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Article(id=1241522857629512578, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522846384583426, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202306462, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1687536000000, receivedDateStr=2023-06-24, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773931715637, onlineDateStr=2026-03-19, pubDate=1707494400000, pubDateStr=2024-02-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773931715637, onlineIssueDateStr=2026-03-19, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773931715637, creator=13701087609, updateTime=1773931715637, updator=13701087609, issue=Issue{id=1241522846384583426, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='3', pageStart='385', pageEnd='576', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773931712956, creator=13701087609, updateTime=1773931842201, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241523388544504301, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522846384583426, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241523388544504302, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522846384583426, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=422, endPage=427, ext={EN=ArticleExt(id=1241522858204132263, articleId=1241522857629512578, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis of epidemic characteristics of pulmonary tuberculosis in Guilin from 2012 to 2022, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the epidemic characteristics of pulmonary tuberculosis in Guilin, Guangxi Zhuang Autonomous region from 2012 to 2022, and to provide theoretical basis for the prevention and control of pulmonary tuberculosis in Guilin.

Methods

The relevant information of pulmonary tuberculosis cases reported by China Disease Prevention and Control Information system (Tuberculosis Surveillance and Report Management system) from 2012 to 2022 in Guilin, Guangxi Zhuang Autonomous region was collected. The distribution characteristics and incidence trend of pulmonary tuberculosis in Guilin from 2012 to 2022 were analyzed by chi-square and chi-square trend, and the average annual reported incidence and etiological positive rate of pulmonary tuberculosis were visually analyzed.

Results

From 2012 to 2022, a total of 32 319 cases of pulmonary tuberculosis were reported in Guilin, with an average annual incidence of 59.40/100 000. The reported incidence of tuberculosis decreased from 68.59/100 000 in 2012 to 45.99/100 000 in 2022, with an annual decline rate of 4.08%. In total 12 132 cases were etiologically positive, accounting for 37.53%. The incidence of pulmonary tuberculosis decreased in all age groups in Guilin. The incidence increased with age (Z=21.017, P < 0.001). The reported incidence of males and females was basically stable at 3:1, and the reported incidence of males was higher than that of females (χ2=25.87, P < 0.001). Farmers were the main occupations of patients (23 375 cases), accounting for 72.32%. The reported incidence rate of pulmonary tuberculosis in more than half of the counties (districts) in Guilin was higher than the annual average level of the whole city, with Lipu county (88.96/100 000) being the highest. The etiological positive rate of most counties (districts) was higher than the average annual level of the whole city, with Pingle county (31.65/100 000) being the highest.

Conclusion

The reported incidence of pulmonary tuberculosis in Guilin shows an overall downward trend from 2012 to 2022. The high incidence of pulmonary tuberculosis is characterized by age 65 and above, male, occupation as farmer, and the place of residence in the south of Guilin.

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目的

了解2012—2022年广西壮族自治区桂林市肺结核流行特征，为桂林市肺结核的预防控制提供理论依据。

方法

收集中国疾病预防控制信息系统（结核病监测报告管理系统）报告的2012—2022年广西壮族自治区桂林市肺结核病例的相关信息，对2012—2022年桂林市肺结核病例在时间、地区、人群的分布特征及发病趋势进行χ2及χ2趋势分析，对地区年均肺结核报告发病率、病原学阳性率进行可视化分析。

结果

2012—2022年间，桂林市累积报告肺结核病例32 319例，年均报告发病率为59.40/10万。肺结核报告发病率从2012年的68.59/10万下降至2022年的45.99/10万，年递降率为4.08% （Z=8.080，P=0.004）。病原学阳性病例12 132例，占37.53%。桂林市各年龄段肺结核发病率均呈下降趋势，年龄越大发病率越高（Z=21.017，P<0.001）。男性和女性报告发病率基本稳定为3：1，男性报告发病率高于女性（χ2=25.87，P<0.001）。患者职业以农民为主，23 375例，占72.32%。桂林市一半以上县（区）的肺结核报告发病率均高于全市年均水平，荔浦县最高，为88.96/10万；大部分县（区）的病原学阳性率均高于全市年均水平，其中平乐县最高，为31.65/10万。

