辽宁省2016-2022年病原学阳性肺结核流行特征及治疗转归分析

Epidemic characteristics and treatment outcomes of etiologically positive pulmonary tuberculosis in Liaoning Province from 2016 to 2022

目的 分析2016-2022年辽宁省病原学阳性肺结核流行特征及治疗转归的情况,为今后制订辽宁省结核病防治措施提供科学依据。方法 从《中国疾病预防控制信息系统》子系统《结核病信息管理系统》中收集辽宁省2016-2022年登记肺结核患者病案信息,对病原学阳性肺结核的流行特征及治疗转归情况进行描述性分析。结果 2016-2022年辽宁省共登记活动性肺结核患者152 778例,登记率由2016年的54.48/10万下降到2022年的39.12/10万,呈下降趋势(χ^(2)趋势=1 921.17,P<0.001)。病原学阳性率由2016年的26.70%上升到2022年的51.21%,呈上升趋势(χ^(2)趋势=5 203.00,P<0.001)。病原学阳性登记率由2016年的14.54/10万上升到2022年的20.03/10万,呈上升趋势(χ^(2)趋势=647.97,P<0.001)。病原学阳性男女性别比为3.35∶1;病原学阳性肺结核报告发病以55~<65岁年龄组(25.45%,16 127/63 376)最多,45岁以上年龄组占发病总数的71.27%(41 570/63 376),年龄构成逐渐趋于老龄化;职业以家务及待业为主,占总体的41.78%(26 477/63 376),呈逐年上升趋势(χ^(2)趋势=17.404,P<0.001);患者来源主要以直接就诊为主,占50.28%(31 864/63 376);就诊延迟占64.54%(40 904/63 376)。病原学阳性肺结核发病具有一定的季节性,每年2月、9月为发病低谷月,5月、6月为发病高峰月;病原学阳性患者以沈阳市、大连市、锦州市等地区为主;2016-2021年病原学阳性肺结核成功治疗构成比从2016年的91.15%下降到2022年的85.88%,呈下降趋势(χ^(2)趋势=35.892,P<0.001)。结论 2016-2022年辽宁省病原学阳性率、病原学阳性登记率呈上升趋势,呈现季节性变化,存在就诊延迟的特征,地区存在分布差异,成功治疗构成比下降,应根据辽宁省实际情况制订有针对性的防控措施。

Objective To analyze the epidemic characteristics of etiologically positive pulmonary tuberculosis,and the outcome of treatment in Liaoning Province from 2016 to 2022,aiming to provide a scientific basis for the formulation of tuberculosis prevention and control measures in Liaoning Province.Methods The medical records information of registered pulmonary tuberculosis patients in Liaoning Province from 2016 to 2022 was collected from the"Tuberculosis Information Management System",a subsystem of the"China Disease Prevention and Control Information System".A descriptive analysis was performed on the epidemiological characteristics and treatment outcomes of cases of pathogen-positive pulmonary tuberculosis.Results From 2016 to 2022,a total of 152778 cases of active pulmonary tuberculosis were registered in Liaoning Province.Registration rates decreased from 54.48/100000 in 2016 to 39.12/100000 in 2022,displaying a downward trend(χ^(2)_(trend)=1921.17,P<0.001).The etiological positive rate increased from 26.70%in 2016 to 51.21%in 2022,indicating an upward trend(χ2 trend=5203.00,P<0.001).The etiological positive registration rate increased from 14.54/100000 in 2016 to 20.03/100000 in 2022,showing an upward trend(χ^(2)_(trend)=647.97,P<0.001).The male-female ratio of etiological positive was 3.35∶1.The age group of 55-<65 had the highest incidence rate at 25.45%(16127/63376)among pathogen-positive pulmonary tuberculosis cases.Patients over 45 years of age accounted for 71.27%(41570/63376)of total cases,pointing towards an aging trend.The main occupations of the patients were household and unemployed,making up 41.78%(26477/63376)of total cases and showed an increasing year-on-year trend(χ^(2)_(trend)=17.404,P<0.001).Direct medical consultation was the primary mode of patient source at 50.28%(31864/63376),while 64.54%(40904/63376)cases reported a delay in seeking treatment.Seasonality was observed in the occurrence of pathogen-positive pulmonary tuberculosis,with February and September being the months of lowest incidence,while May and June witnessed peak incidences.The etiological positive patients were mainly in Shenyang,Dalian,Jinzhou and other regions.The proportion of successful treatment of etiologically positive decreased from 91.15%in 2016 to 85.88%in 2022,manifesting a downward trend(χ^(2)_(trend)=35.892,P<0.001).Conclusions From 2016 to 2022,the incidence and registration rates of pathogen-positive pulmonary tuberculosis in Liaoning Province displayed an upward trend.Several characteristics were observed including seasonal variations,delayed treatment,regional distribution differences,and a decline in successful treatment rates.Targeted prevention and control measures should be formulated according to the actual situation in Liaoning Province.