肺结核住院患者并发肺外结核状况及其与性别和年龄相关性的多中心研究  

A Multicenter Investigation of Pulmonary Tuberculosis with Concurrent Extrapulmonary Tuberculosis and Its Correlation with Gender and Age

作　　者：于佳佳 李亮[1] 杜建[1] 陈鸿雁[2] 刘健雄[3] 马金山 李明武 秦敬民 舒薇[1] 宗佩兰[7] 严晓峰[8] 张义 董永康[10] 杨之怡 梅早仙[12] 邓群益[13] 王璞[14] 韩文革 吴妹英[16] 陈玲[17] 赵新国 谭雷[19] 李福建[20] 郑超[21] 刘宏伟[2] 李昕洁[3] 阿尔泰 杜映荣 刘风林[6] 杨松[8] 崔文玉 王全红[10] 陈晓红 韩骏峰 谢清尧 冯燕梅[14] 刘文玉 唐佩军[16] 张建勇[17] 郑建 陈大为[20] 姚向阳[21] 任彤 李艳[3] 李媛媛 吴磊 宋强[6] 杨梅[8] 张健 刘媛媛[12] 郭述良[14] 严琨 沈兴华[16] 雷丹[17] 张艳丽 康万里[1] 唐神结[1] Yu Jiajia;Li Liang;Du Jian;Chen Hongyan;Liu Jianxiong;Ma Jinshan;Li Mingwu;Qin Jingmin;Shu Wei;Zong Peilan;Yan Xiaofeng;Zhang Yi;Dong Yongkang;Yang Zhiyi;Mei Zaoxian;Deng Qunyi;Wang Pu;Han Wenge;Wu Meiying;Chen Ling;Zhao Xinguo;Tan Lei;Li Fujian;Zheng Chao;Liu Hongwei;Li Xinjie;Du Yingrong;Liu Fenglin;Yang Song;Cui Wenyu;Wang Quanhong;Chen Xiaohong;Han Junfeng;Xie Qingyao;Feng Yanmei;Liu Wenyu;Tang Peijun;Zhang Jianyong;Zheng Jian;Chen Dawei;Yao Xiangyang;Ren Tong;Li Yan;Li Yuanyuan;Wu Lei;Song Qiang;Yang Mei;Zhang Jian;Liu Yuanyuan;Guo Shuliang;Yan Kun;Shen Xinghua;Lei Dan;Zhang Yanli;Kang Wanli;Tang Shenjie(Beijing Chest Hospital,Capital Medical University,Beijing Tuberculosis and Thoracic Tumor Research Institute,Beijing 101149,China;不详)

机构地区：[1]首都医科大学附属北京胸科医院北京市结核病胸部肿瘤研究所结核病多学科诊疗中心,101149 [2]沈阳市胸科医院结核科 [3]广州市胸科医院 [4]新疆维吾尔自治区胸科医院 [5]昆明市第三人民医院结核科 [6]山东省胸科医院 [7]江西省胸科医院(第三人民医院) [8]重庆市公共卫生医疗救治中心 [9]长春市传染病医院 [10]太原市第四人民医院 [11]福州肺科医院结核科 [12]天津市海河医院结核科 [13]深圳市第三人民医院结核科 [14]重庆医科大学附属第一医院呼吸与危重症医学科 [15]山东省潍坊市第二人民医院结核科 [16]苏州市第五人民医院 [17]遵义医学院附属医院结核科 [18]江苏省无锡市第五人民医院结核科 [19]吉林省四平市结核病医院结核科 [20]河北省保定市传染病医院结核科 [21]厦门大学附属第一医院结核科

出　　处：《结核病与胸部肿瘤》2020年第3期193-199,共7页Tuberculosis and Thoracic Tumor

基　　金：“十二五”国家科技重大专项(2015ZX10003001);北京市医院管理局“登峰”人才培养计划(DFL20181601);通州区科学技术委员会(KJ2017CX054);通州区高层次人才发展支持计划(YHLD2019035)。

