2019―2021年泰州市中学新生结核潜伏感染现况及影响因素

王文瑾; 刘巧; 缪昌东; 陈静娟; 王展; 竺丽梅; 陆伟

doi:10.16462/j.cnki.zhjbkz.2022.11.005

2019―2021年泰州市中学新生结核潜伏感染现况及影响因素

doi: 10.16462/j.cnki.zhjbkz.2022.11.005

王文瑾¹,
刘巧²,
缪昌东³,
陈静娟³,
王展¹,
竺丽梅²,
陆伟^{1, 2, ,}

1.
211166 南京，南京医科大学公共卫生学院流行病学系
2.
210009 南京，江苏省疾病预防控制中心慢性传染病防制所
3.
225300 泰州，泰州市疾病预防控制中心慢性传染病防制科

基金项目:

国家自然科学基金 82003516

江苏省卫生健康委科研项目 ZD2021052

江苏省卫生健康委科研项目 ZDA2020022

江苏省卫生健康委科研项目 M2020020

详细信息

通讯作者:
陆伟，E-mail: jsjkmck@163.com

中图分类号: R51;R181.3
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- 被引次数: 0
出版历程
- 收稿日期: 2022-03-06
- 修回日期: 2022-05-20
- 网络出版日期: 2022-12-21
- 刊出日期: 2022-11-10

Status and influencing factors of latent tuberculosis infection among middle school students in Taizhou from 2019 to 2021

1.
Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing 211166, China
2.
Institute of Chronic Infectious Diseases, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
3.
Department of Chronic Infectious Disease Control, Taizhou Center for Disease Control and Prevention, Taizhou 225300, China

Funds:

National Nature Science Foundation of China 82003516

Medical Scientific Research General Project of Jiangsu Health Commission ZD2021052

Medical Scientific Research General Project of Jiangsu Health Commission ZDA2020022

Medical Scientific Research General Project of Jiangsu Health Commission M2020020

More Information

Corresponding author: LU Wei, E-mail: jsjkmck@163.com

摘要

摘要: 目的描述江苏省泰州市2019―2021年中学新生的结核潜伏感染现况，分析中学新生结核潜伏感染影响因素，为学校肺结核防控工作提供参考依据。方法收集入学新生体检资料和结核菌素皮肤试验(tuberculin skin test, TST)结果，问卷收集与肺结核相关的个体特征，采用logistic回归分析模型分析潜伏感染相关影响因素。结果研究共纳入泰州市18所中学13~18岁中学新生23 910人，其结核潜伏感染率为5.675%。多因素结果显示，高中生(aOR=1.569, 95% CI: 1.083~2.273, P=0.017)、18.5 kg/m²≤BMI≤23.9 kg/m²(aOR=1.415, 95% CI: 1.196~1.674, P < 0.001)、BMI>23.9 kg/m²(aOR=1.643, 95% CI: 1.358~1.988, P < 0.001)、既往有结核病史(aOR=5.026, 95% CI: 2.264~11.155, P < 0.001)是结核潜伏感染的危险因素。结论增加户外运动锻炼时间，适当减压，提高机体免疫力，同时平衡膳食营养，以保持合适的BMI，是预防学生结核潜伏感染的有效途径。
- 肺结核 /
- 中学新生 /
- 潜伏感染 /
- 结核菌素皮肤试验
Abstract: Objective To describe the prevalence of latent tuberculosis infection and analyze the influencing factors of latent tuberculosis infection among middle school freshmen from 2019 to 2021 in Taizhou City, Jiangsu Province, and to provide a reference for tuberculosis prevention and control in school. Methods The physical examination data and tuberculin skin test (TST) results of freshmen were collected, and the risk factors related to latent tuberculosis infection were collected by questionnaire. Logistic regression analysis model was used to analyze the data. Results A total of 23 910 participants aged 13-18 years old were included. The overall latent tuberculosis infection rate of tuberculosis among middle school students in Taizhou was 5.675%. Multivariate analysis results showed that senior high school students (aOR=1.569, 95% CI: 1.083-2.273, P=0.017), 18.5 kg/m²≤BMI≤23.9 kg/m²(aOR=1.415, 95% CI: 1.196-1.674, P < 0.001), BMI>23.9 kg/m² (aOR=1.643, 95% CI: 1.358-1.988, P < 0.001), previous tuberculosis (aOR=5.026, 95% CI: 2.264-11.155, P < 0.001) were the risk factors of latent tuberculosis infection. Conclusions Effective ways to prevent latent tuberculosis infection in middle school students include increasing outdoor exercise time, reducing stress appropriately, improving body immunity, and balancing diet nutrition to maintain proper BMI.
- Pulmonary tuberculosis /
- Middle school freshmen /
- Latent infection /
- Tuberculin skin test

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图 1 研究对象纳入筛选流程

Figure 1. Flowchart of the inclusion and exclusion criteria of research participants

