)计数、中性粒细胞计数、淋巴细胞计数及抗感染治疗效果.研究对象根据入院治疗时是否继发肺部感染,分为感染组及非感染组;根据入院检查时,外周血淋巴细胞计数≥0.8×109/L与否,分为淋巴细胞计数正常组和低下组.分析NLR与研究对象继发肺部感染的相关性.结果 研究对象中继发肺部感染者有524例,占55.10％;感染组病灶范围以5～6个肺野为主(60.5％,317/524),明显高于非感染组(41.0％,175/427),差异有统计学意义(x2=42.587,P=0.000).感染组NLR水平[中位数(四分位数)]为6.79(5.10,9.70),明显高于非感染组[中位数(四分位数)为3.01(2.27,3.55)],差异有统计学意义(U=16 545.00,P=0.000).感染组和非感染组外周血淋巴细胞计数低下者NLR水平[中位数(四分位数)分别为:12.09(8.67,16.05)和4.26(3.71,6.39)]均高于外周血淋巴细胞计数正常者[中位数(四分位数)分别为:5.90(4.71,7.55)和2.97(2.25,3.80)];外周血淋巴细胞计数低下者中性粒细胞计数[中位数(四分位数)分别为:6.42(5.01,9.07)×109/L和3.13(1.88,3.51)×109/L]均低于外周血淋巴细胞计数正常者[中位数(四分位数)分别为:7.90(6.72,9.27)×109/L 和4.57(3.70,5.40)×109/L],差异均有统计学意义(U值分别为:5964.00、1695.50、18 697.00、1257.00,P值均为0.000).结论T2DM并发PTB继发肺部感染患者NLR水平明显升高,且外周血淋巴细胞计数低下者容易继发肺部感染.

Objective:To explore the transmission of tuberculosis caused by treatment delay, cavitation, lesion range, bacterial load, and other factors in school contacts with pathogen positive cases of pulmonary tuberculosis.Methods:The clinical diagnosis and treatment data of 79 patients with pathogen-positive pulmonary tuberculosis from the universities and middle schools at Yuexiu District, Guangzhou, including 45 males and 24 females who were 12-25 years old and hereinafter referred to as "clue cases", were retrospectively analyzed. And the results of tuberculin skin test (TST) of their 4 934 contacts at their campuses or schoolyard, including 1 867 males and 3 067 females who were 12-65 years old, were analyzed.Results:The clue cases came from 33 universities and middle schools. Thirteen patients with tuberculosis were found in the close contacts of 12 clue cases at 8 universities and middle schools, hereinafter referred to as "contact cases"; 7 clue cases and 2 contact cases presented treatment delay of 7-81 days and 16-76 days, respectively. There were no statistical differences in delay of seeking medical attention, diagnosis delay, cavitation, lesion range, and pathogenic testing (including smears and cultures) between the healthy and sick cases of the contacts. The positive rate and strong positive rate of TST were 68.36% (1 934/2 829) and 21.81% (617/2 829) in the clue cases' close contacts, and were 47.84% (1 007/2 105) and 3.42% (72/2 105) in the clue cases' non-close contacts ( P＜0.001). Conclusion:It is essential that screening of close contacts should be strengthened in school tuberculosis control for the early detection of tuberculosis cases.

目的:分析广州市越秀区1032例肺结核患者耐药情况.方法:收集2011年1月1日至2015年12月31日结核病信息管理专报系统中可疑耐多药患者病案信息及普通病案信息,共1032例.对其进行酸性改良罗氏培养基培养分枝杆菌,鉴定菌种,最终采用BACTECMGIT960system快速药敏实验,对异烟肼(H)、利福平(R)、链霉素(SM)、乙胺丁醇(E)进行药敏实验.分析患者耐药情况.结果:1032名涂阳患者培养阳性690例,培阴342例,涂阳陪阴率为33.14％.涂阳培阳690例肺结核患者中:耐多药患者101例,广泛耐药患者86例,耐H不耐R98例,耐R不耐H 22例,不耐药383例,总耐药率为44.49％.结论:广州市越秀区肺结核患者耐药率较高,应进一步加强监测与管理工作.

