2010—2020年嘉定工业区结核病病人发现延迟趋势和影响因素分析  

Trend of delayed detection of tuberculosis patients in the Jiading industrial zone and analysis of influencing factors from 2010—2020

作　　者：赵凤 徐立新[1] 孙业桓[2] ZHAO Feng;XU Lixin;SUN Yehuan(Community Health Center of Jiading Industrial Zone,Shanghai 201815,China;Department of Epidemiology and Health Statistics,School of Public Health,Anhui Medical University,Hefei,Anhui 230032,China)

机构地区：[1]上海市嘉定工业区社区卫生服务中心预防保健科,上海201815 [2]安徽医科大学公共卫生学院流行病与卫生统计学系,安徽合肥230032

出　　处：《安徽医药》2023年第2期319-324,共6页Anhui Medical and Pharmaceutical Journal

基　　金：开封市科技发展计划项目(1903103)。

摘　　要：目的分析2010—2020年嘉定工业区结核病病人发现延迟的特点和变化趋势,探讨发现延迟的影响因素。方法该研究资料来源于“中国疾病预防控制信息系统”登记确诊的2010—2020年结核病疫情数据。采用χ^(2)趋势检验分析发现延迟的趋势,logistic回归分析模型分析发现延迟的影响因素。结果本研究检出就诊延迟212例,就诊延迟率为39.92%,诊断延迟168例,诊断延迟率为31.64%。不同年份结核病病人就诊延迟率、诊断延迟率差异无统计学意义。多因素logistic回归模型分析显示痰涂片阳性[β=0.89,OR=2.43,95%CI:(1.04,5.69),P=0.041]、重症[β=−0.85,OR=0.43,95%CI:(0.20,0.90),P=0.025]是就诊延迟的影响因素,病人来源[因症就诊:β=−1.48,OR=0.23,95%CI:(0.08,0.69),P=0.025]、首诊单位类型[专科医院:β=−1.04,OR=0.36,95%CI:(0.17,0.75),P=0.007]、痰涂片阳性[β=−1.46,OR=0.23,95%CI:(0.10,0.56),P=0.001]是诊断延迟的影响因素。结论2010—2020年就诊延迟率、诊断延迟率呈波动趋势,但不同年份就诊延迟率、诊断延迟率差异无统计学意义,痰涂片阳性、是否重症是就诊延迟的影响因素,痰涂片阳性、因症就诊、专科医院就诊是诊断延迟的影响因素。Objective To analyze the characteristics and trends of delayed detection of tuberculosis patients in the Jiading Industrial Zone from 2010 to 2020 and to explore the factors influencing the delayed detection.Methods The present study was based on tuberculosis epidemic data from 2010 to 2020 registered in the China Information System for Disease Control and Prevention.A chisquare trend test was used to analyze the trend of detection delays and a logistic regression analysis model was used to analyze the factors influencing the detection delays.Results In this study,212 cases of delayed visits were detected,with a delayed visit rate of 39.92%,and 168 cases of delayed diagnosis were detected,with a delayed diagnosis rate of 31.64%.There was no statistically significant difference in the rates of delayed visits and delayed diagnosis among tuberculosis patients in different years.Multivariate logistic regression model analysis revealed positive sputum smear[β=0.89,OR=2.43,95%CI:(1.04,5.69),P=0.041],severe illness[β=−0.85,OR=0.43,95%CI:(0.20,0.90),P=0.025]as influencing factors for delayed visit;patient source[due to illness visit:β=−1.48,OR=0.23,95%CI:(0.08,0.69),P=0.025],type of first visit unit[specialty hospital:β=−1.04,OR=0.36,95%CI:(0.17,0.75),P=0.007],and positive sputum smear[β=−1.46,OR=0.23,95%CI:(0.10,0.56),P=0.001]were influential factors for delay in diagnosis.Conclusions The rate of delay in consultation and diagnosis fluctuated from 2010 to 2020,but there were no significant differences in the rates of delay in consultation and diagnosis in different years.Sputum smear results and the presence or absence of severe disease were influential factors for delayed consultation,and positive sputum smear,consultation due to illness,and consultation at a specialist hospital were influential factors for delayed diagnosis.

关 键 词：结核 延迟诊断 发现延迟 就诊延迟 影响因素 

分 类 号：R52[医药卫生—内科学] R181.3[医药卫生—临床医学]