摘要
目的探讨吸烟与结核病发病风险和戒烟后复吸的危险因素。方法对613例肺结核病例和1 226例健康对照采用结构化问卷调查表进行调查。吸烟与结核病患病风险的关联采用Logistic回归分析,并用OR及其95%CI表示。戒烟者中复吸的危险因素采用Cox回归模型进行分析,并用风险比(hazard ratio,HR)及其95%CI表示。Kaplan-Meier生存曲线用于比较不同治疗史和不同教育背景的病人戒烟后复吸风险的差异,并采用Log-rank法进行检验。结果病例组中有吸烟史者(54.6%)高于对照组(45.1%),调整OR=1.93(95%CI:1.51～2.48)。尽管54.9%的结核病人在获知其结核病诊断后停止吸烟,但仍有18.4%的戒烟者在随访期内复吸,复吸高发于戒烟后6～9个月(6%)和12～15个月(11%)。与受教育程度高和有过结核病治疗史的患者比较,受教育程度低和初治患者戒烟后复吸的风险增加,调整HR分别为3.48(95%CI:1.28～9.47)和4.30(95%CI:1.01～18.30)。结论吸烟是中国人群结核病预防和控制工作的一个重要因素,应当将控烟干预指导纳入现行的直接督导短程化疗(directly observed therapy shortcourse,DOTS)策略中去。
Objective To analyze the relationship between cigarette smoking behavior and the risk of tuberculosis（TB） as well as risk factors for smoking relapse after cessation.Methods A total of 613 TB patients frequency matched with 1 226 controls were interviewed by using structured questionnaires.The association between cigarette smoking and the risk of TB was estimated by computing odds ratio（OR） and 95% confidence intervals（CI） using the Logistic regression analysis.Multivariate Cox proportional hazards model was applied to calculate the hazard ratio（HR） and 95% CI in analyzing factors for smoking relapse among patients who ceased smoking after diagnosis.The Kaplan-Meier estimate was computed to plot the ability of smoking free after smoking cessation,with the Log-rank test being used to compare the difference between groups.Results The proportion of cigarette smoking in TB cases（54.6%） was significantly higher than that in controls（45.1%） with the adjusted OR（95% CI） of 1.93（1.51-2.48）.Though 54.9% smokers stopped smoking after being diagnosed with TB,18.4% relapsed during the follow-up period.The risk of relapse was higher during 6-9 months and 12-15 months after smoking cessation.Compared with highly educated and previously treated patients,less educated or newly treated patients had higher risks for smoking relapse,with the HR（95% CI） at 3.48（1.28-9.47） and 4.30（1.01-18.30）,respectively.Conclusions Cigarette smoking was proved to be associated with TB in the Chinese population.Interventions of smoking cessation are recommended to be included in the current directly observed therapy shortcourse（DOTS） practice.
出处
《中华疾病控制杂志》
CAS
北大核心
2012年第7期556-559,共4页
Chinese Journal of Disease Control & Prevention
基金
国家自然科学基金(81072351)
江苏省科技支撑计划(BE2011841)
江苏高校优势学科建设工程
关键词
结核
肺
吸烟
危险因素
Tuberculosis,pulmonary
Smoking
Risk factors
