关键词: 结核/死亡率, 死亡原因, 回顾性研究

Abstract: Objective To know TB death characteristics of the rural residents and assess the TB disease burden and the TB control effect in Xiangtan county，and to provide scientific basis for decreasing TB mortality.  Methods A retrospectively survey was conducted using the stratified cluster sampling method and death case card designed by “TB early warning model research” of “the 11th five-year” state’s major science and technology projects. The case card was mainly consists of three parts: the first was the basic information, including the name, the sex, the occupation, the marital status and the educational level etc.; and the second was the death condition, including the time of death, the age of death, the category of death cause and the diagnosis of death cause etc.; and the third was the condition of TB deaths, including the TB diagnosis and treatment, the death cause of TB patients and the direct death cause of the tuberculosis. Of 2880 case cards were sent out in the baseline survey in 2009 and the terminal survey in 2010, 2873 effective questionnaires were taken back, and the effective rate was 99.8%. We used the collected death case data and population data to analyze TB death feature of rural residents in Xiangtan county, which mainly includes the TB mortality, the composition of death cause, the order of death cause, the death rate of different gender, year, villages and towns. The data is analyzed by the SPSS 13.0 statistical software. The measurement data is described by the median, the minimum value, the maximum value et al. The count data is described by the rate and the composition et al. The difference of mortality is compared in different sex, in different villages and towns, and in years.  Results The total mortality of all kinds of diseases of in 2005—2010 was 568.3/100 000(2873/505 582). The TB mortality in 2005—2010 was 13.4/100 000 (68/505 582),the order TB death cause was 11th;. In 2005—2010 years,the male TB mortality rate was 21.1/100 000 (56/264 924). The women TB mortality rate was 5.0/100 000 (12/240 658), the difference was statistically significant (χ²=24.463, P<0.001). Among 2005—2010, TB mortality respectively was 10.7/100 000(9/83 752), 10.7/100 000(9/83 962), 8.3/100 000(7/84 155), 24.9/100 000 (21/84 389), 20.1/100 000(17/84 633) and 5.9/100 000(5/84 691), the difference was statistically significant (χ²=17.132, P<0.05). The TB mortality in 2010 compared with 2009 and 2008 respectively was statistically significant (χ²=6.555, P<0.05, χ²=9.905, P<0.05). The pulmonary tuberculosis mortality rate in 2005—2010 was 9.7/100 000(49/505 582).The median death was 68 years old, and 44 cases was more than 60 years old. Among 68 death cases of tuberculosis, 60 cases (88.2%) were known as TB patients, 34 were registered in the local CDC, accounting for 56.7%. Among 49 cases dead of pulmonary tuberculosis, 16 cases died of chronic incomplete cardiopulmonary function, accounting for 32.7% (16/49), 14 cases died of the whole body failure, accounting for 28.6% (14/49), 12 cases died of haemoptysis, accounting for 24.5% (12/49).  Conclusion The pulmonary tuberculosis mortality of the rural residents has declined in Xiangtan. TB prevention and control effect is remarkable. But, the TB mortality is still high and the disease burden of TB is heavy.

Key words: Tuberculosis/mortality, Cause of death, Retrospective studies