上海市老年结核病的流行病学特征与防治对策探讨  

STUDY ON THE EPIDEMIOLOGIC SITUATION AND THE CONTROL COUNTERMEASURE OF ELDERLY PULMONARY TUBERCULOSIS IN SHANGHAI

作　　者：黄建生[1] 梅建[1] 夏珍[1] 沈梅[1] 

机构地区：[1]上海市疾病预防控制中心结防科,200336

出　　处：《老年医学与保健》2003年第1期20-23,共4页Geriatrics & Health Care

摘　　要：目的评价和分析上海市老年肺结核流行病学特征以及探讨防治对策。方法根据日常新病例登记报告以及对农村地区老年人群结核病流行病学调查结果进行分析及评价。结果2000年全人口结核病新登记率为3.90/万,涂片结核菌阳性(简称菌阳)新登记率为1.52/万,而≥65岁组两者分别为8.89/万与3.82/万,分别是全人口的2.3和2.5倍,且占新发病人数的31.4%及菌阳病人数的34.7%;老年肺结核死亡率高达12.34/10万(全人口为1.89/10万)。老年肺结核新病例排菌比例为42.7%～49.0%(<65岁组为30.9%～38.4%);非结核性合并症率高达23.0%(<65岁组仅10.1%)。农村中老年肺结核病人的掌握率为43.5%,菌阳病人掌握率为41.9%。2000年化疗一年后治愈78.1%(542/694),死亡17.0%(118/694),失败1.6%(26/694)。结论老年肺结核病例发病率高、病情重,已成为主要的传染源,是当前结核病控制工作的重点。积极采取各种相应的措施提高老年结核病人的发现率和治愈率是当前亟待解决的问题。Objective To analyze and evaluate the epidemio logic situation of elderly pulmonary tuberculosis in Shanghai,and to discuss the control countermeasures of TB.Methods Statistical analysis was performed on the TB reg-istration material and the results o f epidemiologic survey on rural elderly PTB.Results The new registration rate was8.89/10,000for the elderly,and the bacillary positive rate was 3.82/10,000,twice more than those for all cases(for all cases the rates were 3.90/10,000and1.52/10,000respectively).The total mortality was 1.89/100,000being 12.34/100,000for the elderly.The sputum p ositive rate of new PTB cases was 42.7%～49.0%and nontuberculosis compli cation rate was 23.0%for people >=65(for people <65,they were 30.9%～38.4%,10.1%respectively).The case detection rate was 43.5%,and 41.9%for bacilla ry positive TB in the elderly of rural area.In 2000the outcome of one -year chemotherapeutic treatment 78.1%c ured,17.0%died,1.6%failed.Conclusions The situation in the elderly PTB was more severe.The elderly PTB case was the main source of infection.We shou ld pay more attention to the control o f elderly PTB cases;to improve the detection r ate and cured rate of elderly PTB case s.[

关 键 词：上海市 结核病 流行病学 防治 老年人 

分 类 号：R181.3[医药卫生—流行病学]