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中国防痨杂志 ›› 2020, Vol. 42 ›› Issue (5): 498-502.doi: 10.3969/j.issn.1000-6621.2020.05.015

• 论著 • 上一篇    下一篇

2009—2017年上海市学生肺结核疫情特征分析

肖筱, 陈静, 李向群, 夏珍, 栾瑞融, 饶立歆, 沈鑫()   

  1. 200336 上海市疾病预防控制中心结核病防治科
  • 收稿日期:2020-01-17 出版日期:2020-05-10 发布日期:2020-05-08
  • 通信作者: 沈鑫 E-mail:shenxin@scdc.sh.cn
  • 基金资助:
    “十三五”国家科技重大专项(2018ZX10715012)

Analysis of the epidemiological characteristics of tuberculosis students in Shanghai from 2009 to 2017

XIAO Xiao, CHEN Jing, LI Xiang-qun, XIA Zhen, LUAN Rui-rong, RAO Li-xin, SHEN Xin()   

  1. Department of Tuberculosis Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
  • Received:2020-01-17 Online:2020-05-10 Published:2020-05-08
  • Contact: SHEN Xin E-mail:shenxin@scdc.sh.cn

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摘要：

目的 分析2009—2017年上海市学校结核病疫情变化趋势,为制定防控政策提供参考。方法 通过《结核病管理信息系统》收集2009—2017年上海市登记为“学生”的肺结核发病患者资料,包括一般情况、就诊信息、诊断结果等;同时从《2018年上海统计年鉴》获取2009—2017年在校学生人口数资料。通过学生肺结核报告发病率、报告发病例数人群顺位、发病率的变化趋势[以线性回归分析方法计算年度变化百分比(APC)]等指标对2009—2017年上海市学生肺结核疫情的分布特征进行描述。结果 2009—2017年上海市学生肺结核报告发病率维持在15/10万~20/10万,由2009年的19.70/10万(386/1959700)下降至2017年的15.31/10万(301/1966300),总体呈下降趋势(Y=58.562-0.030X,APC=-2.96;t=-5.158,P=0.001)。并发现学生肺结核报告发病例数随年龄增长而增加,峰值为19~岁组(大学)的61.94%(1963/3169);且男性[63.27%(2005/3169)]明显多于女性[36.73%(1164/3169)](χ 2=18.226,P=0.020)。2009—2017年学生报告发病患者中,本地学生患者比例由2009年的64.77%(250/386)下降至2017年的45.85%(138/301),呈明显下降趋势(Y=83.109-0.042X,APC=-4.11;t=-7.897,P<0.001);而外地学生患者构成比由2009年的35.23%(136/386)上升至2017年的44.15%(163/301),呈明显上升趋势(Y=-108.161+0.053X,APC=5.44;t=7.653,P<0.001)。总的重症患者比率由峰值2011年的47.35%(170/359)下降至2017年的3.65%(11/301),呈明显下降趋势(Y=339.673-0.170X,APC=-15.63;t=-2.243,P=0.060),且外地学生中重症患者比率由峰值2011年的48.34%(73/151)下降到2017年的6.13%(10/163),也呈现明显下降趋势(Y=293.665-0.147X,APC=-13.67;t=-2.616,P=0.035)。结论 2009—2017年上海市学生肺结核报告发病率稳中有降,报告学生肺结核患者主要来自大学校园,外地学生患者逐年增加,但重症患者比例明显降低。

关键词: 结核,肺, 学生, 发病率, 流行病学研究特征(主题), 因素分析,统计学, 上海

Abstract:

Objective To investigate the epidemic trend of tuberculosis of students in Shanghai from 2009 to 2017, to improve the tuberculosis control management. Methods The reported data of tuberculosis were collected from Tuberculosis Information Management System, including general conditions, medical information, and diagnosis results, etc. And data of student population were collected from Shanghai Statistical Yearbook 2018. The characteristics of student tuberculosis epidemic in Shanghai from 2009 to 2017 were described by indicators such as the reported incidence of student tuberculosis, the sequence of reported student cases in population, and the trend of incidence (calculated by linear regression analysis method of annual change percentage (APC)). Results From 2009 to 2017, the reported incidence of tuberculosis among students were between 15/100000 and 20/100000 in Shanghai, the incidence decreased from 19.70/100000 (386/1959700) in 2009 to 15.31/100000 (301/1966300) in 2017 (Y=58.562-0.030X, APC=-2.96, t=-5.158, P=0.001). The reported cases were increased by age with the peak at 19 years old and above (when at college) (61.94% (1963/3169)), and male cases were significantly more than female cases (63.27% (2005/3169) vs. 36.73% (1164/3169), χ 2=18.226, P=0.020). The local cases decreased from 64.77% (250/386) in 2009 to 45.85% (138/301) in 2017 (Y=83.109-0.042X, APC=-4.11, t=-7.897, P<0.001), while the immigrant cases increased from 35.23% (136/386) in 2009 to 54.15% (163/301) in 2017 (Y=-108.161+0.053X, APC=5.44, t=7.653, P<0.001). It was found that the ratio of severe patients decreased from the peak of 47.35% (170/359) in 2011 to 3.65% (11/301) in 2017 (Y=339.673-0.170X, APC=-15.63, t=-2.243, P=0.060), the ratio of severe patients in immigrant cases decreased from the peak of 48.34% (73/151) in 2011 to 6.13% (10/163) in 2017, also showing (Y=293.665-0.147X, APC=-13.67, t=-2.616, P=0.035). Conclusion The reported incidence of tuberculosis in students was decreasing, cases were mainly from college. The reported number of immigrant cases was increased, but the ratio of severe patients was decreased significantly.

Key words: Tuberculosis,pulmonary, Students, Incidence, Epidemiologic study characteristics as topic, Factor analysis,statistical, Shanghai

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