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目的了解不同地区新发涂阳肺结核患者延误水平的变化趋势,为制定减少延误发生的干预措施提供科学依据。方法采取典型调查的方法,在东、中、西部各选1个省,共3个省,每省各选择1个县作为研究现场,通过全国结核病网络专报系统获得各调查点2005—2009年患者的个案信息5066例,同时查阅患者病案记录进行核实。使用非参数检验方法,比较各调查点总延误水平的差异和各调查点2005—2009年总延误水平的变化。结果患者中男性占74.7%(3783/5066),女性占25.3%(1283/5066),平均年龄48.1岁(95%CI:47.6～48.6岁),农民占85.5%(4331/5066)。东、中、西部地区患者2005—2009年的平均延误水平分别为24d(0～404d)、42d(0～730d)和62d(0～587d),各调查点延误水平差异有统计学意义(χ2=1095.981,P=0.000);东部地区2005—2009年延误水平的中位数分别为28d(0～398d)、19d(0～387d)、22d(1～404d)、22d(0～219d)和22d(0～96d),差异有统计学意义(χ2=117.840,P=0.000);中部地区2005—2009年延误水平的中位数分别为54d(0～712d)、40d(1～730d)、38d(1～471d)、44d(1～709d)和44d(1～711d),差异无统计学意义(χ2=6.310,P=0.177);西部地区2005—2009年延误水平的中位数分别为91d(5～501d)、67d(0～521d)、42d(4～435d)、51d(3～587d)和59d(4～268d),差异有统计学意义(χ2=166.120,P=0.000)。结论 2005—2009年各调查点延误水平总体上呈下降趋势,但中、西部地区仍有下降的空间。
Objective To understand the trend of the delay of new smear-positive pulmonary tuberculosis in different regions and provide a scientific basis for making interventions to reduce the delay. Methods Taking a typical survey method, we selected 1 province, 3 provinces in each of the eastern, central and western regions, and selected 1 county in each province as the research site and obtained all the survey sites from 2005 to 2009 through the national TB network special report system 5066 cases of patient information, at the same time access to patient records to verify. The non-parametric test method was used to compare the differences between the total delay levels of the survey sites and the total delay levels of the survey sites from 2005 to 2009. Results Male patients accounted for 74.7% (3783/5066) and female patients (25.3%) (1283/5066), with an average age of 48.1 years (95% CI: 47.6-48.6 years) and farmers accounted for 85.5% (4331/5066). The average delay of patients in eastern, central and western regions from 2005 to 2009 were 24d (0 ~ 404d), 42d (0 ~ 730d) and 62d (0 ~ 587d), respectively. = 1095.981, P = 0.000). The median delay of 2005-2009 in the eastern region was 28d (0-398d), 19d (0-38d), 22d (1-440d), 22d (0 ~ 712d) and 40d (1 ~ 730d) respectively in the middle area from 2005 to 2009 (χ2 = 117.840, P = 0.000) There was no significant difference between the two groups (38d, 1-7d, 44d and 1-7d) (χ2 = 6.310, P = 0.177). The median delay of western China from 2005 to 2009 was The difference was statistically significant (χ2 = 166.120, P = 0.000) between 91d (5 ~ 501d), 67d (0 ~ 521d), 42d (4 ~ 435d), 51d (3 ~ 587d) and 59d (4 ~ 268d). Conclusion The overall delay levels of all survey points in 2005-2009 show a downward trend, but there is still room for decline in central and western regions.