2015-2023年中国65岁及以上老年肺结核患者的发现情况分析  

Analysis of pulmonary tuberculosis detection among patients aged 65 and older in China,2015-2023

作　　者：刘玉舒 范明宽 张灿有[1,3] 李涛[1,3] 李玉红 成君[1,3] 张慧 Liu Yushu;Fan Mingkuan;Zhang Canyou;Li Tao;Li Yuhong;Cheng Jun;Zhang Hui(National Center for Tuberculosis Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China;Department of Clinical Medicine,Medical College of Xiangyang Polytechnic,Xiangyang 441025,China;National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases,Beijing 102206,China)

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]襄阳职业技术学院医学院,襄阳441025 [3]传染病溯源预警与智能决策全国重点实验室,北京102206

出　　处：《中华流行病学杂志》2025年第4期630-637,共8页Chinese Journal of Epidemiology

基　　金：国家科技重大专项(2017ZX10201302001);中国疾病预防控制中心结核病预防控制项目。

摘　　要：目的了解我国≥65岁老年肺结核患者发现情况,为老年肺结核防治提供依据。方法资料来源于中国疾病预防控制信息系统结核病子系统,收集全国结核病定点医疗机构登记日期为2015年1月1日至2023年12月31日≥65岁老年肺结核患者的个案信息。采用描述性流行病学方法分析≥65岁老年肺结核患者的发现情况、发现方式的变化趋势、地区差异和人群特征。结果2015-2023年全国共发现≥65岁老年肺结核患者1567047例,占肺结核患者的25.1%(1567047/6243215)。≥65岁老年肺结核患者的平均登记率为96.9/10万,约为全人群患者的2倍,呈下降趋势(Z=-2.61,P=0.009),但在2018和2023年有所上升。2015-2023年≥65岁老年肺结核患者的构成比逐年上升,从2015年的21.3%增至2023年的32.4%(Z=2.30,P=0.022)。2015-2023年主动发现构成比仅为3.0%(47049/1567047),2018年升高至7.3%(14123/194615),然后呈下降趋势。中、西部地区的老年肺结核患者登记率较高,中部地区平均登记率为113.8/10万,主动发现构成比为0.4%(2532/570059),西部地区平均登记率为130.0/10万,主动发现构成比为7.6%(41973/549998)。男性(2.5%,27443/1101091)、80~84岁(2.2%,2978/133855)、流动人口(0.5%,1635/307673)老年人主动发现的构成比更低。结论2015-2023年我国≥65岁老年肺结核患者的主动发现构成比偏低,肺结核负担较重,亟须加强健康教育和主动筛查以改善老年肺结核的早期诊断与防治。Objective To investigate the detection status of pulmonary tuberculosis(PTB)among patients aged≥65 years in China and provide evidence for improving PTB prevention and control in this population.Methods The data were collected from the tuberculosis subsystem of Chinese Disease Control and Prevention Information System,and the case information of elderly PTB patients aged≥65 years old who were registered in designated tuberculosis medical institutions nationwide from January 1,2015 to December 31,2023.Descriptive epidemiological methods were used to analyze trends in detection status,regional differences,and demographic characteristics.Results From 2015 to 2023,1567047 elderly PTB detection were identified,accounting for 25.1%of all PTB patients(1567047/6243215).The average registration rate for elderly PTB patients was 96.9 per 100000,approximately twice that of the general population.The registration rate declined over the years(Z=-2.61,P=0.009)but increased in 2018 and 2023.The proportion of elderly PTB patients rose annually,from 21.3%in 2015 to 32.4%in 2023(Z=2.30,P=0.022).Active case-finding accounted for only 3.0%(47049/1567047)of patients on average during the study period,peaking at 7.3%(14123/194615)in 2018 before declining.The registration rates of elderly tuberculosis patients are relatively higher in central and western regions.In the central region,the average registration rate was 113.8 per 100000,with a proportion of active case detection of 0.4%(2532/570059).In the western region,the average registration rate was 130.0 per 100000,and the proportion of active case-finding was 7.6%(41973/549998).Subgroups with notably lower active detection proportions included males(2.5%,27443/1101091),those aged 80-84 years(2.2%,2978/133855),and migrant populations(0.5%,1635/307673).Conclusions The burden of PTB among the elderly aged≥65 years in China remains high,with a low proportion of active case-finding from 2015-2023.There is an urgent need to strengthen health education and active screening to improv

关 键 词：肺 结核 登记 发现 主动发现 

分 类 号：R521[医药卫生—内科学]