【摘要】 目的 分析重庆市南岸区当前耐药肺结核疫情流行特征及治疗转归情况,为耐药结核病防治策略的制定提供依据。方法 通过中国疾病预防控制信息系统收集2016—2023年登记的现住址为重庆市南岸区的利福平耐药肺结核患者的病案资料,运用描述流行病学方法分析利福平耐药患者的流行特征和治疗转归情况。结果 2016—2023年重庆市南岸区累计登记利福平耐药肺结核患者216例,年均登记率为2.68/10万。男性年均登记率(3.48/10万)高于女性(1.88/10万),且差异有统计学意义(χ~2=19.150,P<0.001)。年龄分布中,25～44岁年龄组登记病例数最多(39.81%);65岁以上年龄组年均登记率最高(3.6/10万);总人群年均登记率随年龄增加,总体呈上升趋势(χ~2趋势=19.465,P<0.001)。职业分布中以家务及待业人群数量最多(124例,57.41%);治疗分类以复治患者居多(163例,75.46%);地区分布中,弹子石街道登记率最高(7.64/10万),各个街、镇年均登记发病率差异有统计学意义(χ~2=94.031,P<0.001)。2016—2021年登记的利福平耐药肺结核患者纳入治疗率为97.58%,治疗成功率为60.87%;随着年龄的增加,治疗成功率逐渐降低,差异有统计学意义(χ~2趋势=24.572,P<0.001);不同性别、不同职业患者的治疗成功率差异有统计学意义(χ~2=7.863,P=0.005;χ~2=23.211,P<0.001)。结论 重庆市南岸区耐药肺结核疫情形势严峻,应重点关注复治、男性、中青年、家务及待业人群,加大对高疫情地区耐药肺结核患者的关注和防控力度。更多还原

【Abstract】 Objective To analyze the current epidemiological characteristics and treatment status of drug-resistant pulmonary tuberculosis in Nan’an District, Chongqing, and to provide a basis for formulating prevention and control strategies for drug-resistant tuberculosis.Methods Medical records of rifampicin-resistant pulmonary tuberculosis patients whose current address was registered in Nan’an District, Chongqing, from 2016 to 2023 were collected through the Chinese Disease Prevention and Control Information System. Descriptive epidemiological methods were used to analyze the epidemiological characteristics and treatment outcomes of these patients.Results Overall, 216 rifampicin-resistant pulmonary tuberculosis cases were registered in Nan’an District, Chongqing, from 2016 to 2023, with an average annual registration rate of 2.68/100 000. The average annual registration rate in males was significantly higher than that in females(3.48/100 000 vs. 1.88/100 000; χ~2=19.150,P<0.001). Regarding age distribution, the 25-44 age group had the highest number of registered cases(39.81%); the age group over 65 years had the highest average annual registration rate(3.6/100 000). The average annual registration rate in the general population showed an overall increasing trend with age(χ~2 for trend=19.465,P<0.001). In terms of occupation, the largest number of cases were in the unemployed/housework category(124 cases, 57.41%). Regarding treatment classification, the majority were retreated patients(163 cases, 75.46%). In terms of regional distribution, Danzishi Subdistrict had the highest registration rate(7.64/100,000). Statistically significant differences were observed in the average annual registration rates among subdistricts and towns(χ~2=94.031,P<0.001). For rifampicin-resistant pulmonary tuberculosis patients registered from 2016 to 2021, the treatment enrollment rate was 97.58%, and the treatment success rate was 60.87%. The treatment success rate gradually decreased with increasing age, with a statistically significant difference(χ~2 for trend=24.572,P<0.001). Statistically significant differences were noted in treatment success among patients of different sexes and occupations(χ~2=7.863, P=0.005;χ~2=23.211,P<0.001).Conclusion The drug-resistant tuberculosis situation in Nan’an District, Chongqing, remains in a serious condition. Attention should be focused on retreated patients, males, young and middle-aged individuals, and the unemployed/housework population. Strengthened attention and prevention and control efforts are needed for drug-resistant pulmonary tuberculosis patients in areas with high epidemic rates.更多还原