2009—2017年新疆维吾尔自治区老年肺结核发现特征分析  

Analysis of the finding characteristics of pulmonary tuberculosis in the elderly population in Xinjiang Uygur Autonomous Region during 2009—2017

作　　者：董晓[1] 赵珍[1] 刘年强[1] 王森路 崔燕[1] DONG Xiao;ZHAO Zhen;LIU Nian-qiang;WANG Sen-lu;CUI Yan(Tuberuloss/Leprosy Prevention and Control Center,Center for Disear Coutrol and Prevention of Xinjeang Uygur Anutomomous Region,Urumgi 830001,China)

机构地区：[1]新疆维吾尔自治区疾病预防控制中心结核病麻风病预防控制中心,乌鲁木齐830001

出　　处：《中国防痨杂志》2020年第9期956-961,共6页Chinese Journal of Antituberculosis

基　　金：新疆南疆地区结核病防治服务体系综合评价与关键技术研究(2017A03006-1)。

摘　　要：目的研究2009—2017年新疆维吾尔自治区(简称"新疆")老年肺结核发现特征,为制订适应本地区的老年人群结核病防治对策提供科学依据。方法从《中国疾病预防控制信息系统》的子系统《结核病信息管理系统》中收集登记日期为2009年1月1日至2017年12月31日、现住址为新疆本地、年龄≥60岁的活动性肺结核患者临床资料,包括登记患者例数,以及年龄、性别、职业、病原学检测结果(即阳性、阴性、无检测结果)、治疗分类、发现方式、延迟就诊等情况;同时收集《新疆统计年鉴》各年度相关人口学资料。采用SPSS 25.0软件对以上资料进行统计学分析,以P<0.05为差异有统计学意义。结果2009—2017年,新疆全人群共登记活动性肺结核患者268765例,其中老年患者占全人群肺结核患者总数的43.58%(117125/268765),且由2009年的36.94%(8753/23692)逐年上升至2017年的50.17%(19810/39486)(χ~2趋势=2257.798,P=0.000);老年患者登记发病率由2009年的431.96/10万(8753/2026328)逐年上升至2017年的795.80/10万(19810/2489318)(χ~2趋势=4740.593,P=0.000)。117125例老年肺结核患者中,病原学检测阴性患者占73.44%(86013例),且自2009年的50.14%(4389/8753)逐年上升至2017年的83.01%(16444/19810)(χ~2趋势=6713.849,P=0.000)。老年患者中,男性[54.98%(64400/117125)]居多;60~<65岁年龄组老年患者登记发病率最低[501.32/10万(33365/6655379)],65~<70岁年龄组最高[628.48/10万(34315/5460043)];发现方式以转诊、因症就诊和因症推荐为主[75.50%(88433/117125)]。新疆老年肺结核患者的就诊延误率为77.42%(90675/117125),而全人群延迟水平为52.89%(142150/268765)。结论新疆老年肺结核防控形势严峻,发病率高于全人群,患者例数、登记发病率、病原学阴性患者均逐年升高,以男性、转诊及因症就诊和因症推荐者居多,就诊延误率高,应及早关注及实施老年人群肺结核防治策略。Objective To investigate the finding characteristics of pulmonary tuberculosis(PTB)in the elderly population in Xinjiang Uygur Autonomous Region ("Xinjiang")from 2009 to 2017,in order to provide a scientific basis for the prevention and control management. Methods Clinical data,including the number of registered patients,age,gender,occupation,pathogen detection results(positive,negative and absent),how to find the patients,and the delayed diagnosis,etc.,of PTB patients who aged≥60 years and lived in Xinjiang,and registered from January 1,2009 to December 31,2017 were obtained through Tuberculosis Information Management System,a subsystem of China Disease Prevention and Control Information System;and demographic data in each year from Xinjiang Annual Statistic were also collected.These data were analyzed using SPSS 25.0.P<0.05 was considered statistically significant. Results From 2009 to 2017,a total of 268 765 PTB patients in Xinjiang were registered,of which 117 125 were elderly(43.58%(117 125/268 765)),the proportion of PTB was increased from 36.94%(8753/23 692)in 2009 to 50.17%(19 810/39 486)in 2017(χt2 rend=2257.798,P=0.000);and the rate of registered elderly patients was increased from 431.96/100 000(8753/2 026 328)in 2009 to795.80/105(19 810/2 489 318)in 2017(χt2 rend=4740.593,P=0.000).Of the 117 125 elderly cases,etiology test was negative in 86 013(73.44%),the proportion was increased from 50.14%(4389/8753)in 2009 to 83.01%(16 444/19 810)in 2017(χt2 rend=6713.849,P=0.000).Mainly of the elderly PTB patients were male(54.98%(64 400/117 125)).The registered rate was lowest in patients aged 60-<65 years old(501.32/100 000,33 365/6 655 379),and highest in patients aged 65-<70 years old(628.48/100 000,34 315/5 460 043).The way of was mainly based on referral,seeing a doctor and recommendation were the main ways to find elderly PTB patients(75.50%,88 433/117 125).The delayed rate of PTB diagnosis in elderly patients in Xinjiang was 77.42%(90 675/117 125),while that of all aged cases was 52.89%(142 150 268

关 键 词：结核 肺 老年人 病例发现 登记 发病率 结果评价(卫生保健) 小地区分析 

分 类 号：R521[医药卫生—内科学]