武汉市汉阳区流动人口结核病发病情况及转归分析

Incidence and outcome of mobile pulmonary tuberculosis cases in Hanyang district of Wuhan City

目的探讨武汉市汉阳区流动人口肺结核的发病情况及临床特点,为开展流动人口结核病防治工作提供依据。方法分析武汉市汉阳区2008年1月～2012年12月登记管理426例流动人口结核病患者的发现方式、年龄特点、临床表现、X线胸片病灶分布特点、痰涂片抗酸杆菌检查结果及治疗转归情况,并与1 038例同年龄段本地户籍患者比较。结果 426例流动人口新发肺结核中15～45岁青壮年患者385例(90.4%,385/426);以健康体检方式发现者253例(59.4%,253/426)、肺部病变累及两个或以上肺叶者267例(62.7%,267/426)、痰涂片抗酸杆菌检查阳性者152例(35.7%,152/426),均高于户籍患者(χ2值分别为98.19,37.38,39.29,P值均<0.001);流动人口新发肺结核治疗成功333例,占78.2%,(333/426),明显低于户籍人口(94.8%,984/1038)(χ2=92.46,P<0.001)。结论流动人口肺结核患者病变范围广、痰涂片抗酸杆菌阳性率高、治疗成功率低,增加了结核病控制工作的难度。

Objective To investigate the incidence and clinical characteristics of pulmonary tuberculosis （TB）cases among mobile population in Hanyang district of Wuhan city. Methods Consulting ways,demographics,clinical representations,lesions distribution, sputum smears and cultures along with the treatment outcomes of 426 TB cases of mobile population who were diagnosed and registered from January 2008 to December 2012 were compared with those of 1 038 local TB cases of the same age group in Hanyang district of Wuhan city. Chi square （~Z）test was employed to compare the difference between the two groups of patients. Results Among 426 TB eases of mobile population,385 eases were young and middle aged adults between 15 and 45 years old （90.4%, 385/426）; 253 cases were diagnosed through regular medical examinations （59.4% ,253/426）,267 cases had two or more pulmonary lobes involved （62.7% ,267/426）; 152 cases were found sputum smear positive （35.7%, 152/426）. All of the above indexes among the mobile were higher than those of the local patients（x2=-98.19,37.38,39.29 ,P〈0.O01 ）. The successful treatment rate among mobile TB cases was 78.2%（333/426） siguificanfly lower than 94.8% （984/1038）among the local TB patients（x2=92.46,P〈0.001 ）. Conclusions The mobile TB patients demonstrated severe illness,Their sputum positive rate was high and cure rate was low to have increased the difficulty of TB control.