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表 1 中学新生入学结核潜伏感染筛查结果

Table 1. Latent tuberculosis infection results of middle school freshmen

组别	合计(N)	非结核潜伏感染		结核潜伏感染		χ²值	P值
组别	合计(N)	例数(n)	百分比(95% CI)值	例数(n)	百分比(95% CI)值	χ²值	P值
学校类型						14.734	0.001
初中	330	315	95.455%(93.207%~97.702%)	15	4.545%(2.298%~6.793%)
高中	18 398	17 296	94.010%(93.667%~94.353%)	1 102	5.990%(5.647%~6.333%)
初高中兼有	5 182	4 942	95.369%(94.796%~95.941%)	240	4.631%(4.059%~5.204%)
性别						3.355	0.067
男	12 303	11 572	94.058%(93.641%~94.476%)	731	5.942%(5.524%~6.359%)
女	11 607	10 981	94.607%(94.196%~95.018%)	626	5.393%(4.982%~5.804%)
年级						7.199	0.007
初中生	840	810	96.429%(95.174%~97.684%)	30	3.571%(2.316%~4.826%)
高中生	23 070	21 743	94.248%(93.947%~94.548%)	1 327	5.752%(5.452%~6.053%)
合计	23 910	22 553	94.325%(94.031%~94.618%)	1 357	5.675%(5.382%~5.969%)

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表 2 中学新生结核潜伏感染logistic回归模型分析[n(%)]

Table 2. Logistic regression analysis of latent tuberculosis infection among middle school freshmen [n(%)]

