【摘要】 目的 分析2016—2025年浙江省开化县肺结核患者就诊延迟情况及影响因素，为识别高危人群、优化肺结核综合防控措施提供依据。方法 通过中国疾病预防控制信息系统结核病管理信息系统收集2016—2025年开化县登记的肺结核患者资料，包括人口学信息、疾病与诊疗信息和治疗政策分期等。分析就诊延迟率，采用多因素logistic回归模型分析肺结核患者就诊延迟的影响因素。结果 2016—2025年开化县登记肺结核患者2 069例，其中男性1 480例，占71.53%；女性589例，占28.47%。年龄M(Q_R)为64.00(20.00)岁。就诊延迟972例，就诊延迟率为46.98%；年龄>40～60岁、因症就诊和基本政策保障期的肺结核患者就诊延迟率较高，分别为51.96%、56.33%和49.25%。2016—2025年肺结核患者就诊延迟率分别为55.81%、44.25%、50.00%、47.27%、42.98%、51.64%、50.79%、44.38%、43.13%和38.67%，总体呈下降趋势(P<0.05)。多因素logistic回归分析结果显示，与因症就诊的肺结核患者相比，体检/主动筛查(OR=0.024,95%CI:0.011～0.047)、转诊/追踪/其他(OR=0.781,95%CI:0.639～0.954)的肺结核患者就诊延迟风险较低。结论 2016—2025年开化县肺结核患者就诊延迟率总体呈下降趋势，但仍处于全国中等水平；患者来源是就诊延迟的影响因素，可通过体检/主动筛查和转诊/追踪降低就诊延迟风险。更多还原

【Abstract】 Objective To analyze the healthcare-seeking delay and its influencing factors among pulmonary tuberculosis patients in Kaihua County, Zhejiang Province from 2016 to 2025, so as to provide a basis for identifying high-risk groups and optimizing comprehensive prevention and control measures for pulmonary tuberculosis. Methods Data on pulmonary tuberculosis patients registered in Kaihua County from 2016 to 2025 were collected through the Tuberculosis Information Management System of Chinese Disease Prevention and Control Information System. The data included demographic information, disease and treatment information, and treatment policy phases. Factors affecting delay in healthcareseeking among pulmonary tuberculosis patients were analyzed using a multivariable logistic regression model. Results A total of 2 069 pulmonary tuberculosis patients were registered in Kaihua County from 2016 to 2025. There were 1 480 males(71.53%) and 589 females(28.47%). The median age was 64.00(interquartile range, 20.00) years. There were972 patients with healthcare-seeking delay, with a healthcare-seeking delay rate of 46.98%. The rates of healthcareseeking delay were relatively high among tuberculosis patients aged >40–60 years, those seeking treatment due to symptoms, and those in the basic policy guarantee period, at 51.96%, 56.33%, and 49.25%, respectively. The rates of healthcare-seeking delay among tuberculosis patients from 2016 to 2025 were 55.81%, 44.25%, 50.00%, 47.27%, 42.98%,51.64%, 50.79%, 44.38%, 43.13% and 38.67%, showing a downward trend(P<0.05). Multivariable logistic regression analysis show that, compared with pulmonary tuberculosis patients seeking medical consultation due to symptoms, those identified through physical examinations/active screening(OR=0.024, 95%CI: 0.011-0.047) and referrals/tracking/other sources(OR=0.781, 95%CI: 0.639-0.954) had a lower risk of healthcare-seeking delay. Conclusions From 2016 to2025, the overall rate of healthcare-seeking delay among pulmonary tuberculosis patients in Kaihua County showed a downward trend from 2016 to 2025, but remained at a moderate level nationwide. The source of patients was an influencing factor for healthcare-seeking delay. Health examination/active screening and referral/tracing could effectively reduce the risk of healthcare-seeking delay.更多还原