2006-2015年四川省彝区与非彝区肺结核流行病学特征分析

A study on epidemiological characteristics of pulmonary tuberculosis in Yi and non Yi districts in Sichuan Province from 2006 to 2015

目的分析地处四川省彝区与非彝区的马边彝族自治县和沐川县2006-2015年登记肺结核患者的流行特征。方法2006-2015年《结核病信息管理系统》中马边彝族自治县登记肺结核患者1733例；沐川县登记肺结核患者1131例。采用描述性统计分析的方法对两个县肺结核患者的构成及年龄、性别、民族、地区流行病学分布等特征进行对比分析。结果2006-2015年马边彝族自治县肺结核患者平均登记率为83．78／10万（1733／2068456），沐川县的肺结核患者平均登记率为43．84／10万（1131／2579967）。沐川县肺结核患者登记率从2006年的65．04／10万（167／256758）下降至2015年的12．52／10万（32／255650）（χ2趋势=125．15，P〈0．05）；2006年马边彝族自治县肺结核患者登记率为96．71／10万（181／187157），2015年肺结核患者登记率为98．86／10万（213／215449），10年间登记率波动不大。马边彝族自治县10年间肺结核男性患者平均登记率为109．19／10万（1170／1071486），高于女性[56．47／10万（563／996970）]，差异有统计学意义（χ2=171．48，P〈0．05）。沐川县10年间登记肺结核男性患者平均登记率为66．76／10万（915／1370503），高于女性[17．86／10万（216／1209 464）]，差异有统计学意义（χ2=350．73，P〈0．05）。2006-2015年马边彝族自治县登记肺结核患者的发病最高峰为30～岁组，占27．52％（477／1733），沐川县登记肺结核患者的发病最高峰为40～岁组，占19．98％（226／1131）。2006-2015年两地区登记的肺结核患者中，马边彝族自治县的彝族患者占84．25％（1460／1733），高于汉族患者[15．52％（269／1733）]；沐川县的汉族患者占99．56％（1126／1131），马边彝族自治县和沐川县10年间不同民族登记肺结核患者的分布差异均有统计学意义（χ2值分别为341．30和8785．64，P值均〈0．05）。2006-2015年马边彝族自治县农村肺结核患者占96．19％（1667／1733），高于城镇[3．81％（66／1733）]；沐川县农村肺结核患者占78．87％（892／1131），高于城镇[21．13％（239／1131）]，差异均有统计学意义（χ2值分别为324．75和22．77，P值均〈0．05）。结论彝区结核病疫情较重，青中年男性、农村居民作为高危人群，将此类人群作为肺结核防治工作的重点。

Objective To analyze the epidemiological characteristics of pulmonary tuberculosis （PTB） between Mahian Autonomous County and Muchuan County which located in Yi and non Yi districts in Sichuan Province during 2006-2015. Methods There were 1733 and 1131 registered PTB patients in Mahian Yi Autonomous County and Muchuan County in the ＇National TB Reporting Information Management System＇ during 2006-2015, respectively. A descriptive statistics analysis was conducted to analyze the epidemiological distribution characteristics of age, gender, ethnic, and regional of PTB patients in the two counties. Results The average registration rate of PTB was 83.78/100 000 （1733/2 068 456） in Mabian Yi Autonomous County from 2006 to 2015, and 43.84/100 000 （1131/2 579 967） in Muchuan County. The registration rate of PTB patients declined obviously from 65.04/100 000 （167/256 758） in 2006 to 12.52/100 000 （32/255 650） in 2015 in Muchuan County （χ2trend= 125.15, P〈0.05）. The registration rate of PTB was 96.71/100 000 （181/187 157） in Mabian Yi Autonomous County in 2006 and 98.86/100 000 （213/215 449） in 2015 with little change in the past 10 years. The average registration rate of male PTB patients was 109.19/100 000 （1170/1 071 486） in Mabian Yi Autonomous County, which was higher than that of female patients （56.47/100 000 （563/996 970））; the difference was statistically significant （χ2 = 171.48, P〈0.05）. The average registration rate of male PTB patients was 66.76/100 000 （915/1 370 503） in Mu- chuan County, which was higher compared with female patients （17.86/100 000 （216/1 209 464））; the difference was statistically significant （χ2 =350.73, P〈0. 05）. The registration incidence peak appeared in 30-- young adults which accounted for 27. 52% （477/1733） in Mabian Yi Autonomous County from 2006 to 2015, while a peak ap- peared in the 40- older group in Muchuan County which accounted for 19.98% （226/1131）. During 2006-2015, the Yi nationality patients accounted for 84.25% （1460/1733）, which was more than Han nationality （15.52% （269/1733）） in Mabian Yi Autonomous County, while Han nationality patients accounted for 99.56% （1126/1131） in Muchuan County; the difference was statistically significant （χ2 =341.30 and 8785.64, respectively, P〈0. 05）. The number of registered PTB in rural accounted for 96.19% （1667/1733）, which was higher than that in urban （3.81% （66/1733）） Mabian Yi Autonomous County, and the registered patients in rural accounted for 78. 87% （892/1131）, which was higher than that in urban （21.13% （239/1131）） Muchuan County from 2006 to 2015, （χ2 =324. 75 and 22.77, respectively, P〈0. 05）. Conclusion The epidemic situation of PTB in Yi district is serious. The Yi people, young and middle-aged men and the peasants should be regarded as high-risk groups in the two counties, and these persons will be the focus of the work of TB prevention and control.