变量	合计(N)	TST阴性	TST阳性	单因素分析			多因素分析
变量	合计(N)	TST阴性	TST阳性	P值	cOR(95% CI)值		P值	aOR(95% CI)值
性别
男	12 303(51.455)	11 572(94.058)	731(5.942)		1.000			1.000
女	11 607(48.545)	10 981(94.607)	626(5.393)	0.067	0.902(0.809~1.007)		0.172	0.925(0.827~1.035)
民族
汉族	23 404(97.884)	22 072(94.309)	1 332(5.691)		1.000
少数民族	506(2.116)	481(95.059)	25(4.941)	0.471	0.861(0.574~1.292)
学校类型
初中	330(1.380)	315(95.455)	15(4.545)		1.000
高中	18 398(76.947)	17 296(94.010)	1 102(5.990)	0.274	1.338(0.794~2.254)
初高中兼有	5 182(21.673)	4 942(95.369)	240(4.631)	0.943	1.020(0.598~1.739)
年级
初中生	840(3.513)	810(96.429)	30(3.571)		1.000			1.000
高中生	23 070(96.487)	21 743(94.248)	1 327(5.752)	0.008	1.648(1.140~2.382)		0.017	1.569(1.083~2.273)
本地居住
常住人口	21 684(90.690)	20 452(94.318)	1 232(5.682)		1.000
流动人口	2 226(9.310)	2 101(94.385)	125(5.615)	0.898	0.988(0.817~1.194)
BMI (kg/m²)
< 18.5	4 161(17.403)	3 990(95.890)	171(4.110)		1.000			1.000
18.5~23.9	14 804(61.915)	13 952(94.245)	852(5.755)	< 0.001	1.425(1.205~1.685)		< 0.001	1.415(1.196~1.674)
＞23.9	4 945(20.682)	4 611(93.246)	334(6.754)	< 0.001	1.690(1.399~2.042)		< 0.001	1.643(1.358~1.988)
咳嗽
无	19 985(83.584)	18 836(94.251)	1 149(5.749)		1.000
有	3 925(16.416)	3 717(94.701)	208(5.299)	0.265	0.917(0.788~1.068)
咳痰
无	23 271(97.327)	21 949(94.319)	1 322(5.681)		1.000
有	639(2.673)	604(94.523)	35(5.477)	0.826	0.962(0.681~1.359)
胸痛
无	23 787(99.486)	22 436(94.320)	1 351(5.680)		1.000
有	123(0.514)	117(95.122)	6(4.878)	0.702	0.852(0.374~1.938)
呼吸困难
无	23 793(99.511)	22 442(94.322)	1 351(5.678)		1.000
有	117(0.489)	111(94.872)	6(5.128)	0.798	0.898(0.394~2.046)
结核病患者密切接触史
无	23 734(99.264)	22 390(94.337)	1 344(5.663)		1.000
有	176(0.736)	163(92.614)	13(7.386)	0.326	1.329(0.753~2.344)
既往结核病史
无	23 876(99.858)	22 527(94.350)	1 349(5.650)		1.000			1.000
有	34(0.142)	26(76.471)	8(23.529)	< 0.001	5.138(2.322~11.370)		< 0.001	5.026(2.264~11.155)
既往抗结核治疗史
无	23 876(99.858)	22 522(94.329)	1 354(5.671)		1.000
有	34(0.142)	31(91.176)	3(8.824)	0.432	1.610(0.492~5.272)
现患疾病
无	23 841(99.711)	22 488(94.325)	1 353(5.675)		1.000
有	69(0.289)	65(94.203)	4(5.797)	0.965	1.023(0.372~2.812)
传染病史
无	23 876(99.858)	22 522(94.329)	1 354(5.671)		1.000
有	34(0.142)	31(91.176)	3(8.824)	0.432	1.610(0.492~5.272)
家族遗传病
无	23 883(99.887)	22 528(94.327)	1 355(5.673)		1.000
有	27(0.113)	25(92.593)	2(7.407)	0.698	1.330(0.315~5.621)
手术外伤史
无	23 243(97.210)	21 920(94.308)	1 323(5.692)		1.000
有	667(2.790)	633(94.903)	34(5.097)	0.513	0.890(0.627~1.262)
既往病史
无	23 639(98.867)	22 303(94.348)	1 336(5.652)		1.000
有	271(1.133)	250(92.251)	21(7.749)	0.140	1.402(0.895~2.196)
学习强度(h/d)
8~12	12 334(51.585)	11 646(94.422)	688(5.578)		1.000
12~15	8 918(37.298)	8 389(94.068)	529(5.932)	0.273	1.067(0.950~1.200)
＞15	2 658(11.117)	2 518(94.733)	140(5.267)	0.524	0.941(0.781~1.134)
睡眠时间(h/d)
< 6	5 859(24.504)	5 551(94.743)	308(5.257)		1.000			1.000
6~8	17 194(71.912)	16 188(94.149)	1 006(5.851)	0.090	1.120(0.982~1.277)		0.091	1.126(0.981~1.291)
＞8	857(3.584)	814(94.982)	43(5.018)	0.769	0.952(0.686~1.321)		0.864	1.030(0.736~1.441)
在校上课时间(h/d)
< 8	1 619(6.771)	1 519(93.823)	100(6.177)		1.000
8~10	11 569(48.386)	10 911(94.312)	658(5.688)	0.429	0.916(0.737~1.138)
>10	10 722(44.843)	10 123(94.413)	599(5.587)	0.339	0.899(0.722~1.118)
是否住校
是	4 529(18.942)	4 267(94.215)	262(5.785)		1.000
否	19 381(81.058)	18 286(94.350)	1 095(5.650)	0.724	0.975(0.849~1.121)
户外活动时间(h/d)
< 1	9 473(39.619)	8 940(94.373)	533(5.627)		1.000		1.000
1~2	12 923(54.049)	12 166(94.142)	757(5.858)	0.463	1.044(0.931~1.170)	0.792	1.016(0.902~1.145)
＞2	1 514(6.332)	1 447(95.575)	67(4.425)	0.057	0.777(0.599~1.007)	0.050	0.767(0.589~1.001)
是否吸烟
是	187(0.782)	178(95.187)	9(4.813)		1.000
否	23 723(99.218)	22 375(94.318)	1 348(5.682)	0.609	1.192(0.609~2.333)
同住的人中是否有人吸烟
是	4 649(19.444)	4 387(94.364)	262(5.636)		1.000
否	19 261(80.556)	18 166(94.315)	1 095(5.685)	0.896	1.009(0.879~1.160)
是否饮酒
是	313(1.309)	302(96.486)	11(3.514)		1.000		1.000
否	23 597(98.691)	22 251(94.296)	1 346(5.704)	0.100	1.661(0.908~3.039)	0.101	1.660(0.906~3.044)
日常饮食规律(餐次/d)
< 3	2 674(11.184)	2 532(94.690)	142(5.310)		1.000
≥3	21 236(88.816)	20 021(94.279)	1 215(5.721)	0.387	1.082(0.905~1.294)
父母最低学历
小学及以下	1 801(7.532)	1 694(94.059)	107(5.941)		1.000
中学	16 749(70.051)	15 802(94.346)	947(5.654)	0.617	0.949(0.772~1.166)
大学及以上	5 360(22.417)	5 057(94.347)	303(5.653)	0.649	0.949(0.756~1.191)
家庭同住人口数(人)
≤4	16 023(67.014)	15 132(94.439)	891(5.561)		1.000
>4	7 887(32.986)	7 421(94.092)	466(5.908)	0.275	1.066(0.950~1.197)
家庭年收入(万元)
< 10	11 614(48.574)	10 974(94.489)	640(5.511)		1.000
10~20	9 722(40.661)	9 141(94.024)	581(5.976)	0.145	1.090(0.971~1.224)
＞20	2 574(10.765)	2 438(94.716)	136(5.284)	0.647	0.957(0.791~1.157)
家族既往结核病史
无	23 678(99.030)	22 337(94.337)	1 341(5.663)		1.000
有	232(0.970)	216(93.103)	16(6.897)	0.420	1.234(0.740~2.056)
家中有几间卧室(间)
< 2	1 199(5.015)	1 125(93.828)	74(6.172)		1.000
2~3	15 711(65.710)	14 835(94.424)	876(5.576)	0.388	0.898(0.703~1.147)
＞3	7 000(29.275)	6 593(94.186)	407(5.814)	0.626	0.938(0.727~1.212)

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