结论

2012—2022年桂林市肺结核报告发病率总体呈下降趋势，其高发人群特征为年龄65岁及以上，性别为男性，职业为农民，居住地为桂林市南部地区。

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谭超，E-mail：
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王林燕、邓玄为共同第一作者

王林燕（1998—），女，硕士在读，研究方向：公共卫生专业；

邓玄（1977—），男，副主任医师，研究方向：结核病预防控制工作；

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王林燕（1998—），女，硕士在读，研究方向：公共卫生专业；

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Chinese Remedies & Clinics,2021, 21(5): 760-763., articleTitle=Analysis of the epidemic characteristics of tuberculosis in Yangquan mining area from 2010 to 2019, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1241680446463996170, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522857629512578, xref=1., ext=[AuthorCompanyExt(id=1241680446497550607, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522857629512578, companyId=1241680446463996170, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health, Guilin Medical College, Guilin, Guangxi 541199, China), AuthorCompanyExt(id=1241680446505939218, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522857629512578, companyId=1241680446463996170, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.桂林医学院公共卫生学院，广西 桂林 541199)]), AuthorCompany(id=1241680446698877207, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522857629512578, xref=2., ext=[AuthorCompanyExt(id=1241680446715654424, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522857629512578, companyId=1241680446698877207, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.桂林市疾病预防控制中心，广西 桂林 541001)])], figs=[ArticleFig(id=1241680450922541573, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522857629512578, language=EN, label=Figure 1, caption=Annual average reported incidence rate of pulmonary tuberculosis in Guilin from 2012 to 2022 (1/100 000), figureFileSmall=+yqiycaD8bqK6B6cOIwRPw==, figureFileBig=6l2TB1coeDTWSjNVKx5ekg==, tableContent=null), ArticleFig(id=1241680451039982096, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522857629512578, language=CN, label=图1, caption=2012—2022年桂林市肺结核年均报告发病率（1/10万）

注：审图号GS（2019）3333号。

, figureFileSmall=+yqiycaD8bqK6B6cOIwRPw==, figureFileBig=6l2TB1coeDTWSjNVKx5ekg==, tableContent=null), ArticleFig(id=1241680451144839704, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522857629512578, language=EN, label=Figure 2, caption=Pathogenic positive incidence rate of pulmonary tuberculosis in Guilin from 2012 to 2022 (1/100 000), figureFileSmall=6HaKoICmA6ut6AkBf9Dd7A==, figureFileBig=+Mg5Q08vu1k3ZsTpsk/msA==, tableContent=null), ArticleFig(id=1241680451258085917, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522857629512578, language=CN, label=图2, caption=2012—2022年桂林市肺结核病原学阳性发病率（1/10万）

注：审图号GS（2019）3333号。

, figureFileSmall=6HaKoICmA6ut6AkBf9Dd7A==, figureFileBig=+Mg5Q08vu1k3ZsTpsk/msA==, tableContent=null), ArticleFig(id=1241680451341972000, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522857629512578, language=EN, label=Table 1, caption=

Reported incidence rate of pulmonary tuberculosis among different age groups in Guilin from 2012 to 2022 (1/100 000)

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄（岁）年均2012年2013年2014年2015年2016年2017年2018年2019年2020年2021年2022年Z值P值
0～143.463.531.752.783.056.282.453.202.745.802.803.670.5030.478
15～2447.5961.2349.7646.3844.8649.3349.8038.9061.6949.1943.4228.902.5770.108
25～2447.3557.7653.6656.4653.7456.2650.5944.9643.8337.0934.2832.228.9060.003
35～2446.8857.6249.0050.3648.6948.7251.2142.8649.2043.1741.9832.846.9920.008
45～2466.2971.0065.4070.1972.2879.2883.1772.7762.3649.1753.4450.114.0690.044
55～2499.49114.19113.79117.9299.29102.14114.5594.5789.9480.4691.4376.067.6440.006
65～24142.85164.79156.75153.50165.40155.34159.08135.84132.76137.83104.95105.117.7700.005
75～24143.39179.68178.53152.32158.76129.95166.35123.53142.75124.81113.31107.347.7090.005
85及以上102.20109.50124.98102.4579.4093.86117.7580.49113.86126.2383.0492.620.4680.494
χ2值72.000
P值0.230
), ArticleFig(id=1241680451442635309, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522857629512578, language=CN, label=表1, caption=

