不同类型结核病定点医疗机构收治的北京市西城区肺结核患者的差异性及病原学影响因素分析

Analysis on the difference and etiological factors of pulmonary tuberculosis patients in Beijing Xicheng District treated by Different types of tuberculosis designated medical institutions

目的分析由不同类型结核病定点医疗机构治疗的北京市西城区肺结核患者的差异,为做好患者诊疗提供参考依据。方法从中国疾病预防控制信息系统导出2020年1月1日~2020年12月31日现管理单位为北京市西城区结核病防治所的肺结核患者资料。按现诊断单位将患者分为防治所组和定点医院组,对两组基本信息和临床特征进行回顾性分析,剔除结核性胸膜炎后进行病原学及其影响因素分析,统计分析软件为SPSS 17.0,P<0.05认为差异有统计学意义。结果183例患者纳入本研究,防治所组93例(50.82%),定点医院组90例(49.18%)。定点医院组合并其他结核的比例高于防治所组(10.00%vs.1.08%),结核性胸膜炎比例高于防治所组(11.11%vs.3.23%),两组比较差异有统计学意义(χ2=7.052、7.015,P<0.05)。剔除13例结核性胸膜炎后分析两组病原学结果,定点医院组无病原学结果的比例高于防治所组(12.50%vs.0.00%),两组比较差异有统计学意义(χ2=12.256,P<0.05)。Logistic回归分析显示合并糖尿病是病原学阳性的相关危险因素,差异有统计学意义(OR=6.476,P<0.05)。结论北京市西城区结核性胸膜炎患者、合并其他结核的肺结核患者于市级结核病定点医院诊治者多于市级结核病防治所,但市级结核病定点医院需加强患者病原学检查。肺结核合并糖尿病者的病原学阳性风险高,应予以关注。

Objective To analyze the difference among pulmonary tuberculosis patients in Beijing Xicheng District treated by different types of tuberculosis designated medical institutions,and to provide reference for the treatment and management of tuberculosis patients.Methods The data of pulmonary tuberculosis patients managed by Tuberculosis Prevention and Control Institute of Beijing Xicheng District from January 1,2020 to December 31,2020 were derived from China Disease Prevention and Control Information System.The patients were divided into the prevention and control institute group and the designated hospital group according to the current diagnosis unit.The basic information and clinical characteristics of the two groups were analyzed retrospectively.After excluding tuberculous pleurisy,the etiological analysis of influencing factors were performed.The statistical analysis software was SPSS 17.0,and P<0.05 was considered statistically significant.Results A total of 183 patients were included in this study,including 93 cases(50.82%)in the prevention and control institute group and 90 cases(49.18%)in the designated hospital group.The proportion of complicated with other tuberculosis in the designated hospital group was higher than that in the prevention and control institute group(10.00%vs 1.08%).The proportion of tuberculous pleurisy in the designated hospital group was higher than that in the prevention and control institute group(11.11%vs.3.23%),and the difference between two groups was statistically significant(χ2=7.052,7.015,P<0.05).After excluding 13 cases of tuberculous pleurisy,the etiological results of the two groups were analyzed.The proportion of no etiological result in the designated hospital group was higher than that in the prevention and control institute group(12.50%vs.0.00%),and the difference between two groups was statistically significant(χ2=12.256,P<0.05).Logistic regression showed that diabetes mellitus was a risk factor of etiological positive,and the difference was statistically significant(OR=6.476,P<0.05).Conclusion Patients with tuberculous pleurisy and pulmonary tuberculosis combined with other tuberculosis in Beijing Xicheng District were more dignosed and treated in municipal tuberculosis designated hospital than municipal tuberculosis prevention and control institutes.But etiological examination should be strengthened in municipal tuberculosis designated hospital.Tuberculosis patients with diabetes mellitus have high risk of positive etiology and should be paid attention to.