2011―2020年全国65岁及以上老年人肺结核报告发病情况分析

张灿有; 陈卉; 张慧; 赵雁林; 成君

doi:10.16462/j.cnki.zhjbkz.2022.11.003

2011―2020年全国65岁及以上老年人肺结核报告发病情况分析

doi: 10.16462/j.cnki.zhjbkz.2022.11.003

102206 北京，中国疾病预防控制中心结核病预防控制中心

基金项目:

国家传染病十二五科技重大专项 2013ZX10003004001001

中国疾病预防控制中心结核病预防控制项目业务日常运转 228711

详细信息

通讯作者:
成君，E-mail: chengjun@chinacdc.cn

中图分类号: R521; R181
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出版历程
- 收稿日期: 2022-03-15
- 修回日期: 2022-06-02
- 网络出版日期: 2022-12-21
- 刊出日期: 2022-11-10

Analysis of the reported incidence of pulmonary tuberculosis in the elderly aged 65 and over in China, 2011-2020

National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China

Funds:

The National Twelfth Five-year Mega-Scientific Projects of Infectious Diseases in China 2013ZX10003004001001

Chinese Center for Disease Control and Prevention The TB Prevention and Control Program Daily Operating 228711

More Information

Corresponding author: CHENG Jun, E-mail: chengjun@chinacdc.cn

摘要

摘要: 目的分析2011―2020年全国≥65岁老年人(简称老年人)肺结核报告发病特征。方法利用中国2011―2020年肺结核发病监测数据，分析老年人肺结核报告发病率及分布特征，计算年均变化趋势。结果全国老年人肺结核报告发病率从2011年的158.7/10万下降至2020年的98.3/10万。老年人肺结核的发病风险是＜65岁人群的2.4~2.9倍，其中以70~＜75岁和75~＜80岁年龄组的发病率最高。老年人中，男性的发病风险是女性的2.5~3.1倍，1月和3月的报告发病数最高，其中2020年1月―2020年4月的报告发病数较既往同期出现了大幅下降。中国东、中、西部老年人肺结核报告发病率分别为95.9/10万、159.0/10万和184.4/10万，中、西部地区分别是东部地区的1.7倍和1.9倍。2011―2019年，老年人肺结核报告发病率的年均递降率为3.5%，东、中、西部分别为4.9%、4.5%和1.5%，推算获得的2020年报告发病率高于实际的报告发病率。结论 2011―2020年，中国老年人肺结核防治工作取得了显著成效，但总体负担依然很重，应重点关注西部的重点地区，并强化老年肺结核患者的发现等工作。
- 肺结核 /
- 发病率 /
- 老年人
Abstract: Objective To analyze the characteristics of pulmonary tuberculosis (PTB) among the elderly aged 65 and over nationwide from 2011 to 2020. Methods Using nationwide surveillance data of PTB from 2011 to 2020, to analyze the reported incidence of PTB in the elderly.The distribution characteristic and the average annual change trends were calculated. Results The reported incidence of PTB in the elderly decreased from 158.7/100 000 in 2011 to 98.3/100 000 in 2020. The risk of developing PTB in the elderly aged 65 and over was 2.4-2.9 times that of those under the age of 65, and the 70- < 75 and 75- < 80 age groups had the highest incidences. Among the elderly, the risk of developing PTB in men was 2.5-3.1 times than that of women. The numbers of reported cases were the highest in January and March, which belong to winter and spring. From January to April 2020, the number of reported cases decreased significantly compared with that of the same period in previous years. The reported incidences of PTB among the elderly in eastern, central, and western China were 95.9/100 000, 159.0/100 000 and 184.4/100 000, respectively, and the incidences in central and western China were 1.7 and 1.9 times higher than that of eastern China, respectively. From 2011 to 2019, the average annual decline rate of the reported incidence of PTB in the elderly aged 65 and over was 3.5%, and the rates in eastern, central and western China were 4.9%, 4.5% and 1.5%, respectively. The estimated reported incidences were higher than the actual reported incidences in 2020. Conclusions From 2011 to 2020, China has remarkable achievements in the prevention and control of PTB in the elderly, but the overall burden is still heavy. We should focus on key provinces in western China, and strengthen the detection of PTB among the elderly.
- Pulmonary tuberculosis /
- Incidence /
- The elderly

