摘要
目的:分析北京市疾病预防控制中心结核门诊部登记治疗的肺结核合并糖尿病患者特征,为肺结核与糖尿病共病防治提供依据。方法:采用描述性方法,将2014—2021年北京市疾病预防控制中心结核门诊部登记治疗的261例肺结核合并糖尿病患者与同期1839例单纯肺结核患者的流行病学特征进行对比分析,包括性别、年龄、治疗分类、发现方式、病原学阳性率、涂阳率、培阳率、利福平耐药率、2个月末痰涂片阴转率、治疗成功率、就诊及确诊延迟率、就诊及确诊时间间隔。结果:肺结核合并糖尿病患者复治比例[16.48%(43/261)]明显高于单纯肺结核患者[8.70%(160/1839)],差异有统计学意义(χ^(2)=15.822,P<0.001),主动发现比例[7.28%(19/261)]明显低于单纯肺结核患者[13.05%(240/1839)],差异有统计学意义(χ^(2)=7.040,P<0.01)。肺结核合并糖尿病患者病原学阳性率[65.90%(172/261)]明显高于单纯肺结核患者[35.07%(645/1839)],差异有统计学意义(χ^(2)=91.381,P<0.001),2个月末痰涂片阴转率和治疗成功率[84.62%(110/130)和80.46%(210/261)]均低于单纯肺结核患者[91.15%(412/452)和87.71%(1613/1839)],差异均有统计学意义(χ^(2)=4.663,P=0.031;χ^(2)=10.495,P=0.001)。肺结核合并糖尿病患者利福平耐药率[3.07%(8/261)]与单纯肺结核患者[1.41%(26/1839)]比较,差异无统计学意义(χ^(2)=2.945,P=0.086)。就诊延迟率、就诊时间[52.87%(138/261)和16(2,53)d]均明显高于单纯肺结核患者[42.09%(774/1839)和9(0,37)d],差异均有统计学意义(χ^(2)=10.822,P=0.001;U=2.775,P=0.006)。确诊延迟率、确诊时间[32.57%(85/261)和7(0,24)d]与单纯肺结核患者[31.92%(587/1839)和7(1,20)d]比较,差异均无统计学意义(χ^(2)=0.044,P=0.834;U=0.167,P=0.867)。结论:肺结核合并糖尿病患者具有病原学阳性率高、复治比例高、就诊延迟率高、就诊时间间隔长、主动发现率低、痰涂片阴转率低和治疗成功率低的特点。
Objective:To analyze the characteristics of tuberculosis patients complicated with diabetes registered in the Tuberculosis Outpatient Department of Beijing Center for Disease Prevention and Control,and to provide evidence for the prevention and treatment of tuberculosis-diabetes comorbidity.Methods:The epidemiological characteristics of 261 tuberculosis patients complicated with diabetes registered in the Tuberculosis Outpatient Department of Beijing Center for Disease Prevention and Control from 2014 to 2021 were descriptively compared with those of 1839 patients with tuberculosis alone during the same period,including gender,age,treatment classification,discovery method,positive rate of etiology,smear positive rate,culture positive rate,drug resistance rate of rifampicin,sputum smear negative conversion rate at the end of the 2nd month,treatment success rate,delay rate of visit and diagnosis,time interval of visit and diagnosis.Results:The rate of retreatment in patients with tuberculosis combined with diabetes(16.48%(43/261))was significantly higher than that in patients with tuberculosis alone(8.70%(160/1839),χ^(2)=15.822,P<0.001),and the proportion of active detection(7.28%(19/261))was significantly lower than that of simple tuberculosis(13.05%(240/1839),χ^(2)=7.040,P<0.01).The positive rate of etiology in patients with tuberculosis combined with diabetes(65.90%(172/261))was significantly higher than that in patients with tuberculosis alone(35.07%(645/1839),χ^(2)=91.381,P<0.001).Sputum smear negative conversion rate at the end of 2nd month and treatment success rate in patients with tuberculosis combined with diabetes were lower than those of patients with simple tuberculosis(84.62%(110/130)vs.91.15%(412/452),χ^(2)=4.663,P=0.031;80.46%(210/261)vs.87.71%(1613/1839),χ^(2)=10.495,P=0.001).There was no significant difference in the drug resistance rate of rifampicin(3.07%(8/261)vs.1.41%(26/1839),χ^(2)=2.945,P=0.086).The visit delay rate and the visit time of patients with tuberculosis combined with diabetes were significantly higher than those of patients with simple tuberculosis(52.87%(138/261)vs.42.09%(774/1839),χ^(2)=10.822,P=0.001;16(2,53)d vs.9(0,37)d,U=2.775,P=0.006).There were no significant differences in diagnosis delay rate and diagnosis time(32.57%(85/261)vs.31.92%(587/1839),χ^(2)=0.044,P=0.834;7(0,24)d vs.7(1,20)d,U=0.167,P=0.867).Conclusion:Patients with tuberculosis complicated with diabetes had the characteristics of high positive rate of etiology,high retreatment rate,high delay rate in treatment,long interval between visits,low active detection rate,low sputum smear negative conversion rate and low success rate of treatment.
作者
徐静
罗萍
贺晓新
XU Jing;LUO Ping;HE Xiao-xin(Tuberculosis Outpatient Department,Beijing Center for Disease Prevention and Control,Beijing 100035,China)
出处
《中国防痨杂志》
CAS
CSCD
2022年第5期494-499,共6页
Chinese Journal of Antituberculosis
基金
首都卫生发展科研专项(首发2011-1012-01)。
关键词
结核
肺
糖尿病
共病现象
流行病学研究特征(主题)
对比研究
Tuberculosis,pulmonary
Diabetes mellitus
Comorbidity
Epidemiologic study characteristics as topic
Comparative study
