2017—2022年毕节市肺结核合并糖尿病患者流行特征及治疗转归影响因素
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R181.3+2

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贵州省发改委省级基本建设前期工作项目(2020-181-131)


Epidemiological characteristics and treatment outcome of pulmonary tuberculosis patients combined with diabetes mellitus in Bijie City from 2017 to 2022
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    摘要:

    目的 分析2017—2022年毕节市肺结核合并糖尿病(PTB-DM)患者的流行分布特征及治疗转归的影响因素,为制定PTB-DM的防治措施提供参考依据。方法 从结核病监测报告信息管理系统中收集2017—2022年毕节市PTB-DM患者登记管理病案;采用Joint-point回归模型分析年登记率及成功治疗率的变化趋势;对比分析PTB-DM与单纯性肺结核(PTB)患者间不同特征;采用χ2检验和二元logistic回归分析治疗转归的影响因素。结果 2017—2022年毕节市共登记679例PTB-DM患者,占总PTB的1.53%,年登记率从2017年的1.11/10万上升到2022年的3.08/10万,年度变化百分比呈上升趋势(APC=26.67%,95%CI:5.36%~52.29%,t=3.564,P=0.024)。在特征分析中,PTB-DM患者男性占比、年龄≥45岁占比、农民占比、直接就诊和转诊的比例、病原学阳性率、复治占比、就诊延迟率均高于单纯性PTB;成功治疗率和流动人口比例均低于单纯性PTB,差异均有统计学有意义(均P<0.05);2017—2022年毕节市PTB-DM患者的成功治疗率为87.80%;年龄、职业、病原学诊断结果是PTB-DM患者治疗转归的影响因素,其中职业为农民(OR=3.68,95%CI:1.22~11.09)、病原学阳性(OR=2.84,95%CI:1.24~6.50)、无病原学结果+结核性胸膜炎(OR=11.35,95%CI:2.16~59.74)是成功治疗的危险因素。结论 2017—2022年毕节市PTB-DM患者占总PTB的比例虽然不高,但呈上升趋势;应高度重视毕节市男性、复治、农民、病原学阳性共病患者;并加强高危人群中PTB-DM的双向筛查工作。

    Abstract:

    Objective To analyze the epidemiological distribution characteristics and influencing factors of treatment outcome of pulmonary tuberculosis (PTB) patients complicated with diabetes mellitus (DM) in Bijie City from 2017 to 2022, and provide reference for formulating prevention and control measures of PTB-DM. Methods The registered management cases of PTB patients combined with DM from the tuberculosis surveillance report information management system in Bijie City in 2017-2022 were collected. Changing trends in annual registration rates and successful treatment rates were analyzed with Joint-point regression models. Different characteristics between patients with PTB-DM and PTB alone were conducted comparative analysis; the influencing factors of treatment outcome were analyzed by χ2 test and binary logistic regression analysis. Results A total of 679 PTB-DM patients were registered in Bijie City from 2017 to 2022, accounting for 1.53% of total PTB patients, the annual registration rate increased from 1.11/100 000 in 2017 to 3.08/100 000 in 2022, with an increasing trend in the annual percentage change (APC=26.67%, 95%CI: 5.36%-52.29%, t=3.564, P=0.024). In the analysis on characteristics, the proportion of PTB-DM male patients, age ≥45 years and farmers, the ratio of direct consultation to transfer treatment, the pathogenicity positive rate, the proportion re-treatment, and rate of delay in consultation were all higher than those of PTB alone; successful treatment rate and proportion of floating population were all lower than PTB alone, difference were all statistically significant (all P<0.05). The successful treatment rate of PTB-DM patients in Bijie City from 2017 to 2022 was 87.80%. Age, occupation, pathogenicity diagnosis results were influencing factors for treatment outcome in patients with PTB-DM, with farmers (OR=3.68, 95%CI: 1.22-11.09), with pathogenicity positivity (OR=2.84, 95%CI: 1.24-6.50), and without pathogenic detection result+tuberculous pleurisy (OR=11.35, 95%CI: 2.16-59.74) being risk factors for successful treatment. Conclusion Although the proportion of PTB-DM in the total PTB patients in Bijie City from 2017 to 2022 was not high, it showed an upward trend; it is necessary to attach great importance to male, re-treated, farmer, and pathogenicity positivity comorbid patients in Bijie City, and strengthen the two-way screening of PTB-DM in high-risk populations.

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张买,杨敬源,余琴,等.2017—2022年毕节市肺结核合并糖尿病患者流行特征及治疗转归影响因素[J]. 中国感染控制杂志,2025,24(3):402-409. DOI:10.12138/j. issn.1671-9638.20256714.
ZHANG Mai, YANG Jingyuan, YU Qin, et al. Epidemiological characteristics and treatment outcome of pulmonary tuberculosis patients combined with diabetes mellitus in Bijie City from 2017 to 2022[J]. Chin J Infect Control, 2025,24(3):402-409. DOI:10.12138/j. issn.1671-9638.20256714.

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  • 收稿日期:2024-07-09
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  • 在线发布日期: 2025-03-26
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