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图 1 2011―2020年全国老年人和老年肺结核患者占比

Figure 1. The proportions of the people and pulmonary tuberculosis cases aged 65 and over in China, 2011-2020

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图 2 2011―2020年全国老年人肺结核报告发病数月度分布情况

Figure 2. The reported incidences of pulmonary tuberculosis monthly among the elderly in China, 2011-2020

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表 1 2011―2020年全国不同年龄组别肺结核发病情况及差异分析

Table 1. The reported incidences of pulmonary tuberculosis in different age groups and differential analysis from 2011-2020

年份(年)	全年龄组		< 65岁		≥65岁		χ²值	P值	RR(95% CI)值
年份(年)	人口数(万)	报告发病数^a	人口数(万)	报告发病数^a	人口数(万)	报告发病数^a	χ²值	P值	RR(95% CI)值
2011	134 091	953 275(71.1)	122 160	763 893(62.5)	11 931	189 382(158.7)	141 413	< 0.001	2.537(2.524~2.550)
2012	134 735	951 508(70.6)	122 621	752 169(61.3)	12 114	199 339(164.5)	166 174	< 0.001	2.681(2.668~2.694)
2013	135 404	904 434(66.8)	123 229	713 939(57.9)	12 175	190 495(156.5)	160 933	< 0.001	2.699(2.685~2.713)
2014	135 517	889 381(65.6)	122 916	695 389(56.6)	12 601	193 992(153.9)	165 007	<0.001	2.719(2.706~2.733)
2015	136 247	864 015(63.4)	123 552	665 684(53.9)	12 695	198 331(156.2)	190 015	< 0.001	2.898(2.883~2.912)
2016	137 078	836 236(61.0)	122 685	641 824(52.3)	14 393	194 412(135.1)	144 530	< 0.001	2.581(2.567~2.594)
2017	137 984	835 193(60.5)	123 423	632 932(51.3)	14 561	202 261(138.9)	165 104	< 0.001	2.707(2.694~2.721)
2018	138 910	823 342(59.3)	123 129	615 334(50.0)	15 781	208 008(131.8)	157 968	< 0.001	2.636(2.623~2.649)
2019	139 654	775 764(55.5)	123 154	578 034(46.9)	16 500	197 730(119.8)	139 186	< 0.001	2.552(2.539~2.566)
2020	140 384	670 538(47.8)	122 737	496 979(40.5)	17 647	173 559(98.3)	108 134	< 0.001	2.428(2.415~2.442)
注：^a括号内为报告发病率(/10万)。

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表 2 2011―2020年全国老年人不同性别肺结核发病情况

Table 2. The reported incidences of pulmonary tuberculosis by gender among the elderly in China, 2011-2020

年份(年)	女性		男性		χ²值	P值	RR(95% CI)值
年份(年)	人口数(万)	报告发病数^a	人口数(万)	报告发病数^a	χ²值	P值	RR(95% CI)值
2011	6 257	49 877(79.7)	5 674	139 505(245.9)	51 835.972	< 0.001	3.084(3.053~3.116)
2012	6 276	53 976(86.0)	5 839	145 363(249.0)	48 885.627	< 0.001	2.895(2.866~2.923)
2013	6 308	53 391(84.6)	5 867	137 104(233.7)	43 235.587	< 0.001	2.761(2.734~2.789)
2014	6 515	55 032(84.5)	6 086	138 960(228.3)	42 362.804	< 0.001	2.703(2.677~2.730)
2015	6 593	58 087(88.1)	6 102	140 244(229.8)	40 812.776	< 0.001	2.609(2.584~2.634)
2016	7 469	58 238(78.0)	6 924	136 174(196.7)	37 528.019	< 0.001	2.522(2.498~2.547)
2017	7 573	60 049(79.3)	6 988	142 212(203.5)	40 434.796	< 0.001	2.567(2.542~2.591)
2018	8 209	63 477(77.3)	7 571	144 531(190.9)	38 591.231	< 0.001	2.469(2.446~2.492)
2019	8 668	59 457(68.6)	7 831	138 273(176.6)	40 071.773	< 0.001	2.574(2.550~2.599)
2020	9 315	51 645(55.4)	8 332	121 914(146.3)	36 961.428	< 0.001	2.639(2.612~2.666)
注：^a括号内为报告发病率(/10万)。

