Yang Zhenhua, Kong Ying, Wilson Frank, Foxman Betsy, Fowler Annadell H, Marrs Carl F, Cave M Donald, Bates Joseph H
Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
Clin Infect Dis. 2004 Jan 15;38(2):199-205. doi: 10.1086/380644. Epub 2003 Dec 19.
The proportion of extrapulmonary tuberculosis cases in the United States has increased from 16% of tuberculosis cases, in 1991, to 20%, in 2001. To determine associations between the demographic, clinical, and life style characteristics of patients with tuberculosis and the occurrence of extrapulmonary tuberculosis, a retrospective case-control study was conducted. This study included 705 patients with tuberculosis, representing 98% of the culture-proven cases of tuberculosis in Arkansas from 1 January 1996 through 31 December 2000. A comparison between 85 patients with extrapulmonary tuberculosis (case patients) and 620 patients with pulmonary tuberculosis (control patients) showed women (OR, 1.98; 95% CI, 1.25-3.13), non-Hispanic blacks (OR, 2.38; 95% CI, 1.42-3.97), and HIV-positive persons (OR, 4.93; 95% CI, 1.95-12.46) to have a significantly higher risk for extrapulmonary tuberculosis than men, non-Hispanic whites, and HIV-negative persons. This study expands the knowledge base regarding the epidemiology of extrapulmonary tuberculosis and enhances our understanding of the relative contribution of host-related factors to the pathogenesis of tuberculosis.
美国肺外结核病例的比例已从1991年占结核病例的16%增至2001年的20%。为了确定结核病患者的人口统计学、临床和生活方式特征与肺外结核发生之间的关联，开展了一项回顾性病例对照研究。该研究纳入了705例结核病患者，占1996年1月1日至2000年12月31日阿肯色州经培养证实的结核病例的98%。对85例肺外结核患者（病例组患者）和620例肺结核患者（对照组患者）进行比较，结果显示女性（比值比[OR]为1.98；95%置信区间[CI]为1.25 - 3.13）、非西班牙裔黑人（OR为2.38；95% CI为1.42 - 3.97）以及HIV阳性者（OR为4.9；95% CI为1.95 - 12.46）患肺外结核的风险显著高于男性、非西班牙裔白人以及HIV阴性者。这项研究扩展了关于肺外结核流行病学的知识库，并增进了我们对宿主相关因素在结核病发病机制中相对作用的理解。
