2008-2017年四川省泸州市肺结核流行趋势分析

Analysis on The Epidemic Trend of Pulmonary Tuberculosis From 2008 to 2017 in Luzhou of Sichuan Province

目的分析2008-2017年四川省泸州市肺结核(pulmonary tuberculosis,PTB)疫情流行特征,掌握流行趋势,为今后制定肺结核防控策略提供科学依据。方法采用描述性流行病学方法对2008-2017年泸州市肺结核疫情资料进行分析,率的比较采用χ~2检验,检验水准α=0. 05。结果 2008-2017年泸州市共报告肺结核患者34 392例,年均报告率为82. 29/10万,报告发病率从103. 66/10万下降至61. 03/10万,肺结核疫情呈逐年下降趋势(χ_(趋势)~2=-32. 83,P<0. 01),年均递降率为6. 70%。2008-2017年,泸州市共登记肺结核患者36 635例,年均登记现患率为87. 66/10万,登记现患率从119. 78/10万下降至65/10万,登记现患率呈逐年下降趋势(χ_(趋势)~2=-36. 19,P<0. 01),年均递降率为7. 03%;男性患者年均报告率为118. 19/10万,女性患者为45. 53/10万,男性发病是女性2. 66倍,两者发病率差异有统计学意义(χ~2=4 760. 56,P<0. 01);发病年龄主要集中在35～64岁,占56. 98%,随着年龄增加发病率呈上升趋势(χ_(趋势)~2=89. 83,P<0. 01),60～79岁老年男性发病率最高;职业分布中农民发病最多,占75. 32%;一年四季均有病例报告,以1月和3月稍高;发病地区分布不均衡,3个贫困县年平均报告发病率94. 85/10万,4个非贫困县区年平均报告发病率74. 61/10万,两者差异有统计学意义(χ~2=745. 55,P <0. 01); 2013-2017年耐多药发现率(8. 97%)高于全国水平(8. 32%)和四川省第五次结核流调水平(4. 2%)。结论四川省泸州市肺结核疫情呈逐年下降趋势,贫困县是结核病高发地区,男性、农民和中老年人群是防控的主要人群,耐药监测和防控将是今后肺结核防控的重点工作。

Objective To analyze the epidemiological characteristics and the epidemic trend of pulmonary tuberculosis( PTB) in Luzhou from 2008 to 2017,so as to provide the evidence for formulating prevention and control strategies. Methods The descriptive epidemiological analysis method was used to analysis the data of PTB in Luzhou from 2008 to 2017. Results There were 34 392 PTB cases reported in Luzhou from 2008 to 2017,and the annual average incidence rate was 61. 03/105. The incidence rates declined from 113. 9/10^5 to 61. 03/10^5,which showed a downward trend year by year( P<0. 01),the annual decline rate was 6. 70%.There were 36 635 cases of PTB patients registered from 2008 to 2017,the annual average registered prevalence rate was 87. 66/10^5,which declined from 119. 78/10^5 to 65/10^5,showing a declining trend year by year( P < 0. 01),and the annual decline rate was 7. 03%. The incidence rate in male and female was 118. 19/10^5 and 45. 53/10^5 respectively,the incidence rate of male was 2. 6 times higher than that of female,the difference was statistical( P<0. 01). Most cases were in the age group from 35-64 years old,accounting for 56. 98%,with the age increased the incidence rate increased( P < 0. 01) and peaked in 60-79 male group. Most cases was farmer,accounting for 75. 32%. The PTB cases were reported all seasons but little higher in January to March. The PTB incidence rate in different district was imbalanced,the annual average incidence rate of the three poverty counties was 94. 85/10^5,the other four counties was 74. 61/105,the difference between them was statistical( P<0. 01). The multidrug resistance rate( 8. 97%) from 2013 to 2017 was higher than that in the fifth epidemiological survey in Sichuan province( 4. 2%) issued in 2010 and the national level( 8. 32%). Conclusion The PTB epidemic trend in Luzhou has steadily declined in recent years.The poverty counties are high incidence area. The male,farmers,middle-aged and elderly population are the focus population of prevention and control,and the drug resistance monitoring and prevention should be the key point in the future.