广州市城区肺结核合并糖尿病流行病学特征分析

目的了解广州市城区肺结核合并糖尿病(TB-DM)流行病学情况,为制定相关的防治策略提供依据。方法统计分析广州市结核病防治所登记中心2004—2008年广州市越秀、荔湾、海珠、天河中心城区肺结核登记的资料。结果 2004—2008年广州市中心城区TB-DM患者1047例,占同期登记肺结核患者总数的比例5年平均6.2%,平均年登记率6.22/10万,5年间无明显的上升或下降趋势(P0.05)。男性TB-DM占肺结核登记人数中男性患者的构成比6.5%,女性构成比5.3%(P0.01)。TB-DM患者年龄19～91岁,中位年龄59岁,以中老年患者为主,40岁后两病并发率大幅上升。在TB-DM患者中,痰涂阳性者632例(60.4%)、涂阴415例(39.6%)、出现空洞527例(50.3%)。TB-DM患者的涂阳率和空洞率均高于无合并糖尿病的肺结核患者(P0.01)。患者的发现主要是因症就诊,占89.2%。结论 TB-DM发生率较高,以中老年发病为主,涂阳率和空洞率均较高,给结核病控制带来一定的困难,要加强这一人群的防治工作。

Epidemiological features of pulmonary tuberculosis(PTB)patients complicated with diabetes in Guangzhou

Objective To understand the epidemiological trends and features of PTB patients complicated with diabetes（TB-DM） in Guangzhou in order to provide evidence base for TB control strategies formulation. Methods Information of PTB patients registered from 2004 to 2008 in Yuexiu,Liwang,Haizhu and Tianhe district were analyzed. Results The total number of TB-DM in these four districts were 1 047 from 2004 to 2008,accounting for 6.2% of total PTB patients over the same periods,the 5-year average annual registration rate is 6.22/100 000,no significant changes within 5 years（P0.05）. Male and female TB-DM accounted for 6.5% and 5.3% of PTB patients of same gender respectively（P0.01）. The age of TB-DM ranged from 19 to 91 with a median of 59 years old,majority was middle-aged and elderly patients over 40 years old. Among TB-DM patients,632 （60.4%）cases were smear positive,415 cases smear negative （39.6%）,527 cases with cavity 527 （50.3%）. The proportion of patients with smear positive result and cavity in TB-DM cases were both significantly higher than tuberculosis cases without diabetes （P0.01）. Patients discovery were mainly by outpatient attendance due to suspected symptoms,accounting for 89.2%. Conclusions The TB-DM incidence is relatively high,and mainly in middle-aged and elderly people,proportions of both smear positive and with cavity are high. All of these bring difficulties to TB control therefore there is a need to strengthen TB control work in this population.