河南省2017―2022年老年肺结核患者治疗转归分析  

Analysis of treatment outcomes of elderly pulmonary tuberculosis in He'nan Province from 2017 to 2020

作　　者：赵阿会 骆洪梅 高敏 李明菊 徐吉英[1] 孙建伟[1] 孙定勇[1] ZHAO Ahui;LUO Hongmei;GAO Min;LI Mingju;XU Jiying;SUN Jianwei;SUN Dingyong(Control and Prevention,Henan Center for Disease Control and Prevention,Zhengzhou,He'nan 450016,China;Maternal and Child Health Center of the National Health Commission,Beijing 100089,China)

机构地区：[1]河南省疾病预防控制中心,河南郑州450016 [2]国家卫生健康委妇幼健康中心,北京100089

出　　处：《中国热带医学》2025年第1期75-80,86,共7页China Tropical Medicine

基　　金：河南省科技攻关项目(No.242102311130)。

摘　　要：目的分析河南省老年肺结核患者治疗转归及其影响因素,为有效治疗老年肺结核患者和制定相关防控措施提供科学依据。方法采用回顾性研究方法,从《全民健康保障信息化工程中国疾病预防控制信息系统》的子系统《结核病信息管理系统》中导出2017―2022年河南省≥65岁结核病患者病案信息,采用百分率(%)描述分布特征,采用χ^(2)_(趋势)描述时间变化趋势,采用χ^(2)检验和多因素logistic回归模型进行影响因素分析。结果河南省2017―2022年老年肺结核成功治疗率为94.89%(60016/63252),不良结局率为5.12%(3236/63252)。不良结局率呈现波动上升趋势(χ^(2)_(趋势)=50.577,P<0.01)。地区分布中,不良结局率以许昌市最低(3.71%),洛阳市最高(9.66%),差异具有统计学意义(χ^(2)=78.531,P<0.01)。影响因素分析显示:与女性、65~<70岁、农民、无合并症、初治、病原学阴性相比,男性(OR=1.332,95%CI:1.231~1.441)、70~<75岁(OR=1.302,95%CI:1.188~1.427)、75~<80岁(OR=1.659,95%CI:1.510~1.822)、≥80岁(OR=2.705,95%CI:2.479~2.952)、家务及待业(OR=1.408,95%CI:1.240~1.599)、有合并症(OR=1.327,95%CI:1.198~1.470)、复治(OR=1.431,95%CI:1.297~1.579)、病原学阳性(OR=1.562,95%CI:1.460~1.670)是影响老年肺结核患者成功治疗的危险因素。结论河南省2017―2022年老年肺结核成功治疗率达到规划目标(90%),但不良结局率呈现波动上升趋势,且地区分布不均。应重点关注男性、有合并症、复治、病原学阳性和高龄(≥80岁)的高风险人群。Objective To analyze the treatment outcomes and influencing factors of elderly pulmonary tuberculosis patients in Henan Province,so as to provide a scientific basis for formulating relevant prevention and control measures as well as effective treatment strategies for elderly tuberculosis patients.Methods A retrospective research method was conducted to extract the case information of pulmonary tuberculosis patients aged≥65 years in Henan Province from January 1,2017,to December 31,2022,from the subsystem"Tuberculosis Information Management System"under the"National Health Insurance Information Project-China Disease Control and Prevention Information System".Percentage(%)was used to characterize the distribution characteristics,a chi-square trend test was used to describe time variation trends,and a chi-square test along with multivariate logistic regression model was used to analyze the influencing factors.Results From 2017-2022,the successful treatment rate of elderly pulmonary tuberculosis patients in Henan Province was 94.89%(60016/63252),while the rate of adverse outcomes was 5.12%(3236/63252).The rate of adverse outcomes showed a fluctuating upward trend(χ^(2)_(trnd)=50.577,P<0.01).Regarding regional distribution,Xuchang City had the lowest rate of adverse outcomes(3.71%)and Luoyang City had the highest rate(9.66%),with a statistically significant difference(χ^(2)=78.531,P<0.01).Influencing factor analysis showed that,in comparison to females,those aged 65-<70,farmers,without comorbidities,newly treated,and pathology negative,the following were identified as risk factors for unsuccessful treatment outcomes:males(OR=1.332,95%CI:1.231-1.441),age 70-<75(OR=1.302,95%CI:1.188-1.427),age 75-<80(OR=1.659,95%CI:1.510-1.822),≥80 years(OR=2.705,95%CI:2.479~2.952),those engaged in housework or unemployed(OR=1.408,95%CI:1.240-1.599),comorbidities(OR=1.327,95%CI:1.198-1.470),retreatment(OR=1.431,95%CI:1.297-1.579),and positive pathology(OR=1.562,95%CI:1.460-1.670).Conclusions The rate of successful treatment of eld

关 键 词：结核病 治疗转归 老年人 影响因素 

分 类 号：R521.1[医药卫生—内科学]