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目的了解广西宾阳县常住人口新发结核病患者治愈或完成疗程后复发情况。方法采用回顾性队列研究的方法,从中国疾病预防控制信息系统中导出广西宾阳县2009—2013年新发结核病患者资料,采用生存分析对其复发情况进行研究。结果本次研究共纳入3 151例研究对象,随访人年数为1 2517.10人年,随访期间共82例患者复发,人年复发率为0.66%人年。其中,1年、3年和5年的复发率分别为0.73%、2.01%和3.07%。多因素Cox模型分析发现,男性复发率低于女性(HR=0.54,95%CI:0.35~0.85),涂阳患者复发率高于涂阴患者(HR=1.71,95%CI:1.08~2.70)。结论尽管本地区常住人口结核病各年复发率仍维持在较低水平,但结核病患者治愈后复发的风险显著高于普通人群,提示应针对高危人群及复发危险因素,建立治愈后的复发随访机制,进一步完善本地区结核病防控策略。
Objective To understand the recurrence of newly diagnosed tuberculosis patients in resident population of Binyang County of Guangxi after completion of treatment or cure. Methods A retrospective cohort study was conducted to analyze the data of newly diagnosed TB patients from 2009 to 2013 in Binyang County of Guangxi Province from China CDC. Survival analysis was used to study the relapse situation. Results A total of 3151 subjects were enrolled in this study. The number of follow-up years was 12,517.10 person-years. A total of 82 patients relapsed during the follow-up period. The annual recurrence rate was 0.66% of years. The recurrence rates at 1 year, 3 years and 5 years were 0.73%, 2.01% and 3.07% respectively. Multivariate Cox regression analysis showed that the recurrence rate was lower in men than in women (HR = 0.54, 95% CI: 0.35-0.85). The recurrence rate in smear positive patients was higher than that in smear negative patients (HR = 1.71,95% CI: 1.08-2.70) . Conclusions Although the recurrence rate of tuberculosis in resident population in our region remains low in recent years, the risk of recurrent TB patients is significantly higher than that in the general population, suggesting that the mechanism of recurrence and follow-up should be established for high-risk groups and relapse risk factors, Further Improve TB Control Strategies in the Region.