苏州市2011—2020年学生肺结核患者发现延迟状况  

Delay in student pulmonary tuberculosis case-finding and associated factors in Suzhou during 2011 to 2020

作　　者：傅颖 蒋骏[1] 张晓龙[1] 李云[1] 王斐娴 FU Ying;JIANG Jun;ZHANG Xiaolong;LI Yun;WANG Feixian(Department of Tuberculosis Prevention and Control,Suzhou Center for Disease Control and Prevention,Suzhou(215004),Jiangsu Province,China)

机构地区：[1]江苏省苏州市疾病预防控制中心结核病防治所,215004

出　　处：《中国学校卫生》2021年第12期1781-1784,共4页Chinese Journal of School Health

基　　金：苏州市“科教兴卫”青年科技项目(KJXW2019050)。

摘　　要：目的分析苏州市学生肺结核患者发现延迟情况,为学校结核病疫情防控工作提供参考依据。方法以2011—2020年苏州市登记管理的1148例学生肺结核患者为研究对象,采用Kruskal-Wallis H检验、χ^(2)检验和Cochran-Armitage趋势检验分析学生肺结核患者发现延迟的时间趋势,采用χ^(2)检验和Logistic回归分析学生肺结核患者入院特征与发现延迟的关系。结果调查的学生肺结核患者中,共有569例发现延迟,发现延迟率为49.6%,发现时长中位数为26(11~49)d。2011—2020年学生肺结核患者发现时长差异有统计学意义(Hc=54.62,P<0.05),发现延迟率(51.2%,44.2%,33.9%,26.2%,65.8%,51.0%,43.2%,61.5%,55.0%,53.5%)差异有统计学意义(χ^(2)=53.69,P<0.05)。发现延迟率随时间变化而波动,总体呈上升趋势(Z=-3.67,P<0.05)。发现方式为因症就诊(OR=5.57,95%CI=1.91~16.27)、病原学检查结果为阳性(OR=1.46,95%CI=1.14~1.86)均与发现延迟呈正相关(P值均<0.05)。结论苏州市学生肺结核患者发现延迟情况不容乐观,因症就诊、病原学检查阳性是发现延迟的影响因素。针对日常学校结核病防控中的突出问题,多部门应联动合作落实相关防控措施,减少发现延迟的发生。Objective To analyze delay in student pulmonary tuberculosis(PTB)case-finding and associated factors in Suzhou,and to provide a reference for tuberculosis outbreak prevention and control in schools.Methods A total of 1148 students with PTB who registered and were treated in Suzhou from 2011 to 2020 were included.Kruskal-Wallis H test,2 test and Cochran-Armitage trend test were used to analyze the time trend of case-finding delay.Logistic regression was used to analyze the correlation between admission characteristics and case-finding delay.Results Among the students with PTB,a total of 569 cases were found to be delayed.The rate of delay was 49.6%,and the median delay time was 26(11-49)days.From 2011 to 2020,the difference in case-finding interval of students with PTB was statistically significant(Hc=54.62,P<0.05),and the difference in case-finding rate was also statistically significant(χ^(2)=53.69,P<0.05).The rate of delay fluctuated,with an overall upward trend over time(Z=-3.67,P<0.05).Clinical consultation(OR=5.57,95%CI=1.91-16.27),positive etiology(OR=1.46,95%CI=1.14-1.86)were positively correlated with case-finding delay(all P<0.05).Conclusion There are significant delays in case-finding among students with PTB in Suzhou.Clinical consultation and positive etiology are associated with case-finding delay.In response to the growing problems in daily school tuberculosis prevention and control,multiple departments should cooperate to implement relevant measures and to reduce the occurrence of case-finding delay.

关 键 词：结核 肺 回归分析 学生 回顾性研究 

分 类 号：R521[医药卫生—内科学] G478[医药卫生—临床医学]