湖北省老年肺结核病防治效果回顾性分析

Retrospective analysis on the effect of prevention and treatment of senile pulmonary tuberculosis in Hubei Province

目的 回顾性分析2016—2020年湖北省老年肺结核防治效果及流行特征,为湖北省老年人群肺结核防治及策略研究提供科学依据。方法 收集2016—2020年现住址登记为湖北省的60岁以及上肺结核患者资料进行分析。对登记率、构成比等采用χ^(2)检验和χ^(2)趋势检验。结果 2016—2020年,湖北省累计登记老年肺结核患者135 967例,年均老年户籍人口老年结核病登记率(是指以60岁及以上老年户籍人口数为分母,60岁及以上结核病患者为分子统计的登记率)为263.51/10万,最高为2017年的300.02/10万,最低为2020年188.19/10万,整体逐年下降(χ^(2)=70 227.603,P<0.001)。60~70岁组患者年均占59.60%,占比逐年下降(χ_(趋势)^(2)=40.448,P<0.001);男性年均占73.35%,明显高于女性(26.65%);职业分布上以农民为主年均占62.03%。从病例管理来看,报卡来源大疫情网报年均占85.17%;病例分类主要为临床诊断类年均占48.33%,且呈逐年下降趋势(χ_(趋势)^(2)=740.911、P<0.001),而确诊病例类年均占25.08%,呈逐年上升趋势(χ_(趋势)^(2)=380.557、P<0.001)。2016—2020年老年结核病患者就诊延迟率为49.42%(67 876/135 967),就诊延迟占比逐年下降(χ_(趋势)^(2)=323.764,P<0.001)。结论 湖北省老年人口肺结核患者呈下降趋势。重点关注定点医院主动发现病例力度,加大确诊病例的占比,保持高追踪到位,减少就诊延误,确保老年人结核防治成效。

Objective To retrospectively analyze the prevention and control effect and epidemic characteristics of elderly tuberculosis in Hubei Province from 2016 to 2020,and to provide a scientific basis for the prevention and treatment of elderly tuberculosis in Hubei Province.Methods The data on tuberculosis patients aged 60 and above who registered their current address in Hubei Province from 2016 to 2020 were collected and analyzed.The registration rates and composition ratios were analyzed using 2 test and 2 test for trend.Results A total of 135976 tuberculosis patients were reported in Hubei from 2016 to 2020.The annual average registration rate of elderly tuberculosis among the elderly registered residence population(referring to the registration rate of elderly registered residence population aged 60 and above as the denominator,and tuberculosis patients aged 60 and above as the numerator)was 263.51/100000.The highest rate was 300.02/100000 in 2017,and the lowest was 188.19/100000 in 2020(X^(2)=70,227.603,P<0.001).In terms of composition,the average annual proportion of tuberculosis patients in the 60-70 years old group was 59.60%,which decreased year by year(X_(trend)^(2)=40.448,P<0.001).The average annual proportion of males was 73.35%,which was significantly higher than that of females(26.65%).The average annual proportion of farmers was 62.03%.From the perspective of case management,the annual average proportion of major epidemic online reports was 85.17%.The classification of cases was mainly based on clinical diagnosis,accounting for 48.33%annually and showing a decreasing trend year by year(X_(trend)^(2)=740.911,P<0.001).The proportion of confirmed cases was 25.08%,which showed an increasing trend(X_(trend)^(2)=380.557,P<0.001).From 2016 to 2019,the delay rate of diagnosis and treatment of elder tuberculosis patients was 49.42%(67876/135967),and the delay rate decreased year by year(2 rend=323.764,P<0.001).Conclusion The elderly population with pulmonary tuberculosis in Hubei Province shows a downward trend.It is necessary to focus on the efforts of designated hospitals to proactively identify cases,increase the proportion of confirmed cases,maintain a high tracking in place,reduce medical delays,and ensure the effectiveness of tuberculosis prevention and treatment for the elderly.