629例老年肺结核患者特征及诊断延迟情况分析  

Analysis of characteristics and diagnosis delay of 629 elderly tuberculosis patients

作　　者：徐静[1] 罗萍[1] 贺晓新[1] XU Jing;LUO Ping;HE Xiao-xin(Department of Outpatient,Beijing Research Institute for Tuberculosis Control,Beijing 100035,China)

机构地区：[1]北京结核病控制研究所门诊部,100035

出　　处：《结核与肺部疾病杂志》2021年第3期216-222,共7页Journal of Tuberculosis and Lung Disease

摘　　要：目的分析北京结核病控制研究所收治的老年肺结核患者特征,为北京地区老年人群肺结核防治提供依据。方法采用描述性方法对2011—2020年北京结核病控制研究所收治的629例年龄≥60岁的老年肺结核患者的资料进行统计分析,并与同期2275例非老年患者进行对比。结果2011—2020年,北京结核病控制研究所登记管理的老年肺结核患者占同期全人群肺结核患者的21.66%(629/2904),各年老年患者构成比分别为13.78%(43/312)、19.24%(71/369)、15.50%(53/342)、18.33%(66/360)、21.57%(55/255)、21.27%(57/268)、14.29%(30/210)、28.77%(84/292)、34.22%(90/263)、34.33%(80/233),呈逐年上升趋势(Z趋势=5.046,P<0.001)。629例患者中,男性392例,女性237例,男∶女=1.65∶1,60~64岁组占比最高,达24.01%(151/629)。初治患者占80.29%(505/629),复治患者占19.71%(124/629);老年复治患者占比明显高于同期非老年复治患者占比(8.09%,184/2275),差异有统计学意义(χ^(2)=70.247,P<0.001)。老年患者病原学阳性率和涂阳率分别为50.87%(320/629)和42.45%(267/629),均明显高于同期非老年患者[30.07%(684/2275)和25.41%(578/2275)],差异均有统计学意义(χ^(2)=94.324,P<0.001;χ^(2)=69.366,P<0.001)。老年患者就诊延迟率(61.69%,388/629)明显高于同期非老年患者(45.19%,1028/2275),差异有统计学意义(χ^(2)=53.684,P<0.001);但确诊延迟率(33.55%,211/629)与同期非老年患者(29.89%,680/2275)比较,差异无统计学意义(χ^(2)=3.096,P=0.079)。老年患者发病至就诊时间[27(5,68)d]明显高于同期非老年患者[11(1,38)d],差异有统计学意义(U=-7.563,P<0.001);但就诊至确诊时间[6(0,28)d]与同期非老年患者[7(1,18)d]比较,差异无统计学意义(U=-0.799,P=0.425)。结论老年肺结核患者存在病原学阳性率高、涂阳率高、复治比例高、就诊延迟率高、就诊时间间隔长的特点。应加强老年肺结核患者的主动发现工作,特别是定期健康检查,减少老年患者的发现�Objective To analyze the characteristics of elderly patients with tuberculosis(TB)admitted to a municipal-level designated medical institution in Beijing,and to provide basis for TB prevention and control in elderly population of Beijing.Methods We descriptively analyzed data of 629 elderly TB patients(≥60 years old)admitted to Beijing Research Institute for Tuberculosis Control from 2011 to 2020,and compared them with the data of2275 non-elderly patients of the same period.Results From 2011 to 2020,the elderly TB patients registered in Beijing Research Institute for Tuberculosis Control accounted for 21.66%(629/2904)of all TB patients in the same period.In recent 10 years,the proportion of elderly patients increased year by year(13.78%(43/312),19.24%(71/369),15.50%(53/342),18.33%(66/360),21.57%(55/255),21.27%(57/268),14.29%(30/210),28.77%(84/292),34.22%(90/263),34.33%(80/233),Ztrend=5.046,P<0.001).There were 392 males and237 females,and the ratio of male to female was 1.65∶1.60-64 age group was the main age group,which was24.01%(151/629)of all elderly patients.Primary patients accounted for 80.29%(505/629)and retreatment patients accounted for 19.71%(124/629);The proportion of retreatment among elderly patients was significantly higher than that of non-elderly patients(8.09%,184/2275,χ^(2)=70.247,P<0.001).The etiologically positive rate and smear positive rate of elderly patients were 50.87%(320/629)and 42.45%(267/629),respectively,which were significantly higher than those of non-elderly patients(30.07%(684/2275)and 25.41%(578/2275),χ^(2)=94.324,P<0.001;χ^(2)=69.366,P<0.001).The patient delay rate of elderly patients(61.69%,388/629)was significantly higher than that of non-elderly patients(45.19%,1028/2275;χ^(2)=53.684,P<0.001).The diagnosis delay rate of elderly patients was 33.55%(211/629),no significant difference was found compared with that of non-elderly patients(29.89%,680/2275;χ^(2)=3.096,P=0.079).The median time from disease onset to medical visit for elderly patients(27(5,68)d)was significant

关 键 词：结核 肺 老年人 流行病学研究特征(主题) 对比研究 

分 类 号：R521[医药卫生—内科学]