辽宁省2013—2017年老年肺结核病流行特征
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摘要
目的分析2013—2017年辽宁省老年肺结核病的流行特征,为今后制定符合我省老年肺结核病的防治策略提供科学依据。方法回顾性收集辽宁省2013—2017年中国疾病预防控制信息系统结核病信息管理系统中年龄≥60岁的老年肺结核患者登记资料并进行描述性统计分析。结果 2013—2017年辽宁省累计登记肺结核患者121 053例,年均登记率为55.26/10万,登记率整体呈上升趋势(χ~2_(趋势)=69.940,P<0.001),老年肺结核累计登记29 415例,登记率呈上升趋势(χ~2_(趋势)=190.056,P<0.001),老年肺结核患者占全省肺结核患者的比例整体呈上升趋势(χ~2_(趋势)=512.160,P<0.001),老年涂阳肺结核患者占全省涂阳肺结核患者的比例整体呈上升趋势(χ~2_(趋势)=108.286,P<0.001);2013—2017年登记的老年患者数各年龄组相比,60～<65岁老年肺结核患者登记率最高,≥85岁老年肺结核患者登记率最低,男性高于女性,职业以农民为主,占49.06%;从时间上看,以3—5月份登记的病人数最多,共8 329例,占患者总数的28.36%;从地区分布看,老年肺结核登记率以本溪市(19.48/10万)、葫芦岛市(19.06/10万)最高,大连市(10.89/10万)最低;老年肺结核病患者发现方式以因症就诊为主,占62.28%。结论老年肺结核患者登记率整体呈上升趋势,老年人已成为肺结核病的高发人群,其发病呈现男性、农民、春季多发的特点。应关注老年人群,开展对老年肺结核病的主动筛查工作,并采取有效防治措施。
Objective To analyze the epidemiological characteristics of tuberculosis(TB) among the elderly population in Liaoning Province from 2013 to 2017, and to provide scientific basis for future development of prevention and treatment strategies for elderly tuberculosis in our province. Methods The registration data of elderly pulmonary tuberculosis patients aged ≥60 years in the 2013-2017 were retrospectively collected by means of tuberculosis special report system of Liaoning Province. The descriptive statistical analysis was conducted. Results There was 121 053 cases of tuberculosis patients registered in Liaoning Province between 2013 and 2017. Annual average registration rate was 55.26/100 000. In total, the registration rate showed an increasing trend(χ~2 trend=69.940, P<0.001). There were 29 415 pulmonary tuberculosis patients and its registration rate was increasing(χ~2 trend=190.056, P<0.001). The proportion of elderly tuberculosis patients was also generally increasing(χ~2 trend=512.160, P<0.001). The proportion of elderly patients who were smear-positive was increasing in smear-positive tuberculosis patients in our province(χ~2 trend=108.286, P<0.001). Among of each age group of elderly patients registered in 2013-2017, 60-≤65 years old elderly tuberculosis patients had the highest registration rate, elderly patients with pulmonary tuberculosis over 85 years old had the lowest registration rate. The registration rate of men was higher than women,the occupation was dominated by farmers with 49.06%.In terms of time, the number of patients registered in March-May was the highest, with a total of 8 329 cases, accounting for 28.36% of the total number of patients. From the perspective of regional distribution, the registration rate of elderly tuberculosis was the highest in Benxi City(19.48/100 000), Huludao City(19.06/100 000), and the lowest in Dalian City(10.89/100 000). The way of finding tuberculosis in the elderly was mainly based on symptomatic treatment, accounting for 62.28%. Conclusions The registration rate of elderly tuberculosis patients has shown an overall upward trend. The elderly has become a high-risk group of tuberculosis, and their incidence is characterized by males, farmers and springs. Based on the above characteristics, we should pay attention to the elderly population, carry out active screening for tuberculosis in the elderly, and take effective preventive measures.
Objective To analyze the epidemiological characteristics of tuberculosis(TB) among the elderly population in Liaoning Province from 2013 to 2017, and to provide scientific basis for future development of prevention and treatment strategies for elderly tuberculosis in our province. Methods The registration data of elderly pulmonary tuberculosis patients aged ≥60 years in the 2013-2017 were retrospectively collected by means of tuberculosis special report system of Liaoning Province. The descriptive statistical analysis was conducted. Results There was 121 053 cases of tuberculosis patients registered in Liaoning Province between 2013 and 2017. Annual average registration rate was 55.26/100 000. In total, the registration rate showed an increasing trend(χ~2 trend=69.940, P<0.001). There were 29 415 pulmonary tuberculosis patients and its registration rate was increasing(χ~2 trend=190.056, P<0.001). The proportion of elderly tuberculosis patients was also generally increasing(χ~2 trend=512.160, P<0.001). The proportion of elderly patients who were smear-positive was increasing in smear-positive tuberculosis patients in our province(χ~2 trend=108.286, P<0.001). Among of each age group of elderly patients registered in 2013-2017, 60-≤65 years old elderly tuberculosis patients had the highest registration rate, elderly patients with pulmonary tuberculosis over 85 years old had the lowest registration rate. The registration rate of men was higher than women,the occupation was dominated by farmers with 49.06%.In terms of time, the number of patients registered in March-May was the highest, with a total of 8 329 cases, accounting for 28.36% of the total number of patients. From the perspective of regional distribution, the registration rate of elderly tuberculosis was the highest in Benxi City(19.48/100 000), Huludao City(19.06/100 000), and the lowest in Dalian City(10.89/100 000). The way of finding tuberculosis in the elderly was mainly based on symptomatic treatment, accounting for 62.28%. Conclusions The registration rate of elderly tuberculosis patients has shown an overall upward trend. The elderly has become a high-risk group of tuberculosis, and their incidence is characterized by males, farmers and springs. Based on the above characteristics, we should pay attention to the elderly population, carry out active screening for tuberculosis in the elderly, and take effective preventive measures.
