1494例老年肺结核患者临床特征及治疗效果分析  

Analysis of clinical characteristics and treatment efficacy of 1494 elderly pulmonary tuberculosis cases

作　　者：李鹏鹏[1] 何飞[1] 袁中行 江艳 LI Pengpeng;HE Fei;YUAN Zhonghang;JIANG Yan(Yandu District Center for Disease Control and Prevention,Yanchen,Jiangsu224006,China;Yanchen Second People’s Hospital,Yanchen,Jiangsu224003,China)

机构地区：[1]盐城市盐都区疾病预防控制中心,江苏盐城224006 [2]盐城市第二人民医院,江苏盐城224003

出　　处：《临床肺科杂志》2024年第11期1729-1734,共6页Journal of Clinical Pulmonary Medicine

摘　　要：目的分析2012年1月1日-2021年12月31日盐城市盐都区老年肺结核患者的临床特征和治疗效果,为高质量开展老年人群肺结核防治工作提供证据支持。方法对2012年1月1日-2021年12月31日盐城市盐都区登记的老年肺结核患者临床资料进行汇总整理,采用描述性统计方法分析患者的临床特征和治疗效果。结果2012年1月1日-2021年12月31日盐城市盐都区共计登记管理肺结核2809例,其中60周岁及以上老年肺结核患者1494例,其全人群肺结核患者占比呈上升趋势,平均每年上升3.28%(APC95%CI:2.20%~4.38%,P<0.001);老年肺结核患者报告发病率呈下降趋势,平均每年下降5.38%(APC95%CI:-6.82%~-3.92%,P<0.001)。从临床特征看,盐都区老年肺结核患者在男性(χ^(2)=16.889,P<0.001)、复治(χ^(2)=12.257,P<0.001)、病原学阳性(χ^(2)=27.700,P<0.001)、未合并结核性胸膜炎(χ^(2)=4.953,P=0.026)等方面占比均高于非老年肺结核患者,差异有统计学意义;老年肺结核患者耐药率12.20%低于非老年肺结核患者耐药率(χ^(2)=8.405,P=0.004)。从治疗转归结局来看,老年肺结核患者的治疗成功率为90.56%(1353/1494),其中男性(χ^(2)=11.089,P<0.001)、≥80岁(χ^(2)=17.957,P<0.001)、复治(χ^(2)=12.389,P<0.001)、病原学阳性(χ^(2)=13.558,P<0.001)、耐药(χ^(2)=84.368,P<0.001)、有合并症(χ^(2)=130.565,P<0.001)、有空洞病变(χ^(2)=9.998,P=0.002)和存在不良反应(χ^(2)=26.811,P<0.001)的老年肺结核患者的治疗成功率较女性、其他年龄组、初治、病原学阴性及无结果、非耐药、无合并症、无空洞病变和无不良反应的老年肺结核患者的治疗成功率低,差异有统计学意义。结论盐都区老年肺结核疫情呈下降趋势,但老年肺结核病例在全人群肺结核病例占比却呈上升趋势。下一阶段的工作应重点关注男性、复治、病原学阳性、耐药、≥80岁、合并空洞和并发症等老年肺结核患者的治疗管理,并制定针对�Objective To analyze the clinical characteristics and treatment efficacy of elderly patients with pulmonary tuberculosis in Yandu District,Yancheng City,from January 1,2012 to December 31,2021,thereby offering insights for enhancing the prevention and treatment strategies for pulmonary tuberculosis among the elderly.Methods We conducted a retrospective analysis of the clinical data of elderly patients diagnosed with pulmonary tuberculosis in Yandu District from 2012 to 2021.The clinical characteristics and treatment outcomes were evaluated using descriptive statistical methods.Results Between January 1,2012 and December 31,2021,a total of 2809 cases of pulmonary tuberculosis were registered in Yandu District,of which 1494 were patients aged 60 years and above.This demographic accounted for an increasing proportion of the total pulmonary tuberculosis cases,with an average annual growth rate of 3.28%(APC 95%CI:2.20%~4.38%,P<0.001).Conversely,the reported incidence of pulmonary tuberculosis in this age group demonstrated a decreasing trend,with an average annual decline of 5.38%(APC 95%CI:-6.82%~-3.92%,P<0.001).Elderly patients were more likely to be male,undergo retreatment,have a positive etiology,and suffer from non-tuberculous pleurisy compared to their younger counterparts,with these differences being statistically significant.The drug resistance rate among the elderly was 12.20%,lower than that of the younger population.The overall treatment success rate for elderly patients was 90.56%(1353/1494).However,the success rate was lower in specific subgroups,including men,patients aged≥80 years,those undergoing retreatment,drug-resistant,with a positive etiology,concurrent complications,cavity lesions,and experiencing adverse reactions,compared to their counterparts.Conclusion In the Yandu district,the incidence of tuberculosis in the elderly showed a decreasing trend,but the proportion of tuberculosis cases in the whole population showed an increasing trend.The next stage of work should focus on the treatment and

关 键 词：结核 肺 老年 临床特征 治疗转归 

分 类 号：R521[医药卫生—内科学]