| Objective To explore the influencing factors of pulmonary tuberculosis and to provide information for controlling pulmonary tuberculosis. Through the examination of chest X-rays for tuberculosis with and without dust exposure, the characteristics of X-rays for tuberclosis were iditified and differences of X-rays in performance between dust-exposed and non dust-exposed persons.Part I: risk factors of pulmonary tuberculosis in HumanMethods A case-control study of 951 pulmonary tuberculosis patients with 7-90 years of age and 951 controls was conducted. All pulmonary tuberculosis patients were come from general hospitals and anti-TB institutions. Each pulmonary tuberculosis patient was matched on age and gender to one control with respiratory diseases and infectious diseases. Clinic diagnosese information was collected from hospital medical records. Personal information for research cases were collected by trained personnel through interviews of the subjects using uniform questionnaire. Univariate and multivariate Uncondition logistic regression models were used to conduct statistic analyses with SAS9.0. Results The tuberculosis risk factors were the number of persons faced for work( OR=1.349,P<0.05 ) , the number of persons lived together(OR=1.623,P<0.05), smoking(OR=1.568,P<0.05), the number of pulmonary tuberculosis patientss faced(OR=2.923,P<0.05), diabetes(OR=1.957,P<0.05), and protective factors were high-level education (OR=0.83,P<0.05) through sigle factor analysis. In occupational factors, peasants(OR=1.921,P<0.05), workers who work with dust exposure have higher risk than workers who have not a history of exposure in dust(OR=3.577,P<0.05). Meanwhile office worker or staff have lower risk than workers who have not a history of exposure in dust(OR=0.630,P<0.05). The results from multiple unconditional logistic regression analysis showed that education, the number of persons faced for work, density of smoking, drinking, the number of pulmonary tuberculosis patients faced, BMI, occupational factors including working in dust environment were also associated with pulmonary tuberculosis (P< 0.05 ), and OR values were 0.693, 1.432, 1.633, 0.443, 3.432, 2.824, 2.242 respectively.Part II: analysis on characteristics of x-ray of TB patientsMethods The dust exposed group is made up of 43 patients of pulmonary tuberculosis ranged from 29 to 77 years old who work in iron ore which is full of dust in the air. Meanwhile 100 non-dust exposed TB patients with similar age and gender are selected as an ordinary TB patients'group. It is possible to measure the characteristic parameters of the pulmonary tuberculosis patients by the help of computer. Comparing the data of patients, we could find differences in characteristic parameters between patients from dust-exposed workers and patients from normal people in the characteristics of x-ray by the use of imageJ software. Results X-ray morphology of the lesion performance in four types: (1) the shadow of large sheet, (2) patchy shadow, (3) nodular shadow, (4) empty, (5) calcified lesions. By comparing the X-ray characteristics of the two groups in a series of indicators of lesion such as area ratio, gray ratio, perimeter, circularity, fit ellipse, the largest diameter, integrated density, we find that dust exposure in work has influenced above-mentioned factors of X-ray characteristics. At the same time through the cluster analysis to the characteristics of indicators, 11 indicators will be divided into 4 categories. The indicators of gray ratio, the minimum/maximum gray value are classified as the first category. Only the indicator of circularity is classified for second, area ratio and angle of ellipse fitting parameter values for the third category, perimeter, long axis, short axis, the largest diameter, integrated density for the fourth category. Take all factors into consideration, we select a representative indicator each group: gray ratio, circularity, area ratio, the largest diameter. Comparing the dust-group of TB patient with non-dust-group in a series of indicators of lesion, we can find that six indicators are different from each other in category of the shadow of large sheet such as minimum gray value, perimeter, long axis, short axis, the largest diameter, integrated density. The indicators of patchy shadow are the same as category of the shadow of large sheet. Four indicators are different from each other in category of empty such as perimeter, long axis, the largest diameter. Only one indicator is different from each other in category of nodular shadow. Two indicators are different from each other in category of nodular shadow such as minimum gray value, long axis. Conclusions1. The number of persons normally contracting during work bigger than 10, smoking, direct contacting experience with pulmonary tuberculosis patients and lower BMI were risk factors of pulmonary tuberculosis. While education, drinking were protective factor. Prevention and control program on pulmonary tuberculosis should be focusing on the risk factors that have been mentioned above.2. Different characteristics of chest X-ray performances between dust-exposed and non dust-exposed pulmonary tuberculosis groups. It provides useful information to understand the role of industrial dust on development of pulmonary tuberculosis.Through the cluster analysis to the characteristics of indicators, 11 indicators will be divided into 4 categories. Take all factors into consideration, we select a representative indicator each group: gray ratio, circularity, area ratio, the largest diameter. And the research also put the foundation of computer-assistant diagnosis of tuberculosis.
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