2005-2014年浙江省老年肺结核病流行病学特征分析

Epidemiology of tuberculosis in the elderly in Zhejiang,2005-2014

目的分析浙江省老年肺结核患者的流行病学特征,探讨老年结核病防治对策。方法通过描述性研究方法对2005-2014年浙江省老年人口（年龄≥60周岁）活动性肺结核报告发病情况进行流行病学分析。结果 10年间,浙江省60岁以上老年肺结核病和菌阳肺结核的报告发病率呈下降趋势,但老年肺结核患者在整个报告发病患者中仍占较大比例（25.00%左右）,老年肺结核病报告发病率是其他人群的2.23倍,菌阳肺结核是其他人群的2.76倍;老年肺结核病报告病例总数以60~64岁组最多,年均报告发病率以75~79岁组最高;老年患者中复治比例是其他人群的1.65倍,差异有统计学意义（χ2=2370.34,P〈0.001）;老年患者就诊延误比例为61.60%,高于其他人群（52.72%）,差异有统计学意义（χ2=1930.59,P〈0.001）。结论浙江省老年肺结核病和菌阳肺结核报告发病率均有下降,但老年肺结核患者所占比例仍较大,菌阳率高,是重要的传染源,应加强特定人群宣传力度,做好老年肺结核病患者的早期发现工作。

Objective To understand the epidemiological characteristics of tuberculosis（ TB） in the elderly in Zhejiang province and provide evidence for the prevention and control of TB. Methods The incidence data of TB in the elderly（ ≥60years） of Zhejiang from 2005 to 2014 were collected and analyzed. Results In the past 10 years,the incidence rate of TB and smear positive TB was in decrease,but the patients aged 〉60 years accounted for a large proportion（ about 25%）. The incidence rate of TB in the elderly was 2. 23 times higher than in other populations. The incidence rate of smear positive TB in the elderly was 2. 76 times higher than in other populations. The case number in the elderly aged 60- 64 years was highest（ 21 441 cases） and the average annual incidence was highest in the elderly aged 75- 79 years. The proportion of retreated patients in age group ≥60 years was 1. 65 times higher than that in age group 〈60 years. The proportion of diagnosis delay in age group ≥60 years was also higher than that in age group 〈60 years,the difference was significant（ χ2= 1930. 59,P 〈0. 001）. Conclusion The incidences of TB and smear positive TB in the elderly were in decrease in Zhejiang,but the proportion of elderly TB patients was still high. The elderly TB patients were important source of infection with high smear positive rate. It is important to strengthen the health education in the elderly and early detection of TB in the elderly.