目的 了解广州市肺结核患者在门诊确诊前及治疗过程的直接医疗费用及构成,为完善结核病医疗保障政策,控制医疗费用,减轻患者医疗负担提供循证依据.方法 采用前瞻性追踪研究方法,对2015年1月至2018年12月在广州市各区结核病防治机构的门诊中确诊及治疗的肺结核患者进行追踪研究.通过文献研究及专家咨询法设计《广州市肺结核疾病负担研究调查表》,包括《基本情况调查表》、《医疗费用调查表》、《治疗情况调查表》三部分,由患者本人在各区结核病防治机构的门诊完成现场问卷调查,由各区结核病防治机构的医务人员开展追踪管理并根据患者诊治情况填写《医疗费用调查表》及《治疗情况调查表》,了解肺结核患者的社会经济情况、确诊前及治疗过程的各项直接医疗费用.用两独立样本Wilcoxon秩和检验方法比较不同类型肺结核患者门诊直接医疗费用及构成的差异.结果(1)共纳入肺结核患者950例,年龄(43.28±15.13)岁.男性占64.6％(614/950),女性占35.4％(336/950).初治病原学阳性肺结核患者占41.8％(397/950),初治病原学阴性肺结核患者占58.2％(553/950),复治病原学阳性肺结核患者占8.0％(76/950).(2)经追踪研究,肺结核治愈患者占96.8％(920/950),死亡占0.3％(3/950),失败占1.4％(13/950),失访占1.5％(14/950).(3)920例治愈肺结核患者的门诊直接医疗总费用为(5546.16±2758.72)元,其中检查费占49.06％,药费占47.70％.确诊前费用为(809.20±352.59)元,占总费用15.58％;治疗期间门诊费用为(4385.82±1787.97)元,占总费用84.42％.支付方式中自费占61.01％,医保支付占27.83％,政府减免费用占10.38％.(4)无论是门诊确诊前还是治疗期间直接医疗费用,均有复治者高于初治者,病原学阳性者高于病原学阴性者(P<0.05),本地户籍者与外地户籍者差异均无统计学意义(P>0.05).结论 广州市肺结核患者确诊前直接医疗费用较低,治疗期间直接医疗费用较高,医保及政府减免费用比例较低,建议结合患者实际治疗情况扩大政府减免项目范围,降低结核病患者医疗负担,遏制结核病危害.

目的 探讨应用奥马哈系统对肺结核患者实施护理的成效.方法 选择2016年11—12月在广州市胸科医院一分所就诊的肺结核患者137例为研究对象.以奥马哈系统为框架建立肺结核患者护理问题评估表,归纳患者的护理问题及干预措施,在患者服药7 d、服药1个月、服药3个月时评估和分析,从患者的认知、行为和状态的变化来动态评价护理结局改善成效.结果 心理社会领域中的社交和心理健康问题在认知、行为和状况方面评分逐步提高,差异具有统计学意义(P<0.05),生理领域中的认知和传染/感染情况的问题在认知、行为和状况方面评分有改善,差异具有统计学意义(P<0.05),健康相关领域中的健康照顾督导和遵从医嘱用药问题在认知和行为方面评分均提高,差异具有统计学意义(P<0.05),在环境领域中的住所环境问题在认知和行为方面评分逐步提高,差异具有统计学意义(P<0.05),但在状况方面评分较低,改善不明显,差异无统计学意义(P>0.05).结论 应用奥马哈系统可动态监测患者的护理结局,有效提高肺结核患者管治质量.

