2013—2017年北京市朝阳区肺结核流行病学特征

Epidemiological analysis of pulmory tuberculosis in Chaoyang District of Beijing from 2013-2017

目的了解2013—2017年北京市朝阳区肺结核病发病及流行情况,为北京市朝阳区制定肺结核预防控制措施提供参考依据。方法将收集的病例资料导入Excel,并对病例资料进行分析。结果 2013—2017年北京市朝阳区肺结核总报告病例6 289例,占同期法定传染病报告总数的5.65%,年平均发病率为32.50/10万,死亡率为0.04/10万。2015—2017年肺结核报告发病数均居北京市朝阳区甲乙类传染病首位。肺结核男性发病率明显高于女性(χ~2=466.845,P<0.01),≥70岁年龄组发病率最高,达67.81/10万。6 289例病例中实验室确诊病例2 488例,占总病例39.56%。47.91%病例出现诊断延误,涂阳病例诊断延误率低于涂阴(χ~2=101.56,P<0.01)。结论 2013—2017年肺结核是北京市朝阳区主要传染病之一,男性和≥70岁老年人是预防肺结核危害的重点人群,涂阴病例易造成诊断延误。应对男性和≥70岁老年人加强健康宣教,同时也要加强对医务人员的培训,提醒群众发病时及时就医和提高医务人员对肺结核可疑症状的警惕性,以减少诊断延误。同时实验室应加强基因检测,以提高病原学诊断的阳性率。

[Objective]To understand the incidence and epidemic of pulmonary tuberculosis in Chaoyang District of Beijing from2013-2017,provide reference for the formulation of tuberculosis prevention and control measures in Chaoyang District of Beijing.[Methods]The collected data were imported into Excel and analyzed.[Results]A total of 6 289 cases of pulmonary tuberculosis were reported in Chaoyang District of Beijing,accounting for 5.65%of total notifiable disease cases during the same period,the average annual incidence was 32.50/lakh and mortality was 0.04/lakh.From 2015 to 2017,the reported case number of tuberculosis occupies first place of class A and B infectious diseases in Chaoyang District of Beijing.The incidence of males was significantly higher than that of females(χ~2=466.845,P<0.01).The incidence of≥70 year-old age group was the highest,reaching 67.81/lakh.There were 2 488 laboratory-confirmed cases among 6 289 cases,accounting for 39.56%.47.91%of total reported cases had delayed diagnosis,and the delayed diagnosis rate of smear-positive cases was lower than smear-negative cases(χ~2=101.56,P<0.01).[Conclusion]From 2013-2017,tuberculosis is one of the major infectious diseases in Chaoyang District of Beijing.Males and elderly people over 70 years old are the key groups to prevent the tuberculosis.Smear-negative cases easily cause delays in diagnosis.It is necessary to strengthen the health education among males and elderly people over 70 years old,improve the training of medical staff,remind the masses to seek medical treatment in time and raise the vigilance of medical staff on suspicious symptoms of tuberculosis to reduce the delay of diagnosis.At the same time,the laboratory should strengthen gene detection in order to improve the positive rate of etiological diagnosis.