2011—2020年西安市肺结核流行趋势的Joinpoint回归分析

Joinpoint regression analysis on prevalence trend of pulmonary tuberculosis in Xi’an City from 2011-2020

目的分析2011—2020年西安市肺结核的发病情况和流行趋势,为制定防控策略和措施提供科学依据。方法收集2011—2020年西安市肺结核登记资料,采用Joinpoint回归模型评价2011—2020年西安市肺结核发病特征的时间变化趋势。结果2011—2020年西安市共报告肺结核患者45458例,肺结核粗报告发病率年平均为49.49/10万,标化报告发病率年平均为46.97/10万,2011—2020年肺结核标化报告发病率整体呈上升趋势。男女标化报告发病率分别为60.05/10万和33.26/10万,男性报告发病率显著高于女性,差异有统计学意义(χ^(2)=509206.81,P<0.05),且二者在2011—2020年均呈上升趋势。新增肺结核患者中利福平耐药患者的比例呈逐年上升趋势,平均每年上升19.0%(P<0.05)。肺结核患者中初治患者的比例呈逐年上升趋势,平均每年上升0.6%(P<0.05),其中利福平耐药患者中初治患者比例上升较快,平均每年上升15.1%(P<0.05)。结论2011—2020年西安市肺结核报告发病率呈上升趋势,新增肺结核患者中利福平耐药患者的比例及初治患者的比例上升较快,提示要扩大耐药筛查范围,及早发现并治疗肺结核患者,减少耐药结核杆菌的持续传播。

Objective To analyze the incidence and epidemiological trends of pulmonary tuberculosis in Xi’an City from 2011 to2020,provide scientific basis for formulating prevention and control strategies and measures.Methods The registration data of pulmonary tuberculosis in Xi’an City from 2011-2020 was collected,and the temporal variation trend on incidence characteristics of pulmonary tuberculosis in Xi’an City from 2011-2020 in the recent years was evaluated by Joinpoint regression model.Results A total of 45458 cases of pulmonary tuberculosis were reported in Xi’an City from 2011-2020,with an average annual crude reported incidence rate of 49.49/100000,the average annual standardized reported incidence rate was 46.97/100000,and the standardized reported incidence rate of pulmonary tuberculosis showed an increasing trend from 2011-2020.The standardized reported incidence rate in males and females was 60.05/100000 and 33.26/100000 respectively,the reported incidence rate in males was higher than that in females,with a statistically significant difference(χ^(2)=509206.81,P<0.05),and both showed an increasing trend from 2011-2020.The proportion of rifampicin-resistant patients among new pulmonary tuberculosis patients showed an increasing trend year by year,with an average annual increase of 19.0%(P<0.05).The proportion of newly treated patients among pulmonary tuberculosis patients showed an increasing trend year by year,with an average annual increase of 0.6%(P<0.05),among which the proportion of newly treated patients among rifampicin-resistant patients increased faster,with an average annual increase of 15.1%(P<0.05).Conclusion The reported incidence of pulmonary tuberculosis in Xi’an City is on the rise from 2011-2020,the proportion of rifampicin-resistant patients among new tuberculosis patients and the proportion of newly treated patients increase rapidly,suggesting that it is necessary to expand drug-resistant screening,detect and treat tuberculosis patients early,so as to reduce the continued transmission of drug-resistant Mycobacterium tuberculosis.