目的 了解结核专科门诊发现初治肺结核患者并发肺部其他感染现状,探讨肺结核并发肺部其他感染患者的临床特点.方法 回顾性分析2015年1月至2016年6月在广州市结核病防治所一分所就诊的、临床资料完整的初治菌阳肺结核患者506例,根据患者就诊时是否并发肺部其他感染,分为肺结核并发肺部其他感染组(简称“并发感染组”;共计200例)及肺结核未并发其他感染组(简称“对照组”;共计306例).506例患者中有98例为老年患者.应用SPSS 19.0软件进行统计学分析,计数资料采用x2检验,以P＜0.05为差异有统计学意义.结果 (1)并发感染组200例,占39.53％;在并发感染组中,老年患者比例(24.50％,49/200)明显高于对照组(16.01％,49/306)(x2=6.583,P=0.037),两组比较差异有统计学意义;(2)在并发感染组中,伴有咳嗽或咳痰症状者占83.00％(166/200),与对照组的76.47％(234/306)相似,两组比较差异无统计学意义(x2=3.510,P=0.319);(3)并发感染组肺部累及病灶＞3个肺野者占49.00％(98/200),明显高于对照组的31.70％(97/306),两组比较差异有统计学意义(x2=6.965,P=0.008);(4)并发感染组患者中,肺结核并发空洞者占42.50％ (85/200),明显高于对照组的26.80％(82/306),两组比较差异有统计学意义(x2=13.487,P=0.000).结论 结核专科门诊发现初治菌阳肺结核并发肺部其他感染患者中,老年患者并发肺部其他感染的比例较高,并发感染组患者肺部病灶累及范围较广泛,常伴有空洞形成.

Objective To explore the epidemiologic characteristics of tuberculosis in Yuexiu District of Guangzhou City from 2014 to 2015,to provide the scientific basic for TB control.Method Descriptive analysis was used to analyze the surveillance data of TB,rate analysis using Chi square test,αt=0.05.Results There were registered 3079 TB patients from 2014 to 2015,with 1395 smear-positive patients (45.31％) and 1684 smearnegative patients (54.69％).The rate of sputum smear was 100％,the rate of sputum culture was 90.45％.There were 2829 cases of new patients,accounting for 91.88％.The incidence of male TB was higher than that of female TB (140.27/100,000 vs.70.80/100,000),with statistically significant difference (x 2=332.774,P＜0.05).There were 1540 cases of young adults (aged from 15 to 44 years old),accounting for 50.02％.The incidence of TB in floating residents and local residents were 379.33/100,000 and 171.18/100,000 respectively,with statistically significant difference (x 2=465.906,P＜0.05).The drug resistance rate was 13.83％,the multi-drug resistance rate was 2.18％.Conclusions The vast majority of TB patients are new patients in Yuexiu District from 2014 to 2015,the coverage rate of sputum smear and the check quality are higher,the drug resistance rate and the multi-drug resistance rate are lower than the national average,which suggest that the control effect is better in recent years.The incidence of male TB is higher than that of female TB,the incidence of TB in floating residents is higher than that in local residents,the vast majority of TB patients are young adults,which suggest that we should strengthen TB prevention and control work in floating population and young adults.

Objective:To investigate the level of social support and coping styles of close contacts with tuberculo‐sis ,to analyze the correlation between them and compare the status quo of social support and coping style of close contacts with tuberculosis with different demographic characteristics .Methods:A total of 1 143 cases of close contacts with tuberculosis family were investigated by using trait coping style questionnaire and social sup‐port rating scale .Results:The positive coping style score of 1 .75% close contacts with tuberculosis was at a low level ,negative coping style score was at a high level in 4 .90% close contacts of tuberculosis ,98% close con‐tacts’ total score of subjective support and social support was at high level ,utilization of support of all close contacts of tuberculosis was at the low level .Objective support and utilization degree of support of close con‐tacts with tuberculosis were positively related to total score of social support and positive coping score ;subjec‐tive support ,objective support ,the utilization degree of support and the total score of social support were nega‐tively related to negative coping score .Multiple linear stepwise regression analysis showed that family condition was the main influencing factors .Conclusion:Coping style is closely related to social support .Few close contacts with tuberculosis use negative coping style ,and social support utilization degree is poor .the family of economic difficulties is the need to focus groups .