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表 3 2011―2020年全国不同年龄组老年人肺结核报告发病情况及趋势检验

Table 3. The reported incidences of pulmonary tuberculosis by age groups and trend tests in China, 2011-2020

年份(年)	65~＜70岁		70~＜75岁		75~＜80岁		80~＜85岁		≥85岁		χ²检验		趋势检验
年份(年)	人口数(万)	报告发病数^a	人口数(万)	报告发病数^a	人口数(万)	报告发病数^a	人口数(万)	报告发病数^a	人口数(万)	报告发病数^a	χ²值	P值	Z值	P值
2011	4 395	61 882(140.8)	3 468	58 793(169.5)	2 421	41 986(173.4)	1 258	19 744(156.9)	388	6 976(179.9)	1 588.604	< 0.001	27.477	< 0.001
2012	4 176	65 981(158.0)	3 303	59 804(181.0)	2 475	44 202(178.6)	1 387	21 385(154.2)	772	7 966(103.2)	2 813.344	< 0.001	-19.903	< 0.001
2013	4 197	64 437(153.5)	3 320	55 546(167.3)	2 488	41 623(167.3)	1 394	21 003(150.7)	776	7 883(101.6)	1 986.378	< 0.001	-19.566	< 0.001
2014	4 316	66 140(153.2)	3 286	55 273(168.2)	2 601	41 929(161.2)	1 555	22 127(142.3)	843	8 520(101.1)	2 197.790	< 0.001	-27.050	< 0.001
2015	4 350	69 185(159.0)	3 314	54 870(165.6)	2 620	41 909(159.9)	1 565	22 900(146.3)	845	9 466(112.0)	1 390.516	< 0.001	-26.355	< 0.001
2016	4 932	69 613(141.2)	3 758	52 924(140.8)	2 971	40 734(137.1)	1 774	21 845(123.1)	958	9 296(97.0)	1 455.843	< 0.001	-32.121	< 0.001
2017	4 981	73 392(147.4)	3 796	53 945(142.1)	3 011	41 416(137.5)	1 800	23 400(130.0)	974	10 108(103.8)	1 256.711	< 0.001	-32.337	< 0.001
2018	5 402	75 970(140.6)	4 111	56 300(136.9)	3 264	41 528(127.2)	1 950	23 460(120.3)	1 055	10 750(101.9)	1 363.882	< 0.001	-35.606	< 0.001
2019	6 671	71 080(106.6)	4 194	53 261(127.0)	2 733	38 777(141.9)	1 909	23 088(121.0)	993	11 524(116.1)	2 285.720	< 0.001	25.704	< 0.001
2020	7 081	61 608(87.0)	4 585	48 048(104.8)	2 906	33 514(115.3)	1 841	20 157(109.5)	1 234	10 229(82.9)	2 505.939	< 0.001	21.678	< 0.001
AAPC	-6.3%		-5.0%		-4.3%		-3.9%		-3.7%
P值	0.001		< 0.001		< 0.001		< 0.001		0.088
注：^a括号内为报告发病率(/10万)。

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表 4 2011―2020年全国不同省份老年人肺结核报告发病率(/10万)

Table 4. The reported incidences of pulmonary tuberculosis among the elderly in different Provinces of China, 2011-2020 (/10⁵)

