上海市嘉定区肺结核合并糖尿病的流行病学分析

Epidemiological Features of Pulmonary Tuberculosis Patients Complicated with Diabetes in Jiading District, Shanghai

目的分析上海市嘉定区2008—2014年肺结核合并糖尿病(TB-DM)的流行病学特征,为TB-DM防治提供相应依据。方法收集整理上海市嘉定区2008—2014年间的活动性肺结核疫情登记资料,并进行统计分析。结果 190例TB-DM患者中,男性162例(85.26%),女性28例(14.74%)。TB-DM患者年龄22~87岁,中位年龄55岁;40岁后男性TB-DM构成比大幅上升。在TB-DM患者中,痰涂片阳性、合并空洞、治疗失败和转入耐多药和复治的患者占比分别为73.67%、56.32%、4.21%和13.16%,均高于未合并糖尿病肺结核组的42.51%、52.91%、0.14%和7.02%,差异有统计学意义。TB-DM患者中治愈率为72.86%,死亡率为3.16%,未合并糖尿病的患者治愈率为76.17%,死亡率为2.54%,差异无统计学意义。结论 TB-DM病情比较复杂、治疗难度高、预后凶险,应引起临床医生及相关卫生管理部门的重视,进一步加强对重点人群的结核病防治工作。

Objective To analyze the epidemiological features of pulmonary tuberculosis patients complicated with diabetes（TB-DM） from 2008 to 2014 in Jiading District of Shanghai, to provide evidence base for controlling PTB. Methods The epidemic situation data of PTB from 2008 to 2014 in Jiading District was collected and analyzed. Results The total number of TB-DM was 190. The cases of male and female of TB-DM patients were 162 and 28 respectively, and accounted for 85.26% and 14.74% respectively. The age of TB-DM ranged from 22 to 87 with a median of 55 years old; constituent ratio increased significantly after age 40. Among TB-DM patients, the proportions of cases with smear positive, cavity, treatment failure and transfer to multi drug resistance, and re-treatment were 73.68%, 56.32%, 4.21%, and 13.16%, which were higher than those of among the non TB-DM patients with 42.51%, 52.91%, 0.14%, and 7.02%; the differences were statistically significant. The rates of cure and death among TB-DM patients were 72.86% and 3.16% respectively, and those among the non TB-DM patients died were 76.17% and 2.54% respectively; the differences were statistically significant. Conclusion The condition of TB-DM is more complicated, and is difficult of treatment with dangerous prognosis, so clinicians and related health management department should pay attention it, to further strengthen the prevention and control of tuberculosis in key population.