【摘要】 目的 分析2010—2022年南昌市新发肺结核的流行病学特征及病例就诊延迟现状，为优化肺结核防控措施、减少病例就诊延迟提供数据支撑。方法 在中国疾病预防控制信息系统的结核病管理信息系统子系统中选取报告日期为2010—2022年且现住址为南昌市的新发肺结核病例，描述新发肺结核的三间分布，利用Joinpoint模型分析新发肺结核病例的发病和就诊延迟风险的变化趋势，通过多因素logistic回归模型分析影响新发肺结核病例就诊延迟的危险因素。结果 2010—2022年南昌市新发肺结核年均报告发病率为76.33/10万，病例就诊延迟率为43.77%;不同年份新发肺结核病例的就诊延迟率总体呈逐年下降趋势(AAPC=-2.608%,95%CI:-4.803%～-1.044%,P=0.002)。多因素logistic回归模型分析显示，≥65岁(OR=1.425,95%CI:1.326～1.531)、本地户籍(OR=1.139,95%CI:1.066～1.217)、农民(OR=1.773,95%CI:1.350～2.327)、病原学阳性(OR=1.322,95%CI:1.271～1.374)、居住在周边县区(OR=1.735,95%CI:1.663～1.810)等是新发肺结核病例就诊延迟的危险因素。结论 遏制肺结核蔓延需识别高危人群与肺结核疫情区域，强化监测和宣教以提升肺结核的早期识别率。应完善肺结核病例转诊机制，缩短病例的诊断治疗间隔以降低肺结核病例就诊延迟率。更多还原

【Abstract】 Objective To analyze the epidemiologic features of newly diagnosed pulmonary tuberculosis and status quo of healthcare-seeking delay of cases in Nanchang City from 2010 to 2022,to provide data support for optimizing pulmonary tuberculosis prevention and control measures and reducing healthcare-seeking delay among cases.Methods Newly diagnosed pulmonary tuberculosis cases with reported dates from 2010 to 2022 and current residence in Nanchang City were collected through the tuberculosis management information system, a subsystem of the China disease prevention and control information system.The spatial, temporal and population distribution of newly diagnosed pulmonary tuberculosis were described.The Joinpoint model was used to analyze the changing trends of incidence and risk of healthcare-seeking delay among newly diagnosed pulmonary tuberculosis cases.Multifactorial logistic regression model was applied to analyze the risk factors for healthcare-seeking delay in newly diagnosed pulmonary tuberculosis cases.Results From 2010 to 2022,the average annual reported incidence rate of newly diagnosed pulmonary tuberculosis in Nanchang City was 76.33/100 000 and the healthcare-seeking delay rate of cases was 43.77%.The healthcare-seeking delay rate of newly diagnosed pulmonary tuberculosis cases showed an overall downward trend year by year in different years(AAPC=-2.608%,95%CI:-4.803%--1.044%,P=0.002).Multifactorial logistic model regression analysis revealed that ≥65 years old(OR=1.425,95%CI:1.326-1.531),local household registration(OR=1.139,95%CI:1.066-1.217),farmer(OR=1.773,95%CI:1.350-2.327),etiologically positive(OR=1.322,95%CI:1.271-1.374),residing in peripheral counties and districts(OR=1.735,95%CI:1.663-1.810) etcetera, were risk factors for healthcare-seeking delay among newly diagnosed pulmonary tuberculosis cases.Conclusion Contain the spread of pulmonary tuberculosis requires the identification of high-risk populations and epidemic areas of pulmonary tuberculosis, as well as enhance surveillance and publicity and education to improve the early identification rate of pulmonary tuberculosis.The referral mechanism for pulmonary tuberculosis cases should be improved and shorten the interval between diagnosis and treatment to reduce the healthcare-seeking delay rate of pulmonary tuberculosis cases.更多还原