【摘要】 目的 分析喀什地区结核病患者成功治疗后三年内复发流行特征、空间聚集性及影响因素，为防治结核病复发提供依据。方法 以喀什地区2013—2020年登记且治疗成功的结核患者为研究对象，观察其完成治疗后三年内复发流行情况；采用空间统计分析，了解结核病复发率的空间聚集性；通过Cox比例风险回归模型探讨复发影响因素。结果 104 899例成功治疗结核病患者中，三年累积复发14 180例，三年累积复发率13.52%;空间分析结果显示，喀什地区结核病复发存在空间正自相关，复发热点乡镇主要集中在莎车县、英吉沙县和巴楚县；Cox比例风险回归模型显示，男性(aHR=1.155, 95%CI:1.118～1.195)、维吾尔族(aHR=2.186, 95%CI:1.786～2.681)、年龄段为45～<60岁组(aHR=1.631, 95%CI:1.061～2.507)和≥60岁组(aHR=1.782, 95%CI:1.160～2.738)、农牧民(aHR=1.104, 95%CI:1.039～1.173)、复治(aHR=1.086, 95%CI:1.036～1.138)、诊断结果为病原学阳性(aHR=1.377, 95%CI:1.324～1.432)、治疗两个月末痰涂片阳性(aHR=1.699, 95%CI:1.501～1.924)、总延迟≥30天(aHR=1.129, 95%CI:1.088～1.171)、现居地为热点地区(aHR=1.470, 95%CI:1.413～1.530)是结核患者成功治疗后三年内出现复发的独立危险因素。结论 应重点加强对复发热点地区患者及复发高风险患者疗程结束后的监测，以便早期识别结核病复发并进行规范化管理。更多还原

【Abstract】 Objective To analyze the epidemiological characteristics, spatial clustering, and influencing factors of tuberculosis recurrence in Kashgar within three years after successful treatment to provide a scientific basis for tuberculosis recurrence management. Methods Taking the tuberculosis patients successfully treated in Kashgar from 2013 to 2020 as the research object, we observed the recurrence epidemic characteristics, conducted spatial analysis to understand the recurrence clustering, and used the Cox regression model to explore the influencing factors. Results Among the 104 899 objects, 14 180 experienced recurrences within three years, with a cumulative recurrence rate of 13.52%. Spatial analysis showed a positive spatial correlation of tuberculosis recurrence, with recurrence hotspots mainly concentrated in Shache, Yingjisha, and Bachu counties. The Cox model showed that male(aHR=1.155, 95%CI: 1.118-1.195), Uyghur(aHR=2.186, 95%CI: 1.786-2.681), 45-<60 age groups(aHR=1.631, 95%CI: 1.061-2.507) and ≥60 age groups(aHR=1.782, 95%CI: 1.160-2.738), farmers and herdsmen(aHR=1.104, 95%CI: 1.039-1.173), re-treatment(aHR=1.086, 95%CI: 1.036-1.138), positive aetiology result(aHR=1.377, 95%CI: 1.324-1.432), positive sputum smear after two months of treatment(aHR=1.699, 95%CI: 1.501-1.924), total delay ≥30 days(aHR=1.129, 95%CI: 1.088-1.171) and living in hotspots(aHR=1.470, 95%CI: 1.413-1.530) were independent risk factors for recurrence after successful treatment. Conclusion Priority should be given to improving the monitoring and management of patients in hotspot regions and those at high risk of relapse after treatment to ensure early detection of TB relapse and standardized care.更多还原