关键词: 结核, 病原, 流行病学研究特征(主题), 因素分析,统计学

Abstract:

Objective To analyze the epidemiological characteristics and influencing factors of extrapulmonary tuberculosis (EPTB) in pathogen positive pulmonary tuberculosis (PTB) patients in Hunan Province. Methods The cluster sampling method was used to collect the diagnosis and treatment information of pathogen positive inpatient PTB patients in Hunan Chest Hospital in 2016, totally 2532 cases were included. The incidence, location, frequency, etc. of EPTB in PTB patients were described. Univariate and multivariate logistic regression analyses were carried to explore the association between sex, age, occupation, place of residence, marital status, smoking history, drinking history, treatment history, sputum smear results, hematogenous disseminated tuberculosis, diabetes, rifampicin resistance with EPTB. Results 574 (22.7%) EPTB patients were found among 2532 cases of pathogen positive PTB, 114 (19.9%, 114/574) of EPTB occurred in two or more tissues or organs. The top five forms of EPTB occurred on cervical lymph nodes (12.1%, 306/2532), larynx (3.9%, 98/2532), abdomen (2.6%, 65/2532), pericardium (2.4%, 62/2532), and intestinal (1.3%, 33/2532). The incidence rate of EPTB in age groups of 6-19 years old, 20-39 years old, 40-59 years old, 60-90 years old were 32.6% (42/129), 31.1% (216/695), 20.3% (201/991), 16.0% (115/717), respectively, trend Chi-square test showed that the incidence of EPTB decreased with the increase of patients’ age ( {\chi }_{\mathrm{trend}}^2=51.731, P<0.001). Multivariate analysis showed that the incidence rate of EPTB in patients of 6-19 years old (OR=2.64, 95%CI: 1.46-4.78), 20-39 years old (OR=2.32, 95%CI: 1.73-3.12), 40-59 years old (OR=1.42, 95%CI: 1.10-1.85; 60-90 years old as age group reference), sputum smear positive (sputum smear negative or untested group as reference, OR=1.29, 95%CI: 1.05-1.58), hematogenous disseminated tuberculosis (without hematogenous disseminated tuberculosis group as reference, OR=5.91, 95%CI: 2.94-11.86) and non-diabetic group (with diabetes group as reference, OR=1.64, 95%CI: 1.20-2.22) was significantly higher than that of the reference group. Conclusion The proportion of hospitalized PTB patients with EPTB is relatively high, with lymphatic tuberculosis higher than other forms of EPTB. The younger patients have a higher incidence of EPTB. Attention should also be paid to EPTB screening in patients with smear-positive, hematogenous disseminated tuberculosis and non-diabetic tuberculosis.

Key words: Tuberculosis, Noxae, Epidemiologic study characteristics as topic, Factor analysis,statistical