文章摘要
李曙光,张修磊,朱丽,李海涛,郭肖岩,王宇,梁明理,李荣,褚丹.三类重点老年群体中活动性肺结核患病率调查[J].中华流行病学杂志,2014,35(6):660-663
三类重点老年群体中活动性肺结核患病率调查
A cross sectional survey on the prevalence of active pulmonary tuberculosis in three‘key’ elderly population
收稿日期:2013-11-28  出版日期:2014-09-02
DOI:
中文关键词: 肺结核;糖尿病;可疑症状者;密切接触者;老年人
英文关键词: Pulmonary tuberculosis;Diabetes;Suspect;Close contact;Elder
基金项目:山东省科技发展项目(2012YD18055)
作者单位E-mail
李曙光 250101 济南, 山东省结核病防治中心山东省胸科医院 shuguang_8818@foxmail.com 
张修磊 250101 济南, 山东省结核病防治中心山东省胸科医院 zhangxiulei0531@126.com 
朱丽 250101 济南, 山东省结核病防治中心山东省胸科医院  
李海涛 250101 济南, 山东省结核病防治中心山东省胸科医院  
郭肖岩 250101 济南, 山东省结核病防治中心山东省胸科医院  
王宇 250101 济南, 山东省结核病防治中心山东省胸科医院  
梁明理 250101 济南, 山东省结核病防治中心山东省胸科医院  
李荣 250101 济南, 山东省结核病防治中心山东省胸科医院  
褚丹 250101 济南, 山东省结核病防治中心山东省胸科医院  
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中文摘要:
      目的 调查≥65 岁肺结核可疑症状者、糖尿病患者、肺结核密切接触者(三类重点人群)中活动性肺结核患病率。方法 采用目的抽样方法选择山东省3 个县市为研究现场,利用当地≥65 岁老年人健康体检项目,并纳入肺结核检查,对2013 年1-9 月登记的三类重点人群实施X线胸片和痰涂片检查。结果 9 041 名检查对象中共检出活动性肺结核82 例,受检者中粗患病率为9.1‰。肺结核可疑症状兼糖尿病患者、糖尿病患者、可疑症状者中活动性肺结核患病率分别为115.0‰、3.4‰、0.9‰,糖尿病兼肺结核密切接触者、肺结核可疑症状兼密切接触者及密切接触者中均未检出活动性肺结核;不同老年人群活动性肺结核患病率差异有统计学意义(χ2=697.478,P=0.000)。糖尿病患者中活动性肺结核患病率是非糖尿病患者的18 倍(RR=17.951),是肺结核可疑症状者的4 倍(RR=3.860);单因素分析显示糖尿病与活动性肺结核的患病率具有相关性(χ2=46.637,P=0.000),糖尿病患病时间延长,其发生肺结核的危险性增高(RR>1)。结论 患糖尿病的老年群体中活动性肺结核患病率较高,应对糖尿病患者、肺结核可疑症状者实施重点人群筛查策略。
英文摘要:
      Objective To conduct a survey on the prevalence of active pulmonary tuberculosis among 65 year olds or above. Study subjects would include those with characteristics of TB suspicious symptoms,diabetes and close contacts. Methods Purpose-sampling method was applied to choose 3 counties in Shandong province as the study sites,relying on the local basic public health service,for those elderly under 65 years old or above. The study team would introduce the process and contents of this study to the subjects followed by chest X-ray and sputum smears on those registered tuberculosis suspects,patients with diabetes,TB close contacts in the past 2 years,from January to September,2013. Results 82 active pulmonary TB cases were identified among 9 041 cases who received the examination,with a crude prevalence rate as 9.1‰. From patients having both suspicious TB and diabetic symptoms,patients with diabetes or having suspicious symptoms of TB,the prevalence rates of active TB were 115‰,3.4‰,0.9‰ respectively. No active pulmonary TB case was found in the TB close contacts,patients with diabetes,or those people with suspicious TB symptoms. TB prevalence rates among all the above mentioned groups were significantly different(χ2=697.478, P=0.000). Prevalence rate of active pulmonary TB with diabetes was 18 times(RR=17.951)higher than those non-diabetic patients,and 2 times higher than those with suspicious symptoms (RR= 3.860). Results from single factor analysis showed that diabetes were closely related to the prevalence of pulmonary tuberculosis(χ 2=46.637,P=0.000),the longer duration of diabetes and the higher risk of tuberculosis(RR>1). Conclusion Our data showed that active pulmonary TB prevalence was high in elderly diabetes patients which suggesting that‘Key crowd screening program’should be introduced into case-finding strategy on TB,with special focus on TB patients with diabetes or those people having suspicious symptoms of TB.
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