摘要
目的分析2012-2022年四川省成都市肺结核病患者登记管理变化趋势及治疗转归影响因素,为进一步制订成都市结核病防治策略和措施奠定基础.方法 通过"中国疾病预防控制信息系统"子系统"结核病信息管理系统"收集2012-2022年成都市肺结核登记与管理的相关资料,2012-2022年肺结核登记管理率的变化采用Joinpoint回归模型进行趋势分析,采用多因素Logistic回归分析研究肺结核患者治疗转归的影响因素.结果2012-2022年,成都市累计登记活动性肺结核患者69 421例,以男性、农民、中青年为主.年平均登记管理率为45.49/10万,登记管理率总体呈下降趋势,平均每年下降6.09％(AAPC=-6.09％,t=-9.37,P＜0.001),下降趋势具有统计学意义.Joinpoint回归模型分段结果显示:2012-2016年肺结核登记管理率逐年下降7.75％,且趋势具有统计学意义(APC=-7.75％,t=-11.53,P＜0.001);2017-2022年下降趋势减缓为3.54％(APC=-3.54％,t=-2.76,P=0.03).2012-2022年病原学阳性患者登记管理率上升趋势无统计学意义(AAPC=0.87％,t=0.79,P=0.43);2012-2016年病原学阳性患者登记管理率呈下降趋势且具有统计学意义(APC=-9.67％,t=-4.76,P=0.003);2017-2022年病原学阳性患者登记管理率呈上升趋势且具有统计学意义(APC=8.57％,t=7.20,P＜0.001).男性与女性年均登记管理率分别为62.25/10万和31.03/10万,男女性登记管理率之比为2.01:1,男性高于女性(x2=708.084,P＜0.001).多因素回归分析表明:男性、年龄、农民、病原学阳性和复治是患者预后的影响因素.结论2012-2022年成都市肺结核登记管理率呈稳定下降趋势.应重点加强中青年男性,以及农村中老年人群的宣传教育、结核病筛查工作力度;加强病原学阳性、复治患者的治疗、随访管理工作.
Abstract
Objective To analyze the change trend of pulmonary tuberculosis patient registration and management and the influencing factors of treatment outcome in Chengdu,Sichuan Province,from 2012 to 2022,so as to lay a foundation for further formulating tuberculosis prevention and control strategies and measures in Chengdu.Method The data related to the registration and management of tuberculosis in Chengdu from 2012 to 2022 were collected through the"Tuberculosis Information Management System",a subsystem of the"China Disease Prevention and Control Information System".The change of the registration and management rate of tuberculosis from 2012 to 2022 was analyzed by the trend analysis of the Joinpoint regression model,and the influencing factors of the treatment outcome of tuberculosis patients were analyzed by the multi factor logistic regression analysis.Result From 2012 to 2022,a total of 69421 active tuberculosis patients were registered in Chengdu,with males,farmers,and middle-aged and young people as the main population,and with an average annual registration rate of 45.49/100 000.The overall registration management rate showed a downward trend,with an average annual decrease of 6.09％(AAPC=-6.09％,t=-9.37,P＜0.001).The downward trend has statistical significance.The segmented results of Joinpoint regression model showed that the registration and management rate of pulmonary tuberculosis decreased by 7.75％year by year from 2012 to 2016,and the trend was statistically significant(APC=-7.75％,t=-11.53,P＜0.001).The downward trend slowed down to 3.54％from 2017 to 2022(APC=-3.54％,t=-2.76,P=0.03).There was no statistically significant increase in the registration and management rate of pathogen positive patients from 2012 to 2022(AAPC=0.87％,t=0.79,P=0.43).However,from the segmented results,the registration and management rate of pathogen positive patients showed a downward trend from 2012 to 2016 and was statistically significant(APC=-9.67％,t=-4.76,P=0.003).But from 2017 to 2022,the registration and management rate of pathogen positive patients showed an upward trend and had statistical significance(APC=8.57％,t=7.20,P＜0.001).The average annual registration and management rates for males and females are 62.25/100 000 and 31.03/100 000,respectively.The ratio of male to female registration and management rates is 2.01:1,with males having a higher rate than females(x2=708.084,P＜0.001).The patient composition is relatively high among young people aged 20 to 29(22.12％)and farmers(44.10％).Univariate and multivariate regression analysis of treatment:Male,age,farmer,pathogen positive,and retreatment are important influencing factors on patient prognosis.Conclusion From 2012 to 2022,the registration and management of pulmonary tuberculosis in Chengdu showed a stable downward trend.Pathogenic positivity and re treatment increased the risk of adverse outcomes.The next step is to focus on strengthening the publicity,education,and screening efforts of males,students,and middle-aged and elderly populations;Strengthen the treatment and follow-up management of patients with positive and recurrent pathogens.
万方数据