浙江省衢州市高疫情农村老年人非活动性肺结核流行特征分析

Epidemiological characteristics of inactive pulmonary tuberculosis among the elderly in high-endemic rural areas in Quzhou City,Zhejiang Province

目的:分析浙江省衢州市高疫情农村老年人群非活动性肺结核的流行特征。方法:通过对浙江省衢州市结核病疫情高发的2个乡镇6个行政村持续居住6个月且满65周岁的老年人群,在居民参加健康体检基础上,结合老年人胸部数字化X线摄影术(digital radiography,DR)免费筛查、γ-干扰素释放试验(IGRA)检测结核分枝杆菌潜伏感染项目等开展非活动性肺结核筛查,获取老年人群非活动性肺结核的患病情况,分析患者特点和检出率情况。结果:符合要求的研究对象共2050名,完成全程所有筛查1658名,筛查率为80.88%(1658/2050);非活动性肺结核检出率为8.62%(143/1658),活动性肺结核检出率为0.24%(4/1658)。老年人非活动性肺结核检出男性所占比例(63.64%,91/143)明显高于女性(36.36%,52/143),差异有统计学意义(χ^(2)=12.161,P=0.000);不同年龄组检出率由65~69岁的5.60%(34/607)上升至85岁及以上的12.20%(10/82),差异有统计学意义(χ^(2_()趋势)=12.329,P=0.000);非活动性肺结核患者纤维性病灶检出率(62.94%,90/143)明显高于普通人群(13.04%,197/1511),差异有统计学意义(χ^(2)=226.817,P=0.000)。结论:浙江省衢州市肺结核疫情高发地区农村老年人非活动性肺结核检出率较高,需要继续开展科学研究监测其发病风险特征,为制定适合降低疫情的干预措施提供基础数据。

Objective:To analyze the epidemiological characteristics of inactive pulmonary tuberculosis among the elderly in high tuberculosis endemic rural areas in Quzhou,Zhejiang Province.Methods:The elderly population aged 65 and above who lived for at least 6 months in 6 administrative villages in 2 townships in Quzhou City,Zhejiang Province with high incidence of tuberculosis,were recruited.Free digital radiography(DR)screening and gamma-interferon release assays(IGRA)were performed to detect latent infection of Mycobacterium tuberculosis and screen inactive pulmonary tuberculosis,thus to obtain the prevalence of inactive pulmonary tuberculosis in the elderly people and analyze characteristics of patients and detection positive rate.Results:A total of 2050 subjects met the enroll criteria,and 1658 completed all screening tests,with a screening rate of 80.88%(1658/2050).The detection positive rate of inactive pulmonary tuberculosis was 8.62%(143/1658),the detection rate of active pulmonary tuberculosis was 0.24%(4/1658).The proportion of detected with inactive pulmonary tuberculosis in the elderly male(63.64%,91/143)significantly higher than females(36.36%,52/143),and the difference was statistically significant(χ^(2)=12.161,P=0.000).The detection positive rate increased from 5.60%(34/607)among 65-69 years age group to 12.20%(10/82)among 85 years old and above age group,and the difference was statistically significant(χ^(2)_(trend)=12.329,P=0.000).The incidence rate of pulmonary fibrous lesions among inactive pulmonary tuberculosis patients(62.94%,90/143)was significantly higher than that of the general population(13.04%,197/1511,χ^(2)=226.817,P=0.000).Conclusion:The detection positive rate of inactive pulmonary tuberculosis in rural elderly people in high tuberculosis incidence areas in Quzhou City,Zhejiang Province is rather high.Scientific researches should be continued to monitor the risk characteristics of the disease,so as to provide basic data for formulating local intervention measures to lower the epidemic.