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中国防痨杂志 ›› 2026, Vol. 48 ›› Issue (5): 567-575.doi: 10.19982/j.issn.1000-6621.20260018

• 论著 • 上一篇    下一篇

基于Joinpoint回归模型分析2009—2023年湖南省肺结核报告发病趋势

黄国军1,2, 王琦琦3, 郑文静4, 刘剑君5, 白丽琼6, 梁军6, 于石成3, 徐祖辉7, 万燕萍7, 刘谢2, 么鸿雁1(), 明辉2()   

  1. 1中国疾病预防控制中心(中国预防医学科学院)教育培训处, 北京 102206
    2湖南省结核病防治所(湖南省胸科医院)科教科, 长沙 410013
    3中国疾病预防控制中心(中国预防医学科学院)流行病学办公室(爱国卫生工作技术指导处), 北京 102206
    4中国中医科学院广安门医院统计信息科, 北京 100053
    5中国防痨协会, 北京 100710
    6湖南省结核病防治所(湖南省胸科医院)办公室, 长沙 410013
    7湖南省结核病防治所(湖南省胸科医院)防治部, 长沙 410013
  • 收稿日期:2026-01-10 出版日期:2026-05-10 发布日期:2026-04-27
  • 通信作者: 么鸿雁,明辉 E-mail:yaohy@chinacdc.cn;17858654@qq.com
  • 基金资助:
    湖南省自然科学基金(2025JJ80682);长沙市指导性科技计划(kzd2501103)

Trend of pulmonary tuberculosis reported incidence in Hunan Province from 2009 to 2023: a population-based study using Joinpoint regression model

Huang Guojun1,2, Wang Qiqi3, Zheng Wenjing4, Liu Jianjun5, Bai Liqiong6, Liang Jun6, Yu Shicheng3, Xu Zuhui7, Wan Yanping7, Liu Xie2, Yao Hongyan1(), Ming Hui2()   

  1. 1Department of Education and Training, Chinese Center for Disease Control and Prevention (Chinese Academy of Preventive Medicine), Beijing 102206, China
    2Department of Science and Education, Hunan Institute for Tuberculosis Control (Hunan Chest Hospital), Changsha 410013, China
    3Office of Epidemiology (Technical Guidance Office for Patriotic Health Work), Chinese Center for Disease Control and Prevention (Chinese Academy of Preventive Medicine), Beijing 102206, China
    4Department of Statistical Information, Guang’anmen Hospital, Chinese Academy of Traditional Chinese Medicin, Beijing 100053, China
    5Chinese Antituberculosis Association, Beijing 100710, China
    6Office of Hunan Institute for Tuberculosis Control (Hunan Chest Hospital), Changsha 410013, China
    7Department of Prevention and Control, Hunan Institute for Tuberculosis Control (Hunan Chest Hospital), Changsha 410013, China
  • Received:2026-01-10 Online:2026-05-10 Published:2026-04-27
  • Contact: Yao Hongyan,Ming Hui E-mail:yaohy@chinacdc.cn;17858654@qq.com
  • Supported by:
    Natural Science Foundation of Hunan Province(2025JJ80682);Changsha Guiding Science and Technology Plan Project(kzd2501103)

