摘要目的 探讨糖尿病患者性格和负性生活事件对其并发肺结核病的影响.方法 采用以医院为基础的病例对照研究方法 ,研究对象包括158例糖尿病并发肺结核病患者(并发组)和281例糖尿病患者(糖尿病组),运用艾森克个性问卷(EPQ)E量表和生活事件量表(LES)对所有对象进行性格和负性生活事件调查,采用Logistic回归模型计算比值比(OR)及其95%可信区间(95%CI),并对可能的混杂因素(文化程度、人均月收入、血糖控制、既往最高BMI、减重比、锻炼、吸烟、负性生活事件或性格)进行调整.结果 性格外向、内外向兼有和性格内向在并发组和糖尿病组的构成比分别为38.6%、11.4%、50.0%和53.0%、11.1%和35.9%(X~2=9.280,P=0.010),性格内向的糖尿病患者发生肺结核的危险为性格外向者的1.91(1.26～2.90)倍,但经上述混杂因素调整后统计学关联消失(P=0.111);2组分别有35.4%和19.6%的人在近1年内有负性生活事件发生(X~2=13.483,P=0.000),调整前后的OR(95%CI)分别为2.26(1.15～3.50)和1.82(1.07～3.10),P值均小于0.05.按性别和年龄分层后显示负性生活事件对男性和60岁以下组作用显著.结论 负性生活事件是增加男性和60岁以下糖尿病患者肺结核发病风险的独立危险因素,对该高危人群应加强心理疏导,增强其应对能力.

abstractsObjective To explore the influence of personality and negative life events on the development of pulmonary tuberculosis among diabetic patients.Methods A hospital-based case-control study was conducted from March 2005 to February 2006.158 newly-diagnosed pulmonary tuberculosis patients with diabetes (DMPTB) were reemited as cases and 281 diabetic patients (DM) as control group.Information on personality and negative life events was collected using Eysenck Personality Questionnaire (EPQ) and Life Events Scale (LES),respectively.Odds ratios(OR) and 95% confidence intervals (95% CI) were estimated using logistic regression models and the potential confounding bias was controlled through adjusted by education,income,glycemic control,previous maximal BMI,weight loss ratio,physical xercises,smoking,negative life events or personality.Results The proportions of introversion,medium,extroversion personality in DM-PTB and DM group were 38.6% ,11.4% ,50.0% vs.53.0% ,11.1% ,35.9% (X~2=9.280,P=0.010).Those with introversion personality had 1.91 (1.26～2.90) times higher risk of DM-PTB than those with extroversion personality,while this association became insignificant after adjustment(P=0.111) ; 35.4% and 19.6% in the two groups had experienced life events during the last one year,and such persons had 2.26(1.15～3.50) (unadjusted) or 1.82(1.07～3.10)(adjusted) higher risk of DM-PTB than those without life events,especially among male and younger (＜60y) diabetics.Conclusion Negative life events are the independent risk factor of pulmonary tuberculosis among male and younger diabetics.Thus,mental measures should be taken in corresponding risk populations to improve their capability of dealing with life events.