目的：探讨临床路径管理在肺结核可疑患者中的实施效果。方法采用前瞻性追踪研究方法，对广州市越秀区200例肺结核可疑患者进行追踪，将200例可疑患者分为观察组100例和对照组100例，观察组采用肺结核可疑患者临床路径管理，对照组采用传统方法诊疗，分别从临床指标和经济学指标方面对两组的效果进行评估。结果两组确诊疾病差异无统计学意义（P＞0.05）。观察组确诊时间较对照组明显缩短（P＜0.01）。观察组直接医疗总费用及检查费较对照组减少（P＜0.05），两组挂号费、药品费及其他治疗费用（雾化取痰费用）差异无统计学意义（P＞0.05）。观察组进入路径时间为（11.21±5.86）d，完成路径率为97.0％，退出路径率为3.0％，变异率为34.0％。结论实施临床路径管理有利于早期发现肺结核患者及减轻患者负担，对控制结核病疫情具有重要意义。

目的：了解肺结核患者的心理健康状况及影响因素，为加强肺结核患者的心理治疗及健康教育提供科学依据。方法采用问卷调查方法，随机抽取广州市越秀区肺结核患者300例，通过自行设计的基本情况调查表、《症状自评量表－SCL90》进行问卷调查。对肺结核患者SCL－90评定结果与国内常模（1388例）进行对比研究，分别对人际关系敏感及抑郁因子分的社会及临床影响因素进行单因素、logistic回归多因素分析。结果肺结核患者SCL－90的总分、总均分、强迫症状、焦虑、敌对、恐怖、偏执、精神病性因子分低于国内常模，差异有统计学意义（ P＜0.05）。人际关系敏感、抑郁因子分高于国内常模，差异有统计学意义（ P＜0.01）。采用多因素分析，人际关系敏感与痰结核菌检查结果有关（P＜0.05），抑郁与经济收入有关（P＜0.05）。结论肺结核患者确诊时心理健康状况以人际关系敏感和抑郁为主要表现，痰结核菌检查阳性、经济收入低是主要影响因素，医务人员在对肺结核患者进行躯体治疗时，应考虑患者心理健康因素的影响，及时给予针对性的心理治疗和健康教育；为切实减轻肺结核患者疾病负担，应进一步完善结核病医疗保障制度。

目的 了解广州市越秀区非结核分枝杆菌肺病特点和探讨影响其治愈的因素. 方法 对2008年1月-2011年12月在广州市结核病防治所确诊治疗的57例属于越秀区常住人口的非结核分枝杆菌肺病患者进行调查,调查内容包括年龄、性别、症状、X线表现、非结核分枝杆菌的类型、药物敏感性试验结果、治疗情况、既往病史以及在治疗期间的不良反应等.使用SPSS 13.0统计软件进行数据分析,以是否治愈进行分组,分别以性别、年龄、菌型、病变部位、病变范围、有(无)空洞、病变吸收情况、初(复)治、规则治疗、是否调整治疗方案、是否合并糖尿病、是否有不良反应和11种药敏试验的结果作为变量进行单因素分析;将调整治疗方案的五种组合形式进行比较. 结果 57例非结核分枝杆菌肺病的发病中位年龄40岁,男女比例(29/28)接近1:1.菌种以Ⅳ组为主,57.9％(33/57)为龟、脓肿分枝杆菌及龟脓肿复合群分枝杆菌.链霉素(S)、异烟肼(H)、利福平(R)、乙胺丁醇(E)、阿米卡星(Am)、克拉霉素(Clr)、左氧氟沙星(Lfx)、莫西沙星(Mfx)、对氨基水杨酸异烟肼(Pa)、利福布汀(Rfb)、丙硫异烟胺(Pto)的耐药率分别为86.8％ (46/53)、94.3％(50/53)、81.1％(43/53)、67.9％(36/53)、39.6％(21/53)、3.8％(2/53)、75.5％(40/53)、75.5％(40/53)、96.2％ (51/53)、71.7％(38/53)、75.5％(40/53).初治、规则治疗、调整治疗方案、RFP敏感是非结核分枝杆菌肺病治愈的有利因素(分别x2=7.695,P=0.006;x2=10.367,P=0.001;x2=10.262,P=0.001;x2 =6.723,P=0.010). 结论 广州市越秀区非结核分枝杆菌肺病菌种以Ⅳ组为主,耐药比较严重;第一次治疗、规则用药、依据药敏结果或结合既往治疗情况及时进行治疗方案调整、细菌对利福平敏感是非结核分枝杆菌肺病治愈的有利因素.

