全军肺结核疫情监测与调查17年分析

Surveillance and investigation of pulmonary tuberculosis in the Army during 17 years

目的掌握军队人员肺结核发病状况,为防控部队肺结核疫情提供依据。方法通过全军疾病监测中心获得军队肺结核发病报告例数,全军结核病研究所对部队肺结核病例进行调查分析。结果 17年间军队肺结核年发病报告例数最低为1060例,最高为2272例,分别占当年传染病报告总数的10.1%和24.5%。其发病序位由第三位升至第一位。新发肺结核平均发病年龄为29岁。平均住院天数1992年为79d,2008年为38d,降低了51.9%。战士发病占68.5%,干部占30.0%(其中老干部占3.8%),职工占1.5%。继发型肺结核占76.7%,结核性胸膜炎占11.6%,继发型+结核性胸膜炎占8.5%,原发型占1.7%,血行播散型占1.5%。痰菌阳性肺结核占发病总数的18.5%。新发肺结核治疗采用6～9个月短程化疗,治愈率达到98%,远期复发率仅为1%～2%。结论军队肺结核发病以因症就诊与非结核病治疗中心发现为主,战士发病比例最高。以继发型肺结核为主。肺结核治疗多采用短程化疗,效果较好。

Objective To master the incidence of pulmonary tuberculosis in the staffs in the Army, and to provide evidence for the prevention and contorl of pulmonary tuberculosis in the Army. Methods The incidence data of pulmonary tuberculosis in the staffs in the Army were collected from PLA Disease Surveillance Center, and analyzed by PLA Tuberculosis Research Institute. Results During 17 years, the lowest annual number of the reported pulmonary tuberculosis cases in the Army was 1060, and the highest 2272, accounting for 10.1% and 24.5% of the annual number of reported infectious diseases cases, respectively. Pulmonary tuberculosis ranked the first from the third among infectious diseases occurring in the Army. The average age of onset of initial pulmonary tuberculosis was 29. The average hospitalized time was 79 days in 1992 and 38 days in 2008, shortened by 51.9%. Of all the cases, soldiers accounted for 68.5%, cadres 30.0% （senior cadres 3.8%）, and workers 1.5%. Secondary pulmonary tuberculosis accounted for 76.7%, tuberculous pleuritis 11.6%, both secondary pulmonary tuberculosis and tuberculous pleuritis 8.5%, primary pulmonary tuberculosis 1.7%, and disseminate pulmonary tuberculosis through blood 1.5%. Smear positive cases accounted for 18.5% of the total cases. Cases of initial pulmonary tubercolosis received 6-9 months of short-course chemotherapy. The curative rate was 98% and long-term recurrence rate was 1%-2%. Conclusions Pulmonary tubercu- losis cases in the Army are mainly discovered according to the symptoms when they visited the doctor outside Tuberculosis Treatment Centers. Soldiers rank the first among the pulmonary tuberculosis cases. Secondary pulmonary tuberculosis is the most commonly seen. Short-course chemotherapy is effective for pulmonary tubercolosis cases.