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目的 调查分析我国东、中、西部地区五市(区、县)的初治菌阳肺结核患者的膳食状况及相关影响因素.方法 对2013年7月至2014年6月在广东省广州市番禺区、黑龙江省哈尔滨市五常县、四川省绵阳市江油市、云南省昆明市东川区和广西壮族自治区百色市平果县[简称“五市(区、县)”]结核病防治所就诊的初治菌阳肺结核患者685例,采用方便抽样的方法抽取18岁及以上符合纳入条件的患者340例进行面对面问卷调查,收回340份问卷,问卷有效率98.8％(336/340).调查内容包括患者的基本情况(包括性别、年龄、家庭收入、文化程度、工作性质、吸烟情况等)及膳食摄入情况.以《中国居民膳食指南》推荐成年居民最低每日摄入量作为各类食物摄入不足的参照标准,用简化的“半定量食物频率法”估算其诊断前一年各类食物平均每日摄入量.采用多因素非条件logistic回归分析供热量食物、供蛋白质食物摄入不足及两类食物均摄入不足的影响因素.结果 336例患者每日摄入量谷薯类为(334.9±186.3)g、蛋类(31.7±40.1)g、大豆及其制品(35.0±45.2)g,均达到了每日推荐摄入量[(250～400 9),(25～50 9),(30～50 9)];而鱼虾类[(18.5±28.1)g]、奶及奶制品[(25.2±51.3)g]、畜禽肉类[(160.4±115.5)g]均低于或高于每日最低推荐摄入量最高值[(50～100 g),300 g,(50～70 g)],3类食物的平均摄入量与每日推荐摄入量的差异均有统计学意义(t=-20.55,t=-98.12,t=17.52,P值均＜0.01).供热能食物(谷薯类)摄入不足者占26.5％(89/336),供蛋白质食物摄入不足者占44.6％(150/336),供热量和蛋白质食物均摄入不足者占15.5％(52/336),100.0％(336/336)的调查对象奶类均摄入不足,90.8％(305/336)调查对象鱼虾类食物摄入不足.多因素非条件logistic回归分析结果显示,脑力劳动是蛋白质食物摄入不足的危险因素[β=0.65,Wald x2=4.52,P=0.034,OR(95％CI)值:1.91(1.05～3.48)],初中、高中及以上文化程度是热量食物摄入不足的保护因素[β=-0.89,Wald x2=5.38,P=0.020,OR(95％CI)值:0.41(0.19～0.87);β=-0.93,Wald x2=5.15,P=0.023,OR(95％CI)值:0.40(0.18～0.88)],年龄≥60岁是供热量和蛋白质食物均摄入不足的保护因素[β=-0.81,Wald x2=3.91,P=0.048,OR(95％CI)值:0.45(0.20～0.99)].结论 五市(区、县)初治菌阳肺结核患者中供热量食物和供蛋白质食物摄入不足者比例都比较高,且存在膳食摄入种类不平衡,不同劳动性质、文化程度及年龄对患者膳食摄入影响不同.“,”Objective To investigate the diet status and influencing factors of new bacteriologically confirmed tuberculosis (TB) patients in five cities in the eastern,middle and western areas in China.Methods Three hundred and forty eligible outpatients aged 18 and above diagnosed with new bacteriological positive pulmonary TB from six hundred and eighty five patients in TB dispensaries of Panyu District,Guangzhou City,Guangdong Province,Wuchang County,Harbin City,Heilongjiang Province,Jiangyou City,Mianyang City,Sichuan Province,Dongchuan District,Kunming City,Yunnan Province and Pingguo County,Baise City,Guangxi Zhuang Autonomous Region (namely ‘five cities (districts and counties) ’) were selected using convenience sampling to participate in a face-to face questionnaire-based survey.Among them,three hundred and forty questionnaires were collected and the valid rate was 98.8％ (336/340).The survey included the basic information of the patients (including sex,age,family income,educational level,type of work,smoking,etc.) and dietary intake.We used the minimun daily intake recommended for adults by the “Chinese dietary guidelines” as the standard to define inadequate intake of various types of food.The simplified semi-quantitative food frequency method was used to estimate the average daily dietary intake a year ago.Multivariate unconditional logistic regression was used to analyze the factors associated with inadequate intake of calory,protein and both.Results Compared with the daily recommended dose (250-400 g,25-50 g,30-50 g),the daily intake of cereal crops (334.9 ± 186.3) g,eggs (31.7 ± 40.1) g,and soybean and its products (35.0±45.2) g achieved the recommended doses,respectively.Fish and shrimp (18.5±28.1) g,milk and dairy products (25.2±51.3) g did not achieve the recommended doses (50-100 g,300 g).Livestock and poultry meat (160.4± 115.5) g was beyond the recommended doses (50-70 g).The differences between the daily intake and recommended dose of the above three types was statistically significant (t=20.55,t=-98.12,t=17.52,P＜0.01).26.5％ (89/336) of the participants had inadequate calorie food (cereal crops) intake.44.6％(150/336) had inadequate protein intake.There were 15.5％ (52/336) of the patients had both calorie and protein inadequate intake.No participants can meet the recommended standard for daily intake of milk.More than 90.8％ (305/336) of them had inadequate intake of fish and shrimp.Multivariable unconditional logistic regression analysis showed that brainwork was the risk factor for the inadequate intake of protein (β=0.65,Wald x2 =4.52,P=0.034,OR(95％CI):1.91 (1.05-3.48)),junior middle school,high school and above were the protective factor for the inadequate intake of calorie (β=-0.89,Wald x2 =5.38,P=0.020,OR(95％CI):0.41 (0.19-0.87);β=-0.93,Wald x2 =5.15,P=0.023,OR(95％CI):0.40 (0.18-0.88)).The age group (≥60 years) was the protective factor for the inadequate intake of both calorie and protein (β=-0.81,Wald x2 =3.91,P =0.048,OR (95％CI):0.45 (0.20-0.99)).Conclusion Inadequate calorie and protein intake is prevalent among the new bacteriological positive pulmonary TB patients in the five cities,and the food types of dietary intake is unbalanced.The dietary intake varies with type of work,educational level and ages.