摘　　要：目的探讨住院肺结核患者并发肺外结核的发生情况及其与性别、年龄的关系。方法采用观察性研究方法,由参加过统一培训的调查员从医院信息管理系统(HIS系统)收集2011年1月1日至2017年12月31日我国15省21家医疗机构360187例住院肺结核患者的性别、年龄,以及结核病灶:累及部位等信息,比较分析肺结核患者并发肺外结核的发生情况及其与性别、年龄的关系。结果360187例肺结核患者中,男238910例(6.33%),女121277(33.67%),年龄中位数(四分位数)[M(Q1,Q3)]为47(28.62)岁:42987例(1.93%)并发肺外结核,并发率依次为结核性脑膜炎[2.72%(9809例)].颈部淋巴结结核[1.93%(6966例)].结核性腹膜炎[1.59%(5733例)].结核性心包炎[0.94%(3399例)].肠结核[0.94%(3380例)]等。男性肺结核患者并发结核性脑膜炎、颈部淋巴结结核、结核性腹膜炎、结核性心包炎、结核性多浆膜炎.腰椎结核胸椎结核.胸壁结核的并发率分别为2.44%(5829例),1.44%(3429例),1.41%(3376例),0.90%(2138例).0.75%(1791例).0.67%(1604例).0.64%(1522例).0.60%(1438例),均明显低于女性[分别为3.28%(3980例).2.92%(3537例).1.94%(2357例)、1.04%(1261例).0.90%(1093例).0.79%(960例)。0.76%(924例),0.66%(805例)](χ^(2)=215.235.930.541,144.480,18.061.23.272.16.442.18.585,4.976;P值均<0.05)。不同年龄组(1~岁组至≥65岁组)肺结核患者并发结核性脑膜炎、颈部淋巴结结核、结核性腹膜炎、肠结核、结核性心包炎、结核性多浆膜炎、腰椎结核、胸椎结核、胸壁结核。咽喉结核的并发率差异均有统计学意义(χ^(2)=3870.549,2939.502.1830.620,673.372,115.428.319.078,52.512.19.308,439.177.136.619;P值均<0.05)。除胸椎结核的并发率未呈现出随年龄变化的趋势(χ^(2)=趋势-0.814.P=0.367),结核性心包炎星现出随年龄增长而增高的趋势(χ^(2)趋势=62.087.P<0.001)外,其他肺外结核的发生率均呈现出随年龄增长而降低的趋势(P值均<0.00)。多因索logistic回Objective To invetigate the incidence of pulmonary tuberculosis concurent with extrapulmonary tuberculosis and its relationship with gender and age group.Methods Using observational research method,360187 hospitalized tuberculosis patients'gender,age and the involved position of tuberculosis were collected from hospital information management system(HIS)of 21 medical institutions in 15 provinces in China from January I,2011 to December 31,2017 by investigators with unifed training.The incidence of extrapulmonary tuberculosis and its relationship with gender and age were analyzed.Results Among 360187 patients with tuberculosis,238910(66.33%)were male,121277(33.67%)were female,and the median age(quartile)(M(Q.,Q))was 47(28,62)years old;42987(11.93%)cases were concurrent with extrapulmonary tuberculosis,the highest incidence was tuberculous meningitis(2.72%(9809 cases),followed by cervical lymph node tuberculosis(1.93%(6966 cases)),tuberculous peritonitis(1.59%(5733 cases)),tuberculous pericarditis(0.94%(3399 cases))and intestinal tuberculosis(0.94%(3380 cases))etc.The incidence of tuberculous meningitis,cervical lymph node tuberculosis,tuberculous peritonitis,tuberculous pericarditis,tuberculous polyserositis,lumbar tuberculosis,thoracic tuberculosis and chest wall tuberculosis in male tuberculosis patients were respctively 2.44%(5829 cases),1.44%(3429 cases),1.41%(3376 cases)..0.90%(2138 cases),0.75%(1791 cases),0.67%(1604 cases),0.64%(1522 cases),0.60%(1438 cases),and significantly lower than that of female(respectively 3.28%(3980 cases).2.92%(3537 cases),1.94%(2357 cases),1.04%(1261 cases),0.90%(1093 cases),0.79%(960 cases),0.76%(924 cases,0.66%(805 cases)(χ^(2)=215.235,930.541,144.480,18.061,23.272,16.442.18.585,4.976;Ps<0.05).The diferences of incidences of tuberculous meningitis,cervical lymph node tuberculosis,tuberculous peritonitis,intestinal tuberculosis,tuberculous pericarditis,tuberculous polyserositis,lumbar tuberculosis,thoracic tuberculosis,chest wall tuberculosis and throat tuberculosis between dif

关 键 词：结核 肺 结核 肺外 性别分布 年龄分布 因素分析 统计学 因果律 多中心研究 

分 类 号：R52[医药卫生—内科学]