368例流动人口活动性肺结核人口信息及临床表型的分析

目的 探讨广州市番禺区流动人口活动性肺结核病例人口信息、临床表型的特点及其与痰涂片结果的关系，为全区流动人口结核病防治策略制定提供依据。方法 符合纳入标准和排除标准的368例流动人口活动性肺结核病例，按痰涂片结果分为涂阳组和涂阴组，比较两组人口信息、影像学特点、结核病类型、耐药及一般基础疾病情况的差异；对痰涂片阳性与病变累及肺叶数、合并支气管结核、合并空洞进行相关性分析，研究痰涂阳性与临床表型的关系。结果 涂阳组40岁以上患者比例较涂阴组多（63例、39.38%）、病变累及2叶及以上为主（103例、64.38%）、合并空洞情况较多（73例、45.60%），两组在年龄构成、病变累及肺叶数、合并空洞以及复治比例上差异有统计学意义（P＜0.05）；相关性分析表明涂阳与病变累及肺叶2叶以下呈负相关，与病变累及肺叶4叶以上呈正相关，与合并支气管结核或空洞呈正相关（均P=0.000）。结论 掌握全区流动人口活动性肺结核涂阳组和涂阴组不同的人口信息和临床表型特点及其相关性对我区结防策略制定具有指导意义。

Analysis of demographic data and clinical phenotype of 368 patients with active pulmonary tuberculosis among migrant population

Objective To explore the characteristics of population information, clinical phenotype in the patients with active pulmonary tuberculosis among migrant population in our district, and its relationship with the results of sputum smear, and to provide the basis for the prevention and control strategies for migrant population in our district. Methods A total of 368 cases of patients with active pulmonary tuberculosis among migrant population who met the inclusion criteria and exclusion criteria were divided into the smear-positive group and smear-negative group according to the sputum smear results. The demographic information, imaging features, tuberculosis type, drug resistance and general underlying disease between the two groups were compared. The correlations between positive sputum smear and lesion-affected pulmonary lobes, associated bronchial tuberculosis, associated cavities were analyzed, and the relationship between positive sputum smear and clinical phenotype was studied. Results The patients over 40 years old in the smear-positive group accounted for a larger proportion than that of the smear-negative group (63 cases, 39.38%); 2 pulmonary lobes and above (103 cases, 64.38%) were mainly lesion-affected; and the associated cavities were more common (73 cases, 45.60%). The differences between the two groups on age structure, lesion-affected pulmonary lobes, associated cavities and retreatment proportion have statistical significance (P<0.05). The correlation analysis showed that the smear positive was negatively correlated with less than 2 lesion-affected lobes, positively correlated with more than 4 lesion-affected lobes, associated bronchial tuberculosis or cavities (P=0.000). Conclusion The research of the characteristics of population information and clinical phenotype in the patients with active pulmonary tuberculosis among migrant population and their correlation between the smear-positive and smear-negative groups has a guiding significance for the formulation of the strategy of prevention and control in our region.