| ObjectivesBy analyzing the survey data of1621cases PTB patients, to know thesocio-demographic characteristics, living behavior and environment,clinicalcharacteristics of the population, provide a reference for the etiology, diagnosis andtreatment of tuberculosis. to comparatively analyze clinical data of smear-negativeand smear-positive PTB patients, and simple PTB patients and PTB patientscomplicated with diabetes (DM), to explore the differences of clinical characteristicsamong different types of PTB, and to provide evidence for proposing measures oftargeted prevention and treatment.MethodsAll the PTB sputum culture patients who were from tuberculosis hospital ofJilin province, and CDCs of Chaoyang and Lvyuan district in Changchun betweenOctober2010and August2010were interviewed face-to-face by the self-designedinformation collection table. The collection tables were1621totally.EPIDATA3.0software was used to double entry the data, and analyzing the databy SPSS13.0. The socio-demographic characteristics, living behavior andenvironment, clinical characteristics of1621PTB cases were analyzed descriptively.Chi-square test used to compare the differences in the demography, environmentaland behavioral factors and clinical data between smear-negative patients andsmear-positive patients. Moreover, univariate and multivariate logistic regressionanalysis used to compare the differences of risk factors between PTB patients andPTB-DM patients.Results(1) Of1621PTB cases, most patients were men (sex ratio was2.01:1), the Hanethnicity (94.5%), aged between40and60(The average age of males than females), married(74.9%),from rural(67.2%),farmer(62.7%), and the primary and junior highschool (68.9%), more than60%per capita monthly income less than500yuan.(2) The study found that the per capita living area≤1room patients accountedfor87.3%, majority of patients (54.5%) use outdoor water,39.0%of the patientsdaily at home over90%, smoking rate was53.2%,33.4%alcohol, more drinkersdrink liquor,14.7%of the patients presence a family history, recurrence oftuberculosis accounted for70.1%, rate of BCG vaccination was only27.6%, only32.3%of tuberculosis awareness,126cases (7.8%) tuberculosis with diabetes.(3) Among these cases, main clinical symptoms were cough (97.0%), sputum(77.1%), fatigue (74.5%), anorexia (61.2%) and fever (56.8%), dominated typeswere secondary pulmonary tuberculosis (97.2%), cavitary pulmonary tuberculosis(56.7%), smear-negative pulmonary and tuberculosis (58.4%), Also, thechemotherapeutics were mainly isoniazid(92.9%), andethambuto(92.7%),pyrazinamide(84.1%) and rifampicin (75.0%).(4)674cases, accounting for41.6%, were smear-positive PTB, and947(58.4%) for smear-negative PTB. The comparative results, by chi-square test,showed that there was significant difference in age distribution, and that mostsmear-positive patients aged between40and50while most smear-negative patientsaged between50and60. Moreover, the proportions of no indoor plumbing system(χ2=4.579, P=0.032), non-smokers (χ2=7.343, P=0.025) and DM patients (χ2=18.111,P<0.001) were relatively high in the smear-positive group. The incident rate ofsecondary (χ2=11.403, P=0.001), X-ray cavity (χ2=118.177, P＜0.001) and cough(χ2=7.092, P=0.008), and the streptomycin (χ2=8.857, P=0.003) and capreomycin(χ2=6.443, P=0.011) usage rate in smear-positive PTB were also higher than that insmear-negative PTB.(5) Simple PTB had1495cases (92.2%),126cases (7.8%) were for PTB-DM.The sex (OR=1.682，95%CI：1.062,2.665), age, and duration of smoking historywere the risk factors of patients complicated with DM. PTB-DM in the incidence rate of TB typing (χ2=3.990, P=0.046), sputum smear-positive (χ2=18.111, P＜0.001)and X-ray cavity (χ2=10.815, P=0.001), and the usage rate of streptomycin (χ2=4.871,P=0.027) was higher than simple PTB, whereas lower in the usage rate ofpyrazinamide (χ2=30.969, P＜0.001) and rifampicin (χ2=3.267, P＜0.001).ConclusionIn the tuberculosis patients, who had sputum culture in the medical institutionsin our province, men, over40years old, the first industrial workers, rural,low-income are in the majority, tuberculosis patients are overcrowding, high rates ofsmoking and drinking, while the rate of BCG vaccination and TB awareness ratelower. Should adopt the " Directly Observed Treatment Short course" strategy for thetreatment of patients, particular attention to their coughing, fatigue, loss of appetiteand other symptoms, and the characteristics of smear-positive PTB andsmear-negative PTB are different, tuberculosis with diabetes affect by gender andage. On the basis of the existing control work, we should take targeted preventionand treatment for TB according to the characteristics of different types oftuberculosis. |
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