目的 了解初治菌阳肺结核患者一线抗结核药物治疗后不良反应的发生情况.方法 于2012年9月至2013年4月,选取广州市越秀区结核病防治所确诊并开始治疗的初治菌阳肺结核患者作为研究对象,共200例.对其在抗结核治疗中出现的不良反应进行分析,并根据是否出现药物不良反应分为不良反应组和无不良反应组,以及根据是否出现肝功异常分为肝功能异常组和肝功能正常组,分别对两组间各评价指标的差异进行分析.结果 200例患者中,发生不良反应者127例,发生率为63.5％,其中出现肝功能异常者50例,发生率25.0％.不良反应出现在治疗开始后前2个月的有111例.肝功能异常组乙型肝炎病毒表面抗原阳性率为18.0％(9/50),肝功能正常组为8.0％(12/150),差异有统计学意义(x2=3.99,P=0.046).所有患者中治愈173例,占86.5％.结论 抗结核药品不良反应发生率较高,但抗结核药物不良反应的发生对治疗方案、治疗效果影响较少.

Objective To compare the clinical features of smear-negative pulmonary tuberculosis (PT-) and the smear-positive pulmonary tuberculosis (PT+),and analyze the patient discovery way,to provide clues for early detection of smear-negative tuberculosis diagnosis.Methods We collected the data of the tuberculosis patients consecutively enrolled in our hospital from 2011-2013.We then divided the patients into two groups as PT-group and PT+ group based on the bacteriology examination results and performed comparative analysis between the two groups.Results PT-group had mild clinical symptoms and lower frequencies of cough,expectoration and fever while compared to PT+ group.Tuberculosis cavity also had statistical significant difference between PT-and PT+ groups.Furthermore,seeing a doctor in medical institutions and health examination were the main ways for tuberculosis patient discovery.Conclusion Smear-negative pulmonary tuberculosis was difficult for diagnosis because of their mild or even no clinical symptoms and without focus specificity,which could easily lead to misdiagnosis and missed diagnosis.Non-tuberculosis medical institutions should pay more attention and people' s annual routine health examination should be recommended for smear-positive pulmonary tuberculosis early detection.

ObjectiveThere is a high burden of both diabetes (DM) and tuberculosis (TB) in China. We evaluated the association between DM and the pattern of disease, 2-month sputum smear conversion and treatment outcomes of patients with TB in Guangzhou, China.MethodAll patients registered with TB from September 2011 to June 2012 were screened for DM and assessed for treatment outcomes in relation to presence or absence of DM and quality of DM control using patient registers, treatment cards and electronic record systems.ResultsThere were 1589 patients with TB of whom 189 (12%) had DM. Among those with DM, there was a significantly higher proportion of men, persons aged 35years and older and persons with smear-positive pulmonary tuberculosis (PTB) (P<0.01). In patients with DM and new smear-positive PTB, there was a higher proportion who had positive sputum smears at 2months (21.7% vs. 5.6%, RR 3.85, 95%CI 2.24-6.63), who were lost-to-follow-up (5.2% vs. 1.7%, RR 3.23, 95%CI 1.08-9.63) and who failed treatment (10.3% vs. 2.3%, RR 4.46, 95%CI 1.96-10.18) compared with patients who had no DM. There was no significant association between these adverse outcomes and DM control as measured by 2 and 6-month fasting blood glucose.ConclusionDiabetes mellitus in new smear-positive patients with PTB was associated with failure to sputum smear convert at 2months and adverse treatment outcomes of loss-to-follow-up and failure. Further research is needed to understand the reasons for these findings and to determine whether the current length of treatment of 6months is adequate.

