≥65岁与<65岁肺结核患者治疗效果的对比分析  

Comparative analysis on treatment effect between aged 65 and above and under aged 65 years with pulmonary tuberculosis patients

作　　者：马艳[1] 黄麦玲[2] 杜建[3] 舒薇 谢仕恒 王红红[1] 谭守勇[4] 李向群[5] 傅衍勇 马丽萍[7] 张联英[8] 刘飞鹰[9] 胡代玉 张艳玲[11] 刘宇红[1] 李亮[3] MA Yan, HUANG Mai-ling, DUJian, SHUWei, XIE Shi-heng, WANG Hong-hong, TAN Shou-yong, LI Xiang-qun, FU Yan-yong, MA Li-ping, ZHANG Lian-ying, LIU Fei-ying, HU Dai-yu, ZHANG Yan-ling, LIU Yu-hong, LI Liang.(Center Office, Beijing Tuberculosis and Thoracic Tumor Research Institute/Clinical Center on Tuberculosis, Chinese Center for Disease Control and Prevention, Beijing Chest Hospital, Capital Medical University, Beijing 101149, Chin)

机构地区：[1]北京市结核病胸部肿瘤研究所中国疾病预防控制中心结核病临床中心首都医科大学附属北京胸科医院中心办,101149 [2]首都医科大学附属北京胸科医院结核科 [3]首都医科大学附属北京胸科医院院长办公室 [4]广州市胸科医院 [5]上海市疾病预防控制中心防治科 [6]天津市结核病控制中心 [7]河南省疾病预防控制中心防治科 [8]河北省疾病预防控制中心防治科 [9]广西壮族自治区疾病预防控制中心防治科 [10]重庆市结核病防治所 [11]云南省疾病预防控制中心防治科

出　　处：《结核病与肺部健康杂志》2018年第1期54-59,共6页Journal of Tuberculosis and Lung Health

基　　金：“十一五”国家科技重大专项(2008ZX10003-008-02)

摘　　要：目的对≥65岁与〈65岁肺结核患者的治疗效果进行对比分析，为制定相应的结核病防治策略提供依据。方法选择我国8个省共49个实施单位确诊的2075例涂阳肺结核患者进行分析，其中≥65岁肺结核患者282例，年龄范围65-91岁，平均年龄（73．6±16．4）岁，〈65岁肺结核患者1793例，年龄范围15～64岁，平均年龄（38．3±18．6）岁，采用卡方检验及Fisher精确概率检验比较≥65岁及〈65岁肺结核患者在不良反应、病灶吸收、空洞闭合、2个月末痰培养及治疗转归方面的差异，检验水准为0．05。结果在2075例涂阳肺结核患者中，≥65岁肺结核患者治疗后的不良反应率、病灶未吸收或恶化率分别为24．8％（70／282）及9．9％（20／203），高于〈65岁肺结核患者的22．0％（390／1793）及7．8％（111／1419），但差异无统计学意义（χ2值分别为0．249及0．248，P值均〉0．05）；≥65岁肺结核患者空洞未闭合及增大、2个月末阴转率及治疗失败率分别为17．6％（13／74）、20．2％（44／218）及12．8％（36／282），明显高于〈65岁肺结核患者的8．9％（51／575）、14．6％（217／1491）及7．8％（139／1793），差异有统计学意义（χ2值分别为0．041、0．034及0．001，P值均〈0．05）。结论65岁及以上老年肺结核患者与65岁以下年龄组相比，其不良反应发生率、空洞恶化及病灶未吸收比率、2个月末未阴转率较高，治疗转归更差。Objective To analyze treatment effect between aged 65 and above and under aged 65 years with pulmonary tuberculosis patients, and provide reference for tuberculosis prevention and control strategy. Methods Two thousand and seventy five patients diagnosed and treated from 8 provinces were enrolled in the study, 282 patients were 65 years old and above,ranging from 65 to 91 years old with an average of （73.6±16.4） years old. 1793 cases were under 65 years old ranging from 15 to 64 years old with an average （38.3±18. 6） years old among 2075 patients. Chi-square test and Fisher exact test were used to compare the following variables between aged 65 and above and under aged 65 years with pulmonary tuberculosis patients： adverse reactions （ADR）, cavity closure, lesions absorption, sputum-culture results at the end of the 2nd month of treatment, and treatment outcome. A P-value of less than 0. 05 is considered statistically significant. Results Sixty five years old and above patients accounted for 13.6% （282/2075）, ADR rate, no change and deterioration of lesions among aged 65 and above group was 24.8% （70/282） and 9.9% （20/203） respectively and was higher than under 65 years old group which was 22. 0% （390/1793） and 7. 8% （111/1419）, but the difference was not significant （ge value was 0. 249 and0. 248,respectively; P-value 〉0.05） ;meanwhile no change and deterioration of cavities, sputum-culture rate at the end of the 2nd month of treatment and failure rate among aged 65 and above group were 17.6% （13/74）, 20.2% （44/218） and 12.8% （36/282） respectively, was significant higher than under 65 years old non-elderly group which was 8.9%（51/575） ,14. 6%（217/1491） and 7.8% （139/1793）（χ2 value was 0. 041, 0. 034 and 0. 001,respectively; P-value 〈0. 05）. Conclusion Treatment effect aged 65 and above group was inferior to those under 65 years old group with higher ADR rate, higher deterioration of lesions and cavities, higher sputum-culture rate at the end

关 键 词：老年人 结核 肺 年龄组 疗效比较研究 

分 类 号：R521[医药卫生—内科学]