The Case-Control Study On Risk Factors Of Chronic Obstructive Pulmonary Disease Patients Complicated With Pulmonary Tuberculosis

Objective: To explore the risk of chronic obstructive pulmonary disease patients complicated with pulmonary tuberculosis.Methods: A hospital-based frequency matching case-control study was conducted. 151 newly diagnosed obstructive pulmonary disease patients complicated with pulmonary tuberculosis in Pingdu Pulmonary Tuberculosis Control Center were recruited from Nov.2006 to Dec.2007.In the meantime, 188 patients without chronic obstructive pulmonary disease ,pulmonary tuberculosis and other respiratory system diseases from Pingdu People's Hospital, Traditional Chinese Hospital of Pingdu were recruited as control group. Datas on risk factors were collected by questionaires through face-to-face interview. Unconditional logistic regression model was used in analysis. New confounding caused by matching on age and gender was adjusted by stratified analysis. Multivariate logistic regression was used to explore risk factors of chronic obstructive pulmonary disease patients complicated with pulmonary tuberculosis,and final main effect functions were built.Results: Several variables were found to be associated with chronic obstructive pulmonary disease complicated with pulmonary tuberculosis. They were marriage, education, occupation, income, cough in childhood, cough for ages, history of tuberculosis contact, history of BCG inoculate, cigarette smoking, drinking, labor intensity, exposure to dust, history of insecticide contact, history of working outside, method of warming, energy sources of cooking, kitchen ventilation, average living area, environment of habitation, stress. The positive results were found with multivariate logistic regression analysis, which were associated with risk of chronic obstructive pulmonary disease patient with pulmonary tuberculosis, including cough for ages (OR=3.054, 95%CI: 1.674～5.573), history of tuberculosis contact(OR=3.674, 95%CI: 1.731～7.799), cigarette smoking (OR=5.223, 95%CI: 2.666～9.466), exposure to dust (OR= 1.979, 95%CI: 1.025～3.822), energy sources of cooking (OR=1.330, 95%CI: 1.016～1.741), stress (OR=2.306, 95%CI: 1.325～4.015); On the other hand, income (OR=0.744, 95%CI: 0.574～0.964), history of BCG inoculate (OR=0.555, 95%CI: 0.323～0.955) were found to be reversely associated with chronic obstructive pulmonary disease patients complicated with pulmonary tuberculosis.Conclusion: The main risk factors of COPD-PTB were cough for ages, history of tuberculosis contact, cigarette smoking, exposure to dust, energy sources of cooking, stress. The risk factors or protective factors were different in different gender and age, and these factors might interact each other to influence the occurrence of chronic obstructive pulmonary disease patients complicated with pulmonary tuberculosis. The effective preventive strategies and measures should be different in different gender and age.