福建省成功治疗的肺结核患者10年复发情况及影响因素分析

戴志松 陈堃 林淑芳 周银发 郑奎城 魏淑贞

戴志松, 陈堃, 林淑芳, 周银发, 郑奎城, 魏淑贞. 福建省成功治疗的肺结核患者10年复发情况及影响因素分析[J]. 疾病监测. doi: 10.3784/jbjc.202106300378
引用本文: 戴志松, 陈堃, 林淑芳, 周银发, 郑奎城, 魏淑贞. 福建省成功治疗的肺结核患者10年复发情况及影响因素分析[J]. 疾病监测. doi: 10.3784/jbjc.202106300378
Dai Zhisong, Chen Kun, Lin Shufang, Zhou Yinfa, Zheng Kuicheng, Wei Shuzhen. Ten-year recurrence rate in pulmonary tuberculosis patients after successful treatment and influencing factors in Fujian[J]. Disease Surveillance. doi: 10.3784/jbjc.202106300378
Citation: Dai Zhisong, Chen Kun, Lin Shufang, Zhou Yinfa, Zheng Kuicheng, Wei Shuzhen. Ten-year recurrence rate in pulmonary tuberculosis patients after successful treatment and influencing factors in Fujian[J]. Disease Surveillance. doi: 10.3784/jbjc.202106300378

福建省成功治疗的肺结核患者10年复发情况及影响因素分析

doi: 10.3784/jbjc.202106300378
基金项目: 福建省科技创新平台建设(No. 2019Y2001),福建省卫生健康科技计划(No. 2019-ZQN-28)
详细信息
    作者简介:

    戴志松,男,福建省南安市人,副主任医师,主要从事结核病防治工作,Email:simonwind100@126.com

    通讯作者:

    魏淑贞,Tel:0591–83431464,Email:499277975@qq.com

  • 中图分类号: R211; R521

Ten-year recurrence rate in pulmonary tuberculosis patients after successful treatment and influencing factors in Fujian

Funds: This study was supported by the foundation of the Construction of Fujian Provincial Scientific and Technological Innovation Platform (No. 2019Y2001) and Fujian Provincial Health Technology Project (No. 2019-ZQN-28)
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  • 摘要:   目的  分析福建省成功治疗的肺结核患者在10年内的复发情况及其影响因素,为结核病防控工作提供参考。  方法  通过“中国疾病预防控制信息系统”收集2010 — 2020年福建省登记的肺结核患者资料,计算2010年登记并成功治疗的肺结核患者10年复发率,采用多因素Cox比例风险回归模型分析复发的影响因素。  结果  纳入的18 367例成功治疗肺结核患者中,10年内复发219例,复发率为0.12/100人年。 中位复发间隔时间为47.40个月。 多因素Cox比例风险回归分析结果显示,男性[风险比(HR)=1.87,95%置信区间(CI):1.31~2.68]、户籍地为本地(HR=1.60,95%CI:1.07~2.39)、就诊延误>14 d(HR=1.37,95%CI:1.03~1.82)、首诊单位为结核专科医院及其他医院(HR=3.06,95%CI:2.13~4.39;HR=1.66,95%CI:1.09~2.53)和复治(HR=1.76,95%CI:1.17~2.65)是成功治疗的肺结核患者复发的危险因素。  结论  福建省成功治疗的肺结核患者10年内复发率为0.12/100人年,男性、户籍地为本地、涂片阳性、就诊延误>14 d、首诊单位为结核专科医院或其他医院和复治的成功治疗肺结核患者复发风险较高。
  • 表  1  成功治疗的肺结核患者复发影响因素的单因素log-rank检验

    Table  1.   Univariate log-rank tests of factors affecting recurrence of pulmonary TB patients after successful treatment