地区	2011年	2012年	2013年	2014年	2015年	2016年	2017年	2018年	2019年	2020年
全国	158.7	164.5	156.5	153.9	156.2	135.1	138.9	131.8	119.8	98.3
东部	117.6	117.7	110.5	108.5	109.4	93.4	94.0	83.6	81.1	68.7
北京市	82.7	75.4	72.9	76.9	72.5	62.2	69.8	65.5	70.0	62.7
天津市	56.4	50.1	54.1	50.3	51.4	48.8	45.5	45.4	59.0	39.9
河北省	123.6	124.7	112.8	108.0	108.9	99.9	87.0	76.8	73.3	58.9
辽宁省	108.0	108.9	81.7	79.3	80.1	71.0	74.5	79.1	71.9	59.2
上海市	44.8	48.5	49.6	52.5	50.8	44.3	42.0	39.1	47.0	37.7
江苏省	116.6	116.1	111.7	102.9	102.0	80.1	77.7	65.9	66.4	60.3
浙江省	108.2	117.0	112.2	115.4	118.0	99.1	98.9	86.2	92.9	86.6
福建省	99.2	106.7	96.0	97.5	90.9	78.1	103.3	107.0	105.2	99.0
山东省	83.3	89.2	85.0	79.5	78.7	66.8	62.4	52.0	49.5	41.8
广东省	205.6	188.1	192.0	196.5	204.9	180.0	184.4	162.5	148.1	118.1
海南省	286.0	252.6	240.5	253.2	276.4	185.1	225.3	236.1	235.0	199.5
中部	183.4	195.6	188.0	183.0	181.4	152.5	152.2	140.6	138.0	111.7
山西省	149.1	142.3	127.9	111.2	116.8	92.7	92.1	82.2	76.6	68.5
吉林省	121.2	110.0	96.5	102.8	99.5	78.9	79.7	74.2	62.4	45.4
黑龙江省	156.3	164.1	162.4	168.3	169.8	144.2	131.0	107.6	98.5	58.8
安徽省	187.9	202.6	201.1	198.4	182.7	155.0	170.9	144.7	130.7	108.2
江西省	235.7	239.8	229.6	224.1	233.9	203.3	200.3	194.2	195.9	149.8
河南省	188.4	204.9	191.4	181.9	173.8	149.9	146.6	136.7	124.8	98.6
湖北省	179.7	190.2	180.9	170.8	179.5	152.5	137.6	126.8	129.4	103.5
湖南省	198.7	228.0	227.6	226.3	226.5	183.0	193.4	193.1	213.6	191.5
西部	198.6	206.0	197.5	191.6	198.8	178.4	196.2	201.3	163.6	132.1
内蒙古自治区	201.0	200.2	166.9	143.6	152.3	140.7	139.2	159.2	147.9	114.5
广西壮族自治区	261.5	289.4	268.4	278.0	285.0	215.8	247.6	221.8	227.8	191.4
重庆市	115.8	116.7	123.9	114.3	118.0	107.7	132.4	126.9	131.8	122.7
四川省	111.1	114.7	109.3	101.6	104.6	92.6	90.4	79.2	86.2	73.4
贵州省	235.9	245.4	259.1	254.0	264.3	228.7	231.9	208.8	189.6	176.5
云南省	104.8	115.3	111.8	105.6	100.2	95.0	117.5	110.9	113.0	112.9
西藏	267.4	278.5	335.1	299.2	311.4	290.1	327.6	274.4	350.6	281.2
陕西省	142.1	136.0	128.1	117.4	118.7	109.1	117.7	103.7	106.2	89.0
甘肃省	295.4	244.4	222.1	203.9	181.6	175.0	203.6	113.5	101.3	90.8
青海省	266.6	322.1	300.4	281.9	330.2	314.9	356.2	322.1	325.3	208.2
宁夏回族自治区	241.6	231.5	241.8	264.3	201.6	189.5	204.3	166.6	152.1	122.2
新疆	1 236.8	1 382.5	1 307.0	1 309.6	1 391.3	1 374.7	1 541.9	2 232.4	1 218.8	752.8

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表 5 2011―2020年全国不同地区老年人肺结核报告发病情况及差异分析

Table 5. The reported incidences and differential analysis of pulmonary tuberculosis by regions among the elderly in China, 2011-2020

地区	2011―2020年			χ²值	P值	RR(95% CI)值
地区	人口数(万)	报告发病数	报告发病率(/10万)	χ²值	P值	RR(95% CI)值
东部	59 038	566 378	95.9			1.000
中部	43 512	691 879	159.0	81 319.238	< 0.001	1.658(1.652~1.663)
西部	37 727	695 657	184.4	138 274.000	< 0.001	1.922(1.915~1.929)

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表 6 2011―2019年全国老年人肺结核报告发病年均递降率及推算比较

Table 6. The average annual decline rate and estimated comparison of the reported incidences of pulmonary tuberculosis among the elderly in China during 2011-2019

地区	2011―2019年AAPC(%)	推算2020年报告发病率(/10万)	2020年实际报告发病率(/10万)	下降幅度(%)
全国	-3.5	115.2	98.3	14.6
东部	-4.9	74.8	68.7	8.2
中部	-4.5	121.2	111.7	7.8
西部	-1.5	173.3	132.1	23.8

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