陈松华, 张钰, 刘魁, 王伟, 吴倩. 新发肺结核病患者成功治疗后发病重新登记情况的跟踪研究[J]. 疾病监测, 2023, 38(11): 1301-1306. DOI: 10.3784/jbjc.202304030143
引用本文: 陈松华, 张钰, 刘魁, 王伟, 吴倩. 新发肺结核病患者成功治疗后发病重新登记情况的跟踪研究[J]. 疾病监测, 2023, 38(11): 1301-1306. DOI: 10.3784/jbjc.202304030143
Chen Songhua, Zhang Yu, Liu Kui, Wang Wei, Wu Qian. Relapse of tuberculosis after successful treatment in newly registered patients[J]. Disease Surveillance, 2023, 38(11): 1301-1306. DOI: 10.3784/jbjc.202304030143
Citation: Chen Songhua, Zhang Yu, Liu Kui, Wang Wei, Wu Qian. Relapse of tuberculosis after successful treatment in newly registered patients[J]. Disease Surveillance, 2023, 38(11): 1301-1306. DOI: 10.3784/jbjc.202304030143

新发肺结核病患者成功治疗后发病重新登记情况的跟踪研究

Relapse of tuberculosis after successful treatment in newly registered patients

  • 摘要:
      目的  基于结核病信息管理系统对新发肺结核病患者成功治疗后复发情况的观察跟踪研究,间接评价肺结核病患者的中长期治疗效果。
      方法  基于全国结核病信息管理系统以某个县(区)2010年登记的所有新发肺结核病患者作为观察队列,通过系统搜寻10年期间(2010-2019年)观察队列的后续发病登记情况。 复发的单因素分析采用 Kaplan-Meier 法,多因素分析采用 Cox比例风险回归模型。
      结果  第2年开始出现后续发病登记,第3年达到高峰(重新登记率为4.46%),第4~6年维持在3.00%以上的后续发病登记水平,往后逐年下降,降到第10年的0.23%。 历年均为男性更容易复发。 历次发病年龄偏向于50岁左右人群,职业偏向于农民。 Kaplan-Meier法和Cox比例风险回归模型分析显示新发肺结核病患者成功治疗后年龄偏大、农民、病原学初次菌阳、非主动就诊、诊断延误这类患者的后续复发风险相对较大。 平均发病间隔天数第一次重新登记最长,以后发病登记间隔呈缩短趋势。
      结论  结核病防治是一项艰巨的系统工程,有条件的地方要结合健康中国行动,加强对新发肺结核病患者成功治疗后后续复发风险较高人群开展的后期随访,甚至实行全生命周期全人群健康管理。

     

    Abstract:
      Objective  To evaluate the medium and long-term treatment effects of tuberculosis (TB) based on the observation of the relapse of TB after successful treatment in newly registered patients.
      Methods  Based on the national tuberculosis information management system, all the registered TB patients registered in a county in 2010 were selected as the observation cohort, and the follow-up for the cohort was conducted during 2010−2019. Kaplan-Meier method was used for univariate analysis on the relapse, and timedependent Cox regression model was used for multivariate analysis.
      Results  The record of TB relapse started in the 2nd year after successful treatment, the relapse rate reached the peak of 4.46% in the 3rd year, remained >3.00% in the 4th−6th year, and then decreased year by year to 0.23% in the 10th year. Men were more likely to have TB relapse and more relapses occurred in age group 50 years in all the years. The relapse TB cases were mainly farmers. The Kaplan Meier method and Cox proportional risk regression model analysis showed that older age, being farmer, being bacterial positive for the first time, non-active medical care seeking and diagnosis delay were the risk factors for the relapse of TB after successful treatment in newly registered patients. The average interval before the relapse was longest after the first registration, then the interval gradually decreased.
      Conclusion  TB prevention and control is a challenging project. If it is feasible, follow-up for newly diagnosed TB patients with high risk for relapse after successful treatment should be strengthened and, furthermore, life cycle health management in whole population can be conducted based on Health China Initiative.

     

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