目的:探讨男性人群肺结核病发病的相关因素.方法:采用1:1配比病例对照研究,166例男性初治涂阳肺结核病患者作为病例组,每个病例选取1名与患者同性别、年龄相近(≤3岁)的涂阳病例密切接触者(排除结核病)作为对照.由经培训的调查人员对调查对象进行问卷调查.将所获得的数据双录入,数据采用SPSS 13.0统计软件进行处理,首先采用配对x2检验、配对t检验进行单因素分析,对单因素分析中有意义的变量再进行多因素条件Logistic回归分析.结果:单因素分析筛选出13个变量与男性肺结核发病有关联,经多因素分析得出9个变量与男性肺结核发病有关联.其中低收入、承担家庭经济主要责任、吸烟、过量饮酒、生活事件总刺激量、消极应对是肺结核危险因素,其比值比(OR)和95%可信区间(95%CI)分别为4.506(1.949～10.415)、21.449(4.693～98.030)、2.553(1.223～5.331)、4.633(0.958～22.413)、1.023(0.996～1.052)、1.115(1.031～1.205),而居室通风、婚姻和客观支持是肺结核保护因素,其OR和95%CI分别为0.062(0.017～0.233)、0.157(0.065～0.380)、0.892(0.786～1.012).结论:个人低收入、在家庭经济中承担主要责任、吸烟、过量饮酒、生活事件刺激量大和消极应对是男性肺结核发病的危险因素,而家居通风、婚姻和客观支持可降低男性发生肺结核的风险.

Objective To explore the risk factors of pulmonary tuberculosis(TB) among young adults of 25-54 years of age.Methods A total of 150 new smear-positive pulmonary TB patients aged 25-54 years in Guangzhou were recruited as cases.The same amount of healthy people from family members with close contact with the patients was recruited as controls and paired with the cases according to the same gender and similar age(age gap,no more than 3 years).Interview was carried out with a uniform questionnaire.Variables of statistical significance screened from 24 variables by the univariate conditional Logistic regression analysis were further subjected to multivariate conditional Logistic regression analysis.Results The univariate analysis showed that 14 variables were associated with TB prevalence,among which 9 variables,that is,low income,bearing the main responsibility for household economy,smoking,drinking,marriage,crowded housing,dark room,the amount of stimulation by life events and negative response,were introduced into the model by multivariate analysis.Their ORs(95.0% CI) were 6.444(2.467～16.834),3.083(1.026～9.260),1.383(0.961～1.988),2.161(1.231～3.794),0.038(0.008～0.177),28.505(1.263～643.123),4.792(1.793～12.808),1.031(1.006～1.057) and 1.087(1.000～1.181),respectively.Conclusions Low income,bearing the main responsibility for the family economy,smoking,drinking,crowded housing,dark room,large amount of life event stimulation and negative response are the risk factors of pulmonary tuberculosis in young adults,while marriage is a protective factor.

Objective To explore the nonbiologic risk factors of pulmonary tuberculosis(TB) and effective measures to control the incidence of tuberculosis in female.Methods With convenience sampling,84 cases of female patients with pulmonary tuberculosis and 84 cases of female who had close contact with smear positive pulmonary tuberculosis patients in family life between July 1st,2011 to June 30th,2011 were selected and consisted of experiment group and control group respectively then 1∶1 case-control matched study on two groups was conducted with a unified questionnaire survey.The matching conditions were as follows: they were with the same gender and their age difference was less than 3 years.The questionnaires included general demographic characteristics questionnaire,the Life Event Scale,the Trait Coping Style Questionnaire and the Social Support Scale.Single-factor analysis and multivariate conditional logistic regression was applied.Results Single-factor analysis showed that 13 variables were associated with TB prevalence(P0.10).Multivariate analysis revealed that low education level,undertaker of household economy,marriage,dark living environment,negative life events,negative coping style,subjective support were independent influence factors of TB(P0.05).Conclusion Great attention should be paid to female populations with low education level.The stability of marriage,air circulation and plenty of sunshine,less emotional stress,positive coping and social support may reduce the incidence of female pulmonary tuberculosis.