2020年湖南省老年肺结核患者流行特征及就诊情况分析

目的 了解湖南省老年肺结核流行特征和就诊情况,为制定老年人群结核病防控对策提供依据。方法 收集2020年“中国疾病预防控制信息系统”中“结核病信息管理系统”中登记的湖南省老年(≥65岁)人群肺结核病例资料,应用SPSS 25.0统计软件进行统计分析。结果 2020年湖南省共登记老年肺结核患者16 316例,占全人群登记肺结核患者总数的33.21%,登记发病率165.78/10万,是全人群肺结核登记发病率的2.24倍,男女性别比为2.64∶1,70-74岁年龄组发病率最高;衡阳市、张家界市和常德市老年肺结核登记发病率位居湖南省前三位。老年肺结核患者主动发现率为0.18%,低于非老年肺结核患者(χ^(2)=104.842,P<0.001);就诊延误率为57.58%,高于非老年肺结核患者(χ^(2)=37.994,P<0.001);诊断延误率为22.41%,低于非老年肺结核患者(χ^(2)=32.216,P<0.001)。老年肺结核患者复治比例高于非老年肺结核患者(χ^(2)=45.407,P<0.001),成功治疗的比例低于非老年肺结核患者(χ^(2)=638.599,P<0.001)。结论 老年患者为湖南省肺结核高危人群,就诊延误率高,成功治疗率偏低,应针对老年人群积极开展主动筛查和规范治疗。

Epidemic characteristics and clinic-visiting status of senile pulmonary tuberculosis patients in Hunan Province, 2020

Objective To understand the epidemic features and consultation of pulmonary tuberculosis (TB) among the elderly in Hunan Province, and to provide evidence for formulating containment countermeasures against TB among elderly population. Methods We collected the registered data about elderly TB patients (aged ≥ 65 years) in Hunan Province from TB Information Management System of China Information System for Disease Control and Prevention in 2020. SPSS 25.0 software was used for statistical analysis. Results A total of 16,316 senile patients with pulmonary TB were registered in Hunan Province in 2020, accounting for 33.21% of the total number of pulmonary TB patients registered in the whole population, with a registered incidence rate of 165.78/100,000, which was 2.24 times higher than the registered incidence rate of pulmonary TB in the whole population. The male to female sex ratio was 2.64:1, with the highest incidence rate in the age group of 70-74 years. As regards the ranking of the registered incidence of senile pulmonary TB in Hunan Province, the top three were Hengyang City, Zhangjiajie City and Changde City. The active detection rate of senile pulmonary TB patients was 0.18%, which was lower than that of non-senile pulmonary TB patients (χ²=104.842, P<0.001). The clinic-visiting delay rate was 57.58%, which was higher than that of non-senile pulmonary TB patients (χ²=37.994, P<0.001). The diagnostic delay rate was 22.41%, which was lower than that of non-senile pulmonary TB patients (χ²=32.216, P<0.001). The proportion of re-treatment was higher in senile pulmonary TBpatients than in non-senile pulmonary TB patients (χ²=45.407, P<0.001), while the proportion of successful treatment was lower in senile pulmonary TB patients than in non-senile pulmonary TB patients (χ²=638.599, P<0.001). Conclusion Elderly patients are a high-risk group for pulmonary TB in Hunan Province, with a high delay rate in consultation and a low successful treatment rate. Active screening and standardized treatment should be actively carried out for elderly population.