2016—2020年全国学生耐药肺结核流行特征与治疗转归分析  

Epidemiological characteristics and medication outcomes in students with drug-resistant pulmonary tuberculosis in China from 2016 to 2020

作　　者：陈卉[1,2] 宋雅婷 李涛[1] 张灿有[1] 陈红缨[3] 张梦娴 周丽平[4] 成君[1] 苏伟[1] CHEN Hui;SONG Ya-ting;LI Tao;ZHANG Can-you;CHEN Hong-ying;ZHANG Meng-xian;ZHOU Li-ping;CHENG Jun;SUWei(National Center for Tuberculosis Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China;Chinese Field Epidemiology Training Program of Education Division,Chinese Center for Disease Control and Prevention;Hubei Provincial Center for Disease Control and Prevention;Institute for Tuberculosis Control and Prevention,Hubei Provincial Center for Disease Control and Prevention)

机构地区：[1]中国疾病预防控制中心结核病预防控制中心,北京102206 [2]中国疾病预防控制中心教育培训处现场流行病学培训项目 [3]湖北省疾病预防控制中心 [4]湖北省疾病预防控制中心结核病防治研究所

出　　处：《热带病与寄生虫学》2023年第2期65-71,共7页Journal of Tropical Diseases and Parasitology

基　　金：中央财政结核病控制项目结核业务日常运转项目(238711)。

摘　　要：目的分析全国学生人群耐药肺结核流行特征和治疗转归情况,为优化学生肺结核防控措施提供依据。方法收集2016—2020年在中国疾病预防控制信息系统结核病管理信息系统中登记的全国耐药肺结核学生病例特征信息,应用描述流行病学方法分析其性别、民族、年龄、地区、治疗和转归情况等。结果2016—2020年全国共登记学生耐药肺结核患者2541例,其中利福平耐药患者2469例,占97.17%。登记患者中,男性1395例(占54.90%),女性1146例(占45.10%);汉族2174例(占85.56%),少数民族367例(占14.44%);年龄中位数为18(17,20)岁;19岁及以上登记患者最多,为1206例(占47.46%),其次是16~18岁,为946例(占37.23%),0~12岁最少,为68例(占2.68%);登记病例数量最多的地区为西部(906例,占35.65%),中部地区登记病例数最少(810例,占31.88%)。以初治的患者为主,为1869例(占73.55%)。利福平单耐药和多耐药、少数民族、0~18岁和初次治疗的患者占比呈逐年上升趋势(χ_(趋势)^(2)=206.016、18.212、17.433、45.651,P均<0.01)。利福平耐药患者的纳入治疗率为91.58%(2261/2469),2016—2020年分别为81.04%(171/211)、85.06%(279/328)、89.77%(500/557)、94.84%(662/698)和96.15%(649/675),呈现逐年上升趋势(χ_(趋势)^(2)=75.340,P<0.01)。利福平耐药患者治疗成功率为74.48%(1684/2261),其中16~18岁组治疗成功率最高(77.62%),0~12岁组治疗成功率最低(59.38%),不同年龄组治疗成功率差异有统计学意义(χ^(2)=13.608,P<0.01);东部地区患者治疗成功率最高(78.46%),中部地区治疗成功率最低(71.29%),不同地区治疗成功率差异有统计学意义(χ^(2)=10.240,P<0.01);2017—2018年登记的患者治疗成功率较高(77.06%和77.00%),2016年登记的患者治疗成功率最低(66.67%),不同登记年份治疗成功率差异有统计学意义(χ^(2)=9.974,P<0.05);本地患者的治疗成功率最高(81.04%),市间流动的患者治疗成功率最低(57.62%),不同流动人群治疗�Objective To analyze the epidemic characteristics of drug-resistant tuberculosis(TB)among students,so as to provide evidence for optimizing disease prevention and control measures.Methods The data were obtained from cases of drug-resistant TB in students registered in Tuberculosis Management Information System of China Information System for Disease Control and Prevention from 2016 to 2020.Descriptive epidemiological methods were used to analyze the gender,age,nationality,treatment and prognosis of the patients with drug-resistant TB.Results A total of 2541 cases of drug-resistant TB were registered in students from 2016 to 2020,in whom 2469(97.17%)were patients resistant to rifampin.Of the registered patients,1395(54.90%)were males,and 1146(45.10%)females.2174(85.56%)cases were Han nationality,and 367(14.44%)minorities.The median age was 18(17,20)years old,and the infection was most seen in students aged 19 or over,accounting for 1206(47.46%),followed by those aged 16-18 years(946,37.23%).Patients aged from 0 to 12 years were least seen(only 68 cases,2.68%).The registered cases were the highest in the western area(906 cases,35.65%),while the registered cases were minimal in the central area of China(810 cases,31.88%).By treatment,patients just underwent initial medication,which accounted for 73.55%.The proportion of patients with single rifampicin resistance and multi-drug resistance,from minority,aged between 0 and 19,and those undergone first medication tended to increase year by year(χ_(trend)^(2)=206.016,18.212,17.433,45.651,all P<0.01).Overall treatment initiation rate of rifampicin-resistant patients was 91.58%(2261/2469),respectively 81.04%(171/211),85.06%(279/328),89.77%(500/557),94.84%(662/698)and 96.15%(649/675)from 2016 to 2020,which showed an upward trend annually(χ_(trend)^(2)=75.340,P<0.01).74.48%(1684/2261)of the patients were successfully treated.The successful medication rate was the highest in patients aged 16-18 years(77.62%)and in the eastern area,and the lowest in those aged 0-12(59.38%)an

关 键 词：肺结核 学生 抗药性 流行特征 治疗结果 

分 类 号：R183[医药卫生—流行病学] R521[医药卫生—公共卫生与预防医学]