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摘要：

目的: 分析湖南省肺结核报告发病的长期趋势,以及不同人群和地区间的流行特征,评估肺结核防治效果,为优化策略和措施提供科学依据。方法: 从“中国疾病预防控制信息系统”获取湖南省2009—2023年肺结核报告发病数据,计算肺结核年龄标准化报告发病率,并按性别、年龄、地区及病原学结果分层分析,采用Joinpoint回归模型分析其趋势变化,以年度变化百分比(the annual percentage change, APC)和平均年度变化百分比(the average annual percentage change, AAPC)作为评价指标,并识别转折点。结果: 2009—2023年,湖南省肺结核年龄标准化报告发病率总体呈下降趋势(AAPC=-3.91%; 95%CI:-5.21%~-2.59%),2020年为转折点,此后下降加速(AAPC=-8.61%; 95%CI:-14.36%~-2.48%)。男性肺结核年龄标准化报告发病率高于女性,且下降速度更快(AAPC:-4.19% vs. -3.03%)。60岁及以上人群肺结核平均报告发病率最高[194.51/10万(322929/166026000)],但下降较慢(AAPC=-2.42%; 95%CI:-3.01%~-1.82%);15~59岁人群肺结核平均报告发病率为75.37/10万(490884/651287000),下降速度较快(AAPC=-3.73%; 95%CI:-4.11%~-3.30%); 0~14岁人群肺结核平均报告发病率低[2.98/10万(5491/184359000)],存在多次波动,其中2016—2019年呈上升趋势(APC=19.50%; 95%CI: 9.90%~25.45%)。各地区间肺结核平均报告发病率表现为湘西地区(94.04/10万)发病率最高,其次是湘南地区(86.10/10万)、湘北地区(78.47/10万)和湘中地区(76.57/10万),湘中地区下降速度最快(AAPC=-2.76%; 95%CI:-3.36%~-2.15%),湘南地区下降较慢(AAPC=-1.93%; 95%CI:-2.85%~-0.63%)。病原学阳性肺结核标准化报告发病率在2009—2017年快速下降(APC=-6.83%; 95%CI:-9.20%~-5.20%),而病原学阴性肺结核报告发病率2018年后急剧下降(APC=-14.97%; 95%CI:-18.06%~-11.45%)。结论: 湖南省肺结核报告发病率显著下降,防控成效显著;然而不同人群和地区发病存在明显差异,其中,老年、男性群体及湘西等地区是防控重点人群和重点区域。

关键词: 结核,肺, 模型, 统计学, 发病率, 流行病学研究设计

Abstract:

Objective: This study aims to evaluate the effectiveness of pulmonary tuberculosis (PTB) prevention and control by analyzing the long-term trend of PTB reported incidence in Hunan Province and to reveal its epidemiological characteristics across different populations and regions, providing a scientific basis for optimizing prevention and control strategies. Methods: Data on PTB reported incidence in Hunan Province from 2009 to 2023 was extracted from the “China Disease Prevention and Control Information System”. The PTB age-standardized reported incidences across years were calculated, and stratified analyses were conducted by sex, age, region, and etiological test result category. The Joinpoint regression model was used to analyze the change trend, identify turning points, and calculate the Annual Percentage Change (APC) and the Average Annual Percentage Change (AAPC) as evaluation metrics. Results: From 2009 to 2023, the age-standardized reported incidence of PTB in Hunan Province showed an overall declining trend (AAPC=-3.91%; 95%CI:-5.21% to -2.59%). The year 2020 marked a turning point, after which the decline accelerated (AAPC=-8.61%; 95%CI:-14.36% to -2.48%). The age-standardized reported incidence of PTB was higher in males than in females, with a faster decline rate in males (AAPC:-4.19% vs. -3.03%). The average reported incidence of PTB was highest among individuals aged 60 and above (194.51/100000 (322929/166026000)), but the decline was slower (AAPC=-2.42%; 95%CI:-3.01% to -1.82%). For those aged 15-59-year, the average reported incidence was (75.37/100000 (490884/651287000)), showing a faster decline (AAPC=-3.73%; 95%CI:-4.11% to -3.30%). The average reported incidence in the 0-14-year age group was low (2.98/100000 (5491/184359000)) and exhibited multiple fluctuations, with an upward trend observed from 2016 to 2019 (APC=19.50%; 95%CI: 9.90% to 25.45%). Regionally, the average reported incidences ranked as follows: Western Hunan (94.04/100000), Southern Hunan (86.10/100000), Northern Hunan (78.47/100000) and Central Hunan (76.57/100000), with Central Hunan showing the fastest decline (AAPC=-2.76%; 95%CI:-3.36% to -2.15%), while Southern Hunan showed a slower decline (AAPC=-1.93%; 95%CI:-2.85% to -0.63%). The standardized reported incidence of bacteriologically confirmed PTB decreased rapidly during 2009—2017 (APC=-6.83%; 95%CI:-9.20% to -5.20%), while the reported incidence of bacteriologically negative PTB declined sharply after 2018 (APC=-14.97%; 95%CI:-18.06% to -11.45%). Conclusion: The reported incidence of PTB in Hunan Province has significantly declined, demonstrating effective prevention and control measures. There are notable differences in incidences among various populations and regions, with the elderly, males, and areas in Western Hunan identified as high-risk groups and key areas.

Key words: Tuberculosis, pulmonary, Models, statistical, Incidence, Epidemiologic research design

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