      变 量总病例数(例)复发例数(例)观察时间(人年)10年复发率(/100人年)log-rank χ2P
    性别12.536<0.001
     男性13 311182131 713.730.14
     女性5 0563750 177.370.07
    年龄组(岁)9.8150.020
      0 ~ 26032 567.790.12
     18 ~ 6 3005862 526.080.09
     35 ~ 7 94711778 512.220.15
     ≥603 8604138 2850.11
    民族0.4750.490
     汉18 058214178 825.540.12
     其他30953 065.560.16
    职业10.7190.057
     工人4 0113539 722.940.09
     家政、家务及待业1 9083118 816.980.16
     离退人员44074 337.830.16
     农民8 69510186 237.780.12
     其他2 5503925 165.860.15
     学生76367 609.700.08
    户籍地址类型6.4750.011
     本地14 293186141 509.610.13
     非本地4 0743340 381.490.08
    现住址3.7910.052
     本县区15 012168148 868.250.11
     非本县区3 3555133 022.850.15
    诊断分型4.3700.224
     Ⅰ6059.030.00
     Ⅱ12111 198.980.08
     Ⅲ17 900218177 286.130.12
     Ⅳ34003 346.960.00
    诊断结果12.2130.007
     病原学检查阴性9 1299090 558.940.10
     单纯结核性胸膜炎32703 226.360.00
     涂片阳性8 90912988 085.670.15
     无病原学结果2020.130.00
    空洞型肺结核2.5080.113
     否17 238200170 810.520.12
     是1 1291911 080.580.17
    就诊延误(d)8.5630.003
     ≤147 9127378 453.930.09
     >1410 455146103 437.160.14
    患者来源8.6120.197
     健康检查25932 577.790.12
     接触者检查201199.750.50
     其他11641 119.980.36
     因症就诊5 8157557 457.160.13
     因症推荐43454 319.960.12
     转诊8 4639483 870.720.11
     追踪3 2603732 345.740.11
    首诊单位类型41.763<0.001
     疾病预防控制中心14 907152148 000.570.10
     结核专科医院1 2363811 989.050.32
     其他2 2242921 901.480.13
    治疗分类15.101<0.001
     初治17 237192170 992.190.11
     复治1 1302710 898.900.25
    诊断延误(d)0.5080.476
     ≤1416 687202165 272.440.12
     >141 6801716 618.660.10
    治疗方案类型3.2160.073
     标准17 078197169 351.270.12
     个体化1 2892212 539.830.18
    下载: 导出CSV

    表  2  成功治疗的肺结核患者复发影响因素的多因素Cox比例风险回归分析

    Table  2.   Multivariate Cox proportional hazard regression analysis on factors affecting recurrence of pulmonary TB patients after successful treatment

      变 量总病例数(例)构成比(%)Wald χ2HR值(95%CIP
    性别
     女性5 05627.53
     男性13 31172.473.4271.87(1.31~2.68)0.001
    年龄组(岁)
      0~2601.41
     18~6 30034.30−0.5160.74(0.23~2.35)0.606
     35~7 94743.270.0321.02(0.32~3.22)0.974
     60~3 86021.02−0.6440.68(0.21~2.21)0.520
    户籍地址类型
     非本地4 07422.03
     本地14 29377.972.2791.60(1.07~2.39)0.023
    诊断结果
     病原学检查阴性9 12949.70
     单纯结核性胸膜炎3271.78−0.0140.00(0.00, Inf)0.989
     涂片阳性8 90948.512.3371.39(1.05~1.82)0.019
     无病原学结果20.01−0.0010.00(0.00, Inf)0.999
    就诊延误(d)
     ≤147 91243.08
     >1410 45556.922.1301.37(1.03~1.82)0.033
    首诊单位类型
     疾病预防控制中心14 90781.16
     结核专科医院1 2366.736.0783.06(2.13~4.39)<0.001
     其他2 22412.112.3461.66(1.09~2.53)0.019
    治疗分类
     初治17 23793.85
     复治1 1306.152.7091.76(1.17~2.65)0.007
    下载: 导出CSV
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