摘要
目的 分析结核性脑膜炎(TBM)的流行病学特征及其不同特征患者的变化趋势,为今后制定相关防治策略提供参考.方法 收集2011-2022年首都医科大学附属北京胸科医院电子病历系统中15岁及以上住院患者中的所有TBM病例(包括确诊、临床诊断、疑似病例),采用描述性统计方法分析TBM不同分类、性别、年龄、合并症、并发症及合并其他结核患者占比的变化趋势.结果 住院结核病患者33 807例,TBM为1 176例(3.48％),其中,男性641例(54.51％)、老年人226例(占19.22％)、农牧民438例(占37.24％)、存在合并症患者682例(占57.99％),并发其他结核患者1 060例(占90.14％)、发生并发症患者769例(占65.31％),确诊患者仅190例(占16.16％).TBM占比总体呈下降趋势(4.76％～2.77％),老年TBM(10.00％～40.22％)、发生并发症(54.00％～67.39％)、合并症(40.00％～82.61％)及确诊TBM(5.00％～25.00％)患者比例呈上升趋势.结论 结核性脑膜炎患者中,老年患者占比逐年增高,合并症及并发症发生率居高不下.因此,应提高对老年结核性脑膜炎的重视程度,加强对结核性脑膜炎合并症及并发症的管理.
Abstract
Objective To analyze the epidemiological characteristics of tuberculous meningitis(TBM)cases aged 15 years and above and its changing trend of patients with different characteristics,and provide reference for formulating relevant prevention and treatment strategies in the future.Methods All cases of tuberculous meningitis(including definite,probable and possible cases)hospitalized in Beijing Chest Hospital Affiliated to Capital Medical University from 2011 to 2022 were collected through the electronic medical record system,and the changing trend of TBM classification,gender,age,whether there were comorbidities and whether there were other tuberculosis in different years was analyzed.Results Among 33 807 hospitalized tuberculosis(TB)patients,only 1 176(3.48％)were TBM,of which 641(54.51％)were males,226(19.22％)were elderly,438(37.24％)were farmers and herdsmen,and 682(57.99％)were patients with complications.1 060 patients(90.14％)were complicated with other tuberculosis,769 patients(65.31％)had complications,and only 190 patients(16.16％)were diagnosed confirmly.The proportion of TBM was generally decreasing(4.76％～2.77％),and the proportion of elderly TBM patients aged 60 years and above(10.00％-40.22％),patients with comorbidities(40.00％～82.61％),patients with complications(54.00％～67.39％),and patients with confirmed TBM(5.00％～25.00％)were increasing.Conclusion The proportion of elderly patients with TBM is increasing year by year,and the incidence of comorbidities and complications remains high.Therefore,we need to increase the attention to elderly patients with TBM and strengthen the management of complications and complications of TBM.
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