2000—2009年上海市金山区活动性肺结核流行病学分析

目的了解上海市金山区肺结核病人发病情况、分布、临床特征及治疗转归情况,为制定结核病防治策略提供依据。方法对2000—2009年金山区活动性肺结核病报告登记管理资料进行分析。结果金山区2000—2009年共新登记该区活动性肺结核病例1 808例,合计发病率为34.42/10万,其中菌阳884例,菌阳率48.89%。金山区共新登记外来流动人口活动性肺结核病例556例,其中菌阳230例,菌阳率41.37%;该区肺结核患者以60岁以上老年人为主,占38.66%,男女性别比为3.26∶1。外来流动人口以青壮年为主,19～40岁占总病例数70.14%,男女性别比为1.79∶1,患者分型以Ⅲ型为主,该区查痰率97.79%,外来流动人口查痰率95.32%。2000—2009年该区涂阳肺结核患者治愈率89.29%,涂阴患者完成疗程率92.73%;2007—2009年外来流动人口涂阳肺结核患者治愈率为67.95%,涂阴患者完成疗程率为81.51%。结论该区活动性肺结核发病率总体趋势略有下降,而菌阳发病率下降趋势不明显;外来流动人口活动性肺结核发病人数呈现上升趋势,菌阳也呈现上升趋势。加强外来流动人口结核病管理,有必要采取切实有效的措施落实外来流动人口的结核病管理。

Epidemiological analysis of active pulmonary tuberculosis in Jinshan district of Shanghai 2000-2009

[Objective]To study the incidence,distribution,clinical features and treatment outcome of patients with pulmonary tuberculosis(TB) in Jinshan district of Shanghai. [Methods]The registration data of active TB in Jinshan district during 2000-2009 were analyzed. [Results]There were a total of 1808 new-registered cases of active TB in Jinshan district during 2000-2009,and the cumulative incidence was 34.42/lakh.884 of them were the smear-positive,and the smear-positive rate was 48.89%.There were 556 new-registered cases of active TB in floating population in Jinshan district,230 were smear-positive cases with the smear-positive rate of 41.37%.38.66% of TB patients were elderly people over 60 years old,and the ratio of male to female was 3.26∶1.The floating population was dominated by young adults,patients aged 19-40 years old accounted for 70.14% of total cases,and the ratio of male to female was 1.79∶1.Most of patients were type Ⅲ.The sputum examination rate in this district was 97.79%,and that in floating population was 95.32%.During 2000-2009,the cure rate of smear-positive TB patients in this district was 89.29%,and the treatment completion rate of smear-negative patients was 92.73%.During 2007-2009,the cure rate of smear-positive TB patients among floating population was 67.95%,and the treatment completion rate of smear-negative patients was 81.51%. [Conclusion]The general trend of incidence rate of active TB in Jinshan district decreases slightly,and the decreasing trend of incidence rate of smear-negative TB is not obvious.Among floating population,the active TB cases and smear-negative TB cases showed an increasing trend.It is necessary to take effective measures to strengthen and implement the TB management in floating population.