Email Alert | RSS    帮助

中国防痨杂志 ›› 2021, Vol. 43 ›› Issue (11): 1176-1182.doi: 10.3969/j.issn.1000-6621.2021.11.013

• 论著 • 上一篇    下一篇

2011—2020年新疆喀什地区初治肺结核患者复发影响因素分析

地尔木拉提·吐孙, 麦维兰江·阿不力米提, 刘振江, 西日扎提·马木提, 李冠贞, 李涛, 陈金瓯, 力瓦依丁·阿尔斯拉, 赵雁林, 张丽杰, 欧喜超()   

  1. 844000 新疆维吾尔自治区喀什地区结核病防治所结核病防治科(地尔木拉提·吐孙、麦维兰江·阿不力米提、刘振江、西日扎提·马木提、力瓦依丁·阿尔斯拉);山东省立医院信访与法规事务处(李冠贞);中国疾病预防控制中心结核病预防控制中心(李涛、赵雁林、欧喜超),教育培训处(张丽杰);云南省疾病预防控制中心结核病防治科(陈金瓯)
  • 收稿日期:2021-08-02 出版日期:2021-11-10 发布日期:2021-11-02
  • 通信作者: 欧喜超 E-mail:ouxc@chinacdc.cn

Analysis of influencing factors of tuberculosis recurrence among primary treated pulmonary tuberculosis patients in Kashgar, Xinjiang

Diermulati ·Tusun, Maiweilanjiang ·Abulimiti, LIU Zhen-jiang, Xirizhati ·Mamuti, LI Guan-zhen, LI Tao, CHEN Jin-ou, Liwayiding ·Aersila, ZHAO Yan-lin, ZHANG Li-jie, OU Xi-chao()   

  1. Department of Tuberculosis Control and Prevention, Tuberculosis Dispensary of Kashgar Prefecture, Kashgar 844000, China
  • Received:2021-08-02 Online:2021-11-10 Published:2021-11-02
  • Contact: OU Xi-chao E-mail:ouxc@chinacdc.cn

摘要:

目的 了解2011—2020年间新疆喀什地区登记治疗的初治肺结核患者复发的影响因素,为制定和完善干预措施,减少当地结核病的复发提供科学依据。方法 从《中国疾病预防控制信息系统》子系统《结核病管理信息系统》中,收集2011年1月至2020年12月喀什地区登记治疗的100699例初治肺结核患者病案信息,采用Cox比例风险回归模型对15730例复发肺结核患者的一般资料、临床信息、病原学结果及治疗转归信息等情况进行分析。结果 登记并成功治疗的100699例初治肺结核患者中,15730例肺结核患者复发,复发密度为4.13/100人年,3年累积复发患者占69.69%(10962/15730),5年累积复发患者占89.04%(14006/15730)。Cox比例风险回归模型显示,15~64岁组患者(aHR=2.37,95%CI:1.50~3.76)、≥65岁组患者(aHR=2.44,95%CI:1.54~3.87)、苗族患者(aHR=3.46,95%CI:2.20~5.44)、维吾尔族患者(aHR=2.39,95%CI:2.01~2.84)、农民(aHR=1.98,95%CI:1.70~2.31)、待业(aHR=1.51,95%CI:1.28~1.77)、5个月末痰涂片阳性(aHR=1.59,95%CI:1.18~2.14)是结核病复发的独立危险因素。 结论 喀什地区初治肺结核患者复发风险较高,应重点关注65岁以上老年患者、农民、待业、抗结核治疗5个月末痰涂片阳性患者的规范化治疗与随访管理,应早期对这些高危人群开展针对性的干预措施。

关键词: 结核, 复发, 流行特征, 影响因素

Abstract:

Objective To understand the influencing factors of tuberculosis (TB) recurrence among primary treated pulmonary TB patients in Kashgar, Xinjiang from 2011 to 2020, and provide scientific evidence for formulating and improving intervention strategies to reduce local TB recurrence rate. Methods From January 2011 to December 2020, medical records of 100699 primary treated TB patients registered in Kashgar were derived from TB Information Management System which was a subsystem of the “China Disease Prevention and Control Information System”. Cox proportional hazard regression model was used to analyze the general information, clinical data, etiological results, and treatment outcomes of 15730 patients with recurrent TB. Results Among 100699 primary treated pulmonary TB patients registered and successfully treated, 15730 patients recurrent with a recurrence density of 4.13/100 person-years. The 3-year cumulative recurrence accounted for 69.69% (10962/15730) of all recurrences, and the 5-year cumulative recurrence accounted for 89.04% (14006/15730). The Cox proportional hazards regression model showed that: 15-64 years old (aHR=2.37, 95%CI: 1.50-3.76), ≥65-year-old (aHR=2.44, 95%CI: 1.54-3.87), Miao ethnic group (aHR=3.46, 95%CI: 2.20-5.44), Uyghur ethnic group (aHR=2.39, 95%CI: 2.01-2.84), farmers (aHR=1.98, 95%CI: 1.70-2.31), unemployed (aHR=1.51, 95%CI: 1.28-1.77), sputum smear positive at the end of fifth month after treatment (aHR=1.59, 95%CI: 1.18-2.14) were independent risk factors for TB recurrence. Conclusion The risk of recurrence for primary treated TB patients in Kashgar was relatively high. We should focus on providing standardized treatment and follow-up management for patients over 65 years old, patients who were farmers or unemployed, and patients with sputum smear positive results at the end of fifth month of anti-TB treatment. Targeted intervention measures should be imposed on these high-risk groups at early stage.

Key words: Tuberculosis, Recurrence, Epidemiological characteristics, Influencing factors