Leung Chi C, Li Teresa, Lam Tai H, Yew Wing W, Law Wing S, Tam Cheuk M, Chan Wai M, Chan Chi K, Ho Kin S, Chang Kwok C
TB and Chest Service, Department of Community Medicine, The University of Hong Kong, China.
Am J Respir Crit Care Med. 2004 Nov 1;170(9):1027-33. doi: 10.1164/rccm.200404-512OC. Epub 2004 Jul 28.
A cohort of 42,655 clients that were first registered with the Elderly Health Service in 2000 were followed prospectively through the tuberculosis (TB) notification registry until the end of 2002. A total of 286 active TB cases (186 culture confirmed) were identified. The annual TB notification rates were 735, 427, and 174 per 100,000 among current smokers, ex-smokers, and never-smokers, respectively (p < 0.001). The trend in TB risk persisted after the control of background characteristics using Cox proportional hazards analysis (adjusted hazard ratios [HRs]: 2.63, 1.41, and 1, p < 0.001). In comparison with never-smokers, current smokers had an excess risk of pulmonary TB (adjusted HR, 2.87; 95% confidence interval [CI], 2.00-4.11; p < 0.001), but not extrapulmonary TB (adjusted HR, 1.04; 95% CI, 0.33-3.30; p = 0.95). Among the current smokers, those who developed TB smoked more cigarettes per day than those who did not (13.43, SD 8.76 vs. 10.96, SD 7.87, p = 0.01). A statistically significant dose-response relationship was observed with respect to active TB and culture-confirmed TB (both p < 0.05). Smoking accounted for 32.8% (95% CI, 14.9-48.0%), 8.6% (95% CI, 3.3-15.1%), and 18.7% (95% CI, 7.7-30.4%) of the TB risk among males, females, and the entire cohort, respectively. Approximately 44.9% (95% CI, 20.7-64.6%) of the sex difference was attributable to smoking.
对2000年首次在老年健康服务机构登记的42655名客户进行了前瞻性随访，通过结核病（TB）通报登记系统一直追踪到2002年底。共发现286例活动性结核病病例（186例经培养确诊）。当前吸烟者、既往吸烟者和从不吸烟者的结核病年通报率分别为每10万人735例、427例和174例（p<0.001）。在使用Cox比例风险分析控制背景特征后，结核病风险趋势依然存在（调整后的风险比[HRs]：2.63、1.41和1，p<0.001）。与从不吸烟者相比，当前吸烟者患肺结核的风险更高（调整后的HR，2.87；95%置信区间[CI]，2.00 - 4.11；p<0.001），但肺外结核风险无差异（调整后的HR，1.04；95%CI，0.33 - 3.30；p = 0.95）。在当前吸烟者中，患结核病的人每天吸烟量比未患结核病的人更多（13.43，标准差8.76对10.96，标准差7.87，p = 0.01）。在活动性结核病和培养确诊的结核病方面观察到具有统计学意义的剂量反应关系（均p<0.05）。吸烟分别占男性、女性和整个队列结核病风险的32.8%（95%CI，14.9 - 48.0%）、8.6%（95%CI，3.3 - 15.1%）和18.7%（95%CI，7.7 - 30.4%）。约44.9%（95%CI，20.7 - 64.6%）的性别差异可归因于吸烟。
