重庆市2015-2020年≥65岁老年肺结核患者治疗转归分析  

Analysis of treatment outcomes of elderly pulmonary tuberculosis aged 65 and above in Chongqing from 2015 to 2020

作　　者：范君 张娅 张婷 余雅 苏倩 成君[2] 汪清雅 FAN Jun;ZHANG Ya;ZHANG Ting;YU Ya;SU Qian;CHENG Jun;WANG Qingya(Institute of Tuberculosis Prevention and Treatment of Chongqing,Chongqing 400050,China;Chinese Center for Disease Control and Prevention Center for Tuberculosis,Beijing 102206,China)

机构地区：[1]重庆市结核病防治所,重庆400050 [2]中国疾病预防控制中心结核病预防控制中心,北京102206

出　　处：《中国热带医学》2023年第7期715-719,724,共6页China Tropical Medicine

基　　金：重庆市首批公共卫生重点专科(学科)建设项目(渝卫办发﹝2022﹞72号);重庆市科卫联合医学科研项目(No.2022MSXM101,No.2023MSXM053);重庆市结核病防治所科研项目(No.2022CQJFS01)。

摘　　要：目的 分析重庆市老年肺结核患者治疗转归情况,为老年肺结核疫情防控策略提供参考依据。方法 收集全民健康保障信息化工程疾病预防控制信息系统2015-2020年重庆市登记的年龄≥65岁肺结核病例数据,采用描述性统计学方法进行分析。结果 重庆市2015年老年活动性肺结核患者和病原学阳性患者登记率分别为110.95/10万和32.25/10万,2020年分别为84.06/10万和57.29/10万,活动性肺结核登记率年递降率为5.40%,病原学阳性肺结核登记率年递增率为12.18%;2015年全人群活动性肺结核患者和病原学阳性患者登记率分别为70.75/10万和17.63/10万,2020年分别为50.34/10万和29.14/10万,活动性肺结核年递降率为6.58%,病原学阳性肺结核登记率年递增率为10.57%。2015-2020年共登记老年肺结核患者25 931例,其中21 374例(82.43%)为成功治疗,4 010例(15.80%)为不良结局,治愈患者和死亡患者占比均呈逐年升高趋势(χ2趋势=313.853、100.502,P<0.01)。2015-2020年全市老年肺结核年平均成功治疗率为82.43%,渝东南地区(74.23%)最低,其次为主城地区(81.99%),全市平均、渝西、渝东北、渝东南地区老年肺结核治疗成功率均呈逐年下降趋势(χ^(2)趋势=230.199、35.278、108.076、112.130,P<0.01),年递降率分别为2.77%、2.26%、3.0%、4.12%。登记的老年患者中女性、65~<75岁、汉族、初治、无合并症、病原学阴性治疗的成功率更高(χ^(2)=15.234、255.910、146.842、179.998、25.575、131.170,P<0.01)。结论 重庆市老年肺结核疫情呈下降趋势,但病原学阳性登记率逐年升高,治疗成功率逐年下降,应加强老年患者(尤其是渝东南地区、男性、病原学阳性患者、重症患者等)系统管理与宣传教育,有效控制老年结核病疫情。Objective To analyze the treatment outcomes of elderly patients with pulmonary tuberculosis in Chongqing,so as to provide reference for the prevention and control strategies of the epidemic of elderly pulmonary tuberculosis.Methods The data of tuberculosis cases aged≥65 years in Chongqing from 2015 to 2020 were collected from the National Health Insurance Information Project Disease Prevention and Control Information system.Descriptive statistical methods were used to analyze the data.Results The registration rates of elderly active pulmonary tuberculosis patients and etiological positive patients were 110.95/10-5 and 32.25/10-5 in 2015 and 84.06/10-5 and 57.29/10-5 in 2020.The annual decline rate of active tuberculosis registration was 5.40%,and the annual increase rate of pathogenic-positive tuberculosis registration was 12.18%.The registration rates of active tuberculosis patients and etiological positive patients in the whole population were 70.75/10-5 and 17.63/10-5 in 2015 and 50.34/10-5 and 29.14/10-5 in 2020.The annual decline rate of active tuberculosis registration was 6.58%,and the annual increase rate of pathogenic-positive tuberculosis registration was 10.57%.From 2015 to 2020,a total of 25931 cases of elderly pulmonary tuberculosis were registered,of which 21374(82.43%)cases were successfully treated and 4010(15.80%)cases had unfavorable outcomes.The proportion of cured and death patients showed an increasing trend year by year(χ^(2) trend=313.853,100.502,P<0.01).From 2015 to 2020,the average annual successful treatment rate of elderly pulmonary tuberculosis in the whole city was 82.43%,with the lowest rate in southeast Chongqing(74.23%),followed by urban areas(81.99%).The success rate of elderly pulmonary tuberculosis treatment in the whole city,west Chongqing,northeast Chongqing and southeast Chongqing showed a downward trend year by year(χ^(2) trend=230.199,35.278,108.076,112.130,all P<0.01),with annual decline rates of 2.77%,2.26%,3.0%and 4.12%,respectively.Among the registered elderly patie

关 键 词：肺结核 老年人 活动性肺结核登记率 病原学阳性肺结核登记率 成功治疗率 转归 

分 类 号：R521.1[医药卫生—内科学]