【摘要】 目的 了解中国东部、中部和西部3个县(区)≥65岁老年人口结核病的患病情况及特征,为制定有针对性的老年人口结核病防控策略提供依据。方法 利用“十二五”国家重大科技专项“结核病发病和干预模式,研究”东部、中部、西部的3个研究现场,对浙江省衢州市江山市、河南省开封市尉氏县、云南省昆明市东川区≥65岁常住老年人口10 944名进行结核病可疑症状问卷调查和胸部X线摄片检查,对肺结核可疑症状者和(或)胸部X线摄片异常者收集痰标本开展痰涂片和痰培养,经过综合诊断,获得老年人口结核病的患病信息及特征。利用课题组设计好的调查问卷,由经过培训的调查员在现场通过入户或集中调查相结合的方式,采用一对一、面对面的方法进行调查。调查内容包括受检对象的姓名、性别、年龄、文化程度、职业等基本信息,以及肺结核可疑症状、既往病史和结核病患者接触史等信息。参与问卷调查的≥65岁老年人口10 944名,实际接受问卷调查的≥65岁老年人口10 379名,,回收问卷10 379份,问卷的回收率100%。利用SPSS 19.0软件对整理的资料进行统计分析,对组间差异的比较,二分类变量及无序多分类变量使用卡方检验,理论频数小于5时则使用似然比卡方值或Fisher精确检验法,以P<0.05为差异有统计学意义。结果 研究现场居住或生活≥6个月的≥65岁老年人口10 944名,参与问卷调查10 379名,问卷调查的参与率94.84%,接受结核病X线胸片检查的老年人口9319名,有肺结核可疑症状者390例,占4.18%。共发现活动性肺结核、涂阳和菌阳患者分别为100例、17例和28例,活动性肺结核、涂阳和菌阳肺结核患病率分别为1073.08/10万,182.42/10万和300.46/10万。老年人口活动性肺结核患病率农村(1337.67/10万,74/5532)高于城镇(686.56/10万,26/3787)(x~2=8.98,P=0.003);活动性肺结核男性(1807.37/10万,79/4371)高于女性(424.41/10万,21/4948)(x~2=41.813,P<0.0001);活动性肺结核随着年龄增长呈上升趋势,从65~岁的患病率671.57/10万上升至80~岁的2120.14/10万(x~2=22.31,P=0.002)。结论 老年人口结核病患病率较高,而且农村和高年龄组人口疫情更严重。因此,应加强老年人口结核病患者的发现和控制工作,以有效控制老年人口的结核病疫情。更多还原

【Abstract】 Objective To understand the tuberculosis(TB) prevalence and the features of the elderly people in three counties in China,and to provide evidence for the development of targeted TB control strategy for the elderly.Methods We selected Qinhu Township in Zhejiang Province,Zhangshi Township in Henan Province,and Dongchuan and Jingtong Community in Yunnan Province from 10 study sites of the National Science and Technology Major Project in the period of the Twelfth Five-year Plan- "Tuberculosis Incidence and Intervention Pattern" project The symptoms of TB and the chest X-rays for all elderly people in three study sites were investigated.Three sputum specimens for smearing and culturing were collected from those with TB suspects and/or abnormal chest X-rays.The TB prevalence and features of the elderly were acquired from comprehensive diagnosis.With the questionnaire designed by the project group,the subjects were investigated by the trained staff face-to-face through the combination of household surveys and concentrated surveys The contents covered name,sex,age,education level,occupation,TB symptoms,disease history and TB patients contact history,etc.There were 10 944 elderly people enrolled in the investigation,among whom 10 379 people received the survey,the response rate was 100%.SPSS19.0 software was used for statistical analysis,Chi-square test was uses for the comparison of different groups with two category variables.P<0.05 was considered as the significant testing level.Results There were 10 944 elderly people who lived for more than 6 months in the study sites,and 10 379 received the questionnaire survey,(94.84%).Nine thousand three hundred and ninteen elderly people took chest X-rays,and 390 people had TB symptom(4.18%).One hundred active pulmonary TB cases,17 smear positive(SS+) PTB cases,and 28 bacteriological positive(Bac+)PTB cases were detected.The prevalence of PTB,SS +,Bac+ were 1073.08/100 000,182.42/100 000 and300.46/100 000 respectively.The prevalence of PTB in elderly was significantly higher in rural areas(1337.67/100 000,74/5532) than township areas(686.56/100 000,26/3787)(x~2=8.98,P=0.003).The prevalence of PTB was higher in male(1807.37/100 000,79/4371) than in female(424.41/100 000,21/4948)(x~2=41.813,P<0.0001).The PTB prevalence increased with the increase of age,which was from 671.57/100 000 in 65- group to 2120.14/100 000 in 80- group(x~2=22.31,P=0.002).Conclusion PTB prevalence is higher in elderly people,and more higher in rural areas and higher age-groups.We should improve the cases detection and control of the elderly,in order to control TB epidemic of the elderly people in China.更多还原