CAJ | 학술논문

目的了解山东省结核病疫情现状及评价控制效果.方法按照全国第五次结核病流行病学抽样调查方案采取分层整群(每群1250 ～ 1750人)等比例随机抽样法,在山东省抽取35个整群抽样点,对群内15岁及以上居民进行问卷调查和X线检查,对可疑症状者和胸部X线检查发现异常阴影者,进行痰涂片检查和痰结核分枝杆菌培养,对培养阳性标本做菌种初步鉴定和药物敏感性试验.结果 2010年共计检查54 279人,占应检人口的95.78％.共发现183例活动性肺结核,其中60.11％无任何症状.有2个抽样点(5.71％)未发现活动性肺结核病例,有24个点(68.57％)未发现涂阳病例.经加权校正后山东省活动性肺结核、涂阳肺结核和菌阳肺结核患病率分别为270.87/10万、17.45/10万和29.57/10万,据此估算山东省现有活动性肺结核病例21.19万(17.01万～25.36万),涂阳肺结核病例1.36万(0.58万～2.15万)、菌阳肺结核病例2.31万(1.32万～3.30万).与2000年第四次结核病流行病学调查结果比较疫情有所下降,涂阳肺结核患病率和菌阳肺结核患病率分别下降81.63％和75.56％,年均下降15.59％和13.14％.城市人群比农村下降明显,女性比男性下降明显.发现病例中以农村、老年人、男性居多.结论结核病依然是山东省一个突出的公共卫生问题.重点应放在不排菌、有症状的活动性肺结核病例,尤其应关注农村地区、男性以及老年人群.
목적 료해산동성결핵병역정현상급평개공제효과.방법 안조전국제오차결핵병류행병학추양조사방안채취분층정군(매군1250 ～ 1750인)등비례수궤추양법,재산동성추취35개정군추양점,대군내15세급이상거민진행문권조사화X선검사,대가의증상자화흉부X선검사발현이상음영자,진행담도편검사화담결핵분지간균배양,대배양양성표본주균충초보감정화약물민감성시험.결과 2010년공계검사54 279인,점응검인구적95.78％.공발현183례활동성폐결핵,기중60.11％무임하증상.유2개추양점(5.71％)미발현활동성폐결핵병례,유24개점(68.57％)미발현도양병례.경가권교정후산동성활동성폐결핵、도양폐결핵화균양폐결핵환병솔분별위270.87/10만、17.45/10만화29.57/10만,거차고산산동성현유활동성폐결핵병례21.19만(17.01만～25.36만),도양폐결핵병례1.36만(0.58만～2.15만)、균양폐결핵병례2.31만(1.32만～3.30만).여2000년제사차결핵병류행병학조사결과비교역정유소하강,도양폐결핵환병솔화균양폐결핵환병솔분별하강81.63％화75.56％,년균하강15.59％화13.14％.성시인군비농촌하강명현,녀성비남성하강명현.발현병례중이농촌、노년인、남성거다.결론 결핵병의연시산동성일개돌출적공공위생문제.중점응방재불배균、유증상적활동성폐결핵병례,우기응관주농촌지구、남성이급노년인군.
Objective To study the prevalence and trend of tuberculosis for related policy development in Shandong.Methods The population under the current study was randomly sampled,using both stratified clustering sampling and proportional population sampling methods,following the national survey protocol.A total of 35 clusters including about 1500 subjects per cluster were established,representing a population of 9.31 million.Questionnaire interview and chest X-ray exam were applied to all inhabitants above 15 years of age.Sputum microscopy and culture were given to all suspected cases with cough longer than 2 weeks or having abnormal X-ray results.Results In total,54 279 subjects were interviewed and examined,accounting for 95.78％ of eligible population.Of them,183 active pulmonary tuberculosis cases were identified,with 60.11％ asymptomatic.Two of the 35 (5.71％) clusters had no active tuberculosis cases found,and 24(68.57％) did not show smear positive results.The standardized prevalence rates of active,smear positive and bacteriologic positive pulmonary tuberculosis cases were 270.87/105,17.45/105 and 29.57/105,with the estimated case numbers as 211 900 (170 100-253 600),13 600 (5800-21 500) and 23 100 (13 200-33 000)respectively.Compared to the survey in 2000,the rates on smear positive and bacteriologic positive tuberculosis had decreased significantly,at a rate of 81.63％,and 75.56％ respectively.The rates in urban areas and in women decreased quickly than those in rural areas and in men.People living in the rural areas,being elderly or males,had significantly higher prevalence rates of tuberculosis.Conclusion Remarkable reduction of tuberculosis prevalence had been achieved despite the fact that tuberculosis remained a major public health problem in Shandong province.Symptomatic patients should be under more serious concern in order to improve the detection of early cases.More efforts should be given to rural population,especially elderly,male population.