引文
[1]WHO.Global tuberculosis report 2017[R].2017.https://www.who.int/tb/publications/global_report/en/.
[2]陈晓燕,吴文杰,成浩.2009-2011年无锡市老年肺结核病疫情分析[J].职业与健康,2012,28(17):2139-2140.
[3]毛宁,梁爽,何琳,等.2009-2014年辽宁省结核病流行特征分析[J].中华疾病控制杂志,2017,21(3):287-290.
[4]杜昕,黄飞,陆伟,等.2010-2012年全国肺结核登记率变化趋势分析[J].中国防痨杂志,2013,35(5):337-342.
[5]吴清芳,吕德良,管红云,等.2007-2016年深圳市肺结核病流行特征[J].热带医学杂志,2018,18(1):86-89.
[6]冯地忠,何伏华,陈寿东.老年结核病患者临床特征分析[J].预防医学,2018,30(12):1255-1257.
[7]李君,张淑兰,毛玲琼.温州市本地户籍老年人口肺结核流行病学分析[J].上海预防医学,2015,27(2):57-58.
[8]李峻,钟沛康,梁立群,等.香港老年人结核病疫情特征及影响因素的研究进展[J].中国防痨杂志,2016,38(8):678-681.
[9]赵飞,王黎霞,徐飚,等.全球结核病患病率宏观影响因素分析[J].疾病监测,2014,29(4):266-270.
[10]张威,李成俊,王洋,等.312例不典型肺结核病老年患者临床特点和治疗转归的性别差异[J].实用预防医学,2018,25(9):1121-1124.
[11]中华人民共和国卫生部.2000年全国结核病流行病学抽样调查资料汇编[M].北京:人民卫生出版社,2003.
[12]张根友,王纪祥,邹铮,等.2005-2012年安徽省结核病流行特征分析[J].中华疾病控制杂志,2014,18(6):504-507.
[13]丁守华,万青灵,邵文荣,等.江苏淮安市2011-2015年肺结核流行病学分析[J].中国热带医学,2017,17(8):791-794.
[14]毛宁,钟威,丁红芳,等.辽宁省2010-2014年肺结核患者就诊情况和发现方式分析[J].中国卫生工程学,2016,15(6):587-588,591.
[15]陈向君,陈沛学,王继江,等.山东省苍山县结核患者发现方式分析[J].中国防痨杂志,2010,32(2):73-76.
[16]段琼红,陈军,王卫华.MIRU-VNTR在耐多药结核病分子流行病学中的应用进展[J].实用预防医学,2017,24(8):971-973.2019-02-02
[2]陈晓燕,吴文杰,成浩.2009-2011年无锡市老年肺结核病疫情分析[J].职业与健康,2012,28(17):2139-2140.
[3]毛宁,梁爽,何琳,等.2009-2014年辽宁省结核病流行特征分析[J].中华疾病控制杂志,2017,21(3):287-290.
[4]杜昕,黄飞,陆伟,等.2010-2012年全国肺结核登记率变化趋势分析[J].中国防痨杂志,2013,35(5):337-342.
[5]吴清芳,吕德良,管红云,等.2007-2016年深圳市肺结核病流行特征[J].热带医学杂志,2018,18(1):86-89.
[6]冯地忠,何伏华,陈寿东.老年结核病患者临床特征分析[J].预防医学,2018,30(12):1255-1257.
[7]李君,张淑兰,毛玲琼.温州市本地户籍老年人口肺结核流行病学分析[J].上海预防医学,2015,27(2):57-58.
[8]李峻,钟沛康,梁立群,等.香港老年人结核病疫情特征及影响因素的研究进展[J].中国防痨杂志,2016,38(8):678-681.
[9]赵飞,王黎霞,徐飚,等.全球结核病患病率宏观影响因素分析[J].疾病监测,2014,29(4):266-270.
[10]张威,李成俊,王洋,等.312例不典型肺结核病老年患者临床特点和治疗转归的性别差异[J].实用预防医学,2018,25(9):1121-1124.
[11]中华人民共和国卫生部.2000年全国结核病流行病学抽样调查资料汇编[M].北京:人民卫生出版社,2003.
[12]张根友,王纪祥,邹铮,等.2005-2012年安徽省结核病流行特征分析[J].中华疾病控制杂志,2014,18(6):504-507.
[13]丁守华,万青灵,邵文荣,等.江苏淮安市2011-2015年肺结核流行病学分析[J].中国热带医学,2017,17(8):791-794.
[14]毛宁,钟威,丁红芳,等.辽宁省2010-2014年肺结核患者就诊情况和发现方式分析[J].中国卫生工程学,2016,15(6):587-588,591.
[15]陈向君,陈沛学,王继江,等.山东省苍山县结核患者发现方式分析[J].中国防痨杂志,2010,32(2):73-76.
[16]段琼红,陈军,王卫华.MIRU-VNTR在耐多药结核病分子流行病学中的应用进展[J].实用预防医学,2017,24(8):971-973.2019-02-02