摘要
目的分析研究现场老年人群肺结核主动筛查情况和患者特点。方法通过2013—2019年间4次(分别为2013、2014、2015、2018—2019年)对全国8个县区的12个乡镇/街道(分别为上海市闵行区莘庄镇,江苏省丹阳县导墅镇,浙江省衢州市江山市清湖镇,广东省广州市番禺区东环街道,河南省开封市尉氏县张市镇,黑龙江省哈尔滨市五常县安家镇和常堡乡,四川省绵阳市江油市后坝镇、二郎庙镇、重华镇,广西壮族自治区百色市平果县旧城镇、海城乡)持续居住6个月及以上且满65周岁的老年人群入户开展基本信息调查和肺结核筛查,获得老年人群肺结核患病情况,比较分析患者特点和检出率的变化情况。结果2018—2019年符合要求的研究对象共36843名,实际完成胸部X线摄影(简称“胸片”)检查者23566名,受检率为63.96%;发现活动性肺结核患者82例。老年人群活动性肺结核检出率男性(519.53/10万,56/10779)明显高于女性(203.44/10万,26/12780),差异有统计学意义(χ^(2)=16.843,P<0.01);检出率由65~74岁的275.70/10万(45/16322)上升至85~113岁的542.01/10万(6/1107),差异有统计学意义(χ^(2)_(趋势)=7.385,P=0.007);西部地区检出率较高(657.50/10万,66/10038),活动性肺结核患者密切接触者和既往结核病患者的检出率较高[9547.74/10万(19/199)和1108.03/10万(4/361)]。2013—2019年在相同研究现场开展4次筛查,随着筛查次数的增加,老年肺结核患者痰标本细菌学阳性率[31.43%(55/175);21.15%(33/156);35.29%(36/102);12.20%(10/82)]呈现降低的趋势(χ^(2)_(趋势)=7.290,P=0.007);4次筛查老年人群活动性肺结核检出率分别为650.49/10万(175/26903)、618.07/10万(156/25240)、474.79/10万(102/21483)和347.96/10万(82/23566),呈现下降趋势(χ^(2)_(趋势)=25.659,P<0.01)。结论开展多次主动发现后,老年人群活动性肺结核检出率持续大幅下降,需要根据人群高危因素、筛查频率和方法优化筛查策略。
Objective To explore the characteristics of patients and detection rate by active screening of pulmonary tuberculosis in the elderly population in the pilot sites.Methods During 2013—2019,the basic information and tuberculosis(TB)screening were carried out four times among permanent residents over 65 years old in 12 towns or communities in 8 counties(Xinzhuang Town,Minhang District,Shanghai;Daoshu Town,Danyang County,Jiangsu Province;Qinghu Town,Jiangshan City,Quzhou City,Zhejiang Province;Donghuan Street,Panyu District,Guangzhou City,Guangdong Province;Zhangshi Town,Weishi County,Kaifeng City,He’nan Province;Anjia Town and Changbao Town,Wuchang County,Harbin City,Heilongjiang Province;Houba Town,Erlangmiao Town and Chonghua town,Jiangyou City,Mianyang City,Sichuan Province;Jiucheng Town,Haicheng Town,Pingguo County,Baise City,Guangxi Zhuang Autonomous Region),the prevalence of TB among elderly was obtained and the characteristics of patients and the trend of detection rate were compared.Results From 2018 to 2019,among the 36843 individuals,23566 completed chest X-ray examination with the screening rate of 63.96%,and 82 patients were diagnosed.The PTB detection rate in the elderly was significantly higher in men(519.53/100000,56/10779)than in women(203.44/100000,26/12780)(χ^(2)=16.843,P<0.01).The detection rate increased with age,from 275.70/100000(65-74 years old group,45/16322)to 542.01/100000(85-113 years old group,6/1107)(χ^(2)_(trend)=7.385,P=0.007).The detection rate was higher in western regions(Guangxi and Sichuan,657.50/100000(66/10038))compared to the counties located in middle and eastern regions of China.The detection rate of close contacts and previous TB patients was significantly higher(9547.74/100000(19/199)and 1108.03/100000(4/361))compared to that of non-close contacts and new cases,respectively.From 2013 to 2019,there were four times screenings conducted in the same pilot site,the bacteriology positive rate of sputum smear in elderly TB patients(31.43%(55/175),21.15%(33/156),35.29%(36/102
作者
陈卉
孙彦波
沈鑫
竺丽梅
王晓萌
孙定勇
周琳
林定文
陈闯
张灿有
张慧
王黎霞
詹思延
成君
CHEN Hui;SUN Yan-bo;SHEN Xin;ZHU Li-mei;WANG Xiao-meng;SUN Ding-yong;ZHOU Lin;LIN Ding-wen;CHEN Chuang;ZHANG Can-you;ZHANG Hui;WANG Li-xia;ZHAN Si-yan;CHENG Jun(Department of Epidemiology and Biostatistics,School of Public Health,Peking University,Beijing 100191,China)
出处
《中国防痨杂志》
CAS
CSCD
2021年第6期550-556,共7页
Chinese Journal of Antituberculosis
基金
“十二五”国家科技重大专项(2013ZX10003-004)
中国疾病预防控制中心项目(JY18-1-08)。
关键词
结核
肺
主动发现
老年人
疾病特征
Tuberculosis
pulmonary
Active case finding
Aged
Disease attributes
