1996-2005年高唐县初治涂阳肺结核病人短程化疗治愈后复发情况分析

目的]了解现代结核病控制策略全程监督短程化疗（DOTS）治疗初治涂阳肺结核病人的效果与治愈后的复发情况，探讨影响治愈后复发的因素。方法]对1996-2005年高唐县结核病防治所登记管理的初治涂阳肺结核病人资料进行分析。结果]1996-2005年登记的新发涂阳病例合计1341例，治愈1167例，占87．02％；拒治的占6．19％，治疗失败的占3．80％，人院治疗的占1．04％，死亡的占0．30％，其他占1．79％。满疗程阴转的1167例病人，2年随访期内死亡27例，中断随访37例；完成随访的1103例。复发31例，复发率为2．81％。病人复发率，治愈后≤6个月内为0．45％，7～12个月为0．82％，13-18个月为0．82％，19～24个月为0．45％，25月至5年为0．27％；≤40岁为1．89％，41～60岁为2．71％，61岁以上为3．53％（P〉0．05）；有空洞的为5．29％，无空洞的为2.36％（P〈0．05）；规律用药的为1．90％．不规律用药的为6．73％（P〈0．01）。结论]高唐县初治涂阳肺结核病人治愈后的复发率较低，规律用药、治愈时无空洞者可降低复发率。

Analysis of the Recurrence of New Smear Positive Tuberculosis Patients after DOTS from 1996 to 2005

Objective]To understand the treatment effect of new smear positive tuberculosis patients after the implementation of the program of directly observed treatment short-course（DOTS） and the recurrence after cured by DOTS, explore the causes of recurrence. Methods]Data of new smear positive tuberculosis patients registered at Gaotang County Center for Tuberculosis Prevention and Control from 1996 to 2005 were analyzed. Results]1 341 new smear positive tuberculosis patients registered from 1996 to 2005,1 167 of them were cured, accounting for 87.02 %. refuse treatment cases accounted for 6.19% ,failure treatment cases accounted for 3.80%, inpatients accounted for 1.04% ,0.30% of the cases died, other cases accounted for 1.79%. Of the 1 167 negative conversion cases after whole course treatment, 27 of them dies during the 2-year follow-up, follow-up was interrupted for 37 cases,of the 1 130 whole course follow-up cases, there are 31 recurrence cases, accounting for 2.81%. The recurrence rate was 0. 45 % within 6 months after cured, 0. 82 % within 7-12 months,0. 82% within 13-18 months, 0.45% within 19-24 months, 0.27% within 25 months to 5 years;the recurrenee rate was 1.89% ,2. 71% and 3.54% in the people aged under 40,from 41 to 60 and over 61（ P 〉0. 05）. 5.29% of them had cavity formation while 2.36% of them had no cavity formation （ P 〈0. 05）. 1.90% of them had medicine regularly while 6.73% of them had medicine irregularly （ P 〈0. 01）. Conclusion]The recurrence rate of new smear positive tuberculosis patients was low after cure in Gaotang county,the recurrence rate can be reduced by regular taking medicine and no cavity after cure.