住院精神病人并发肺结核的流行病学研究

目的了解江西省九江市第五人民医院住院精神病并发肺结核的流行特征,探讨其治疗效果与转归。方法选择2000年1月1日—2004年12月31日,在九江市第五人民医院住院的精神病人为研究对象(重复住院记为1次)。由专科医师复习病人的肺部X光片,查看检验报告单、治疗方案以及转归情况,并逐一登记,以每年为1组,将结果与九江市2003年肺结核流行病学调查结果进行比较分析。结果共调查住院精神病患者6098人,年龄18～75岁,平均(43.5±3.21)岁;伴发肺结核57人,患病率为935/10万,且呈逐年上升趋势。各年精神病并发肺结核患病率均高于2003年九江市普通人群的肺结核患病率(420/10万),经χ2检验,差别有统计学意义P(<0.05)。各年精神病并发肺结核患者登记率均低于普通人群,经χ2检验,差别无统计学意义P(>0.05)。精神病并发肺结核患者中,痰检者16人,痰检率28.6%(16/57),痰检阳性者0人。精神病并发肺结核患者中,仅有4人(长期住院)接受过正规全程抗痨化疗,占7.14%;11人因住院时间短等原因未完成全程抗痨化疗,占19.64%;其余41例未进行抗痨化疗,占73.21%。化疗病人无1例完全康复,且均未采取隔离措施。住院精神病并发肺结核患者化疗率均低于普通人群,经χ2检验,差别有统计学意义P(<0.01)。结论精神病人是肺结核的高发人群,精神病医院应加强规范管理与治疗。

Clinical Characteristics of the Psychotic Patients Complicated with Lung Tuberculosis

Objective To investigate the clinical features,treatment effect and outcomes of pulmonary tuberculosis(TB) in psychotic patients.Methods All data of 6 098 inpatients with psychotics in the No 5 People's hospital of Jiujiang city during Jan 1 of 2000 to Dec 12 of 2003 were collected and studied,and the results were compared with the result of epidemical investigation of tuberculosis in Jiujiang in 2003.Results The prevalent rate of tuberculosis in psychotic patients(57/6 098) was significantly higher than that in common people(420/100 000)(P<0.05),while the rates of enrollment and treatment were no significance than those in common people(P>0.05).The rate of sputum examination was 28.86% in 56 patients complicated with TB,and only 7.14% of them finished whole-course standard medication while 73.21% of them were not given anti-tuberculosis treatment.Conclusions The psychotic patients were the risk population of tuberculosis and the management and treatment still didn't reach criterion.So we should enhance the standard management and treatment on TB in psychotics.