2012—2022年桂林市不同年龄人群肺结核报告发病率（1/10万）

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄（岁）年均2012年2013年2014年2015年2016年2017年2018年2019年2020年2021年2022年Z值P值
0～143.463.531.752.783.056.282.453.202.745.802.803.670.5030.478
15～2447.5961.2349.7646.3844.8649.3349.8038.9061.6949.1943.4228.902.5770.108
25～2447.3557.7653.6656.4653.7456.2650.5944.9643.8337.0934.2832.228.9060.003
35～2446.8857.6249.0050.3648.6948.7251.2142.8649.2043.1741.9832.846.9920.008
45～2466.2971.0065.4070.1972.2879.2883.1772.7762.3649.1753.4450.114.0690.044
55～2499.49114.19113.79117.9299.29102.14114.5594.5789.9480.4691.4376.067.6440.006
65～24142.85164.79156.75153.50165.40155.34159.08135.84132.76137.83104.95105.117.7700.005
75～24143.39179.68178.53152.32158.76129.95166.35123.53142.75124.81113.31107.347.7090.005
85及以上102.20109.50124.98102.4579.4093.86117.7580.49113.86126.2383.0492.620.4680.494
χ2值72.000
P值0.230
), ArticleFig(id=1241680451547492920, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522857629512578, language=EN, label=Table 2, caption=

Reported incidence of pulmonary tuberculosis in different sex groups in Guilin from 2012 to 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）报告发病数报告发病率（1/10万）χ2值P值
男女男女
20122 44482798.6936.08
20132 36172094.1731.00
20142 38975695.0132.06
20152 31475591.1331.86
20162 38781292.0634.28
20172 51484198.0634.39
20182 13171881.0029.59
20192 16279582.1632.40
20201 94069473.2428.17
20211 86962174.5825.61
20221 67059966.5324.72
年均86.0630.9225.870<0.001
Z值199 593.805186 599.169
P值<0.001<0.001
), ArticleFig(id=1241680451631379009, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522857629512578, language=CN, label=表2, caption=

2012—2022年桂林市不同性别人群肺结核报告发病情况

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）报告发病数报告发病率（1/10万）χ2值P值
男女男女
20122 44482798.6936.08
20132 36172094.1731.00
20142 38975695.0132.06
20152 31475591.1331.86
20162 38781292.0634.28
20172 51484198.0634.39
20182 13171881.0029.59
20192 16279582.1632.40
20201 94069473.2428.17
20211 86962174.5825.61
20221 67059966.5324.72
年均86.0630.9225.870<0.001
Z值199 593.805186 599.169
P值<0.001<0.001
), ArticleFig(id=1241680451719459397, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522857629512578, language=EN, label=Table 3, caption=

Occupational distribution of reported cases of pulmonary tuberculosis in Guilin from 2012 to 2022 ［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）总计农民离退人员家务及待业工人学生教师商业服务医务人员干部职员其他
20123 2712 300(70.3)158(4.8)241(7.4)98(3.0)117(3.6)25(0.8)41(1.3)8(0.2)53(1.6)230(7.0)
20133 0812 311(75.0)138(4.5)182(5.9)63(2.0)79(2.6)20(0.6)30(1.0)15(0.5)45(1.5)198(6.4)
20143 1452 321(73.8)170(5.4)206(6.6)79(2.5)88(2.8)16(0.5)39(1.2)13(0.4)45(1.4)168(5.3)
20153 0692 273(74.1)158(5.1)181(5.9)69(2.2)69(2.2)13(0.4)22(0.7)7(0.2)54(1.8)223(7.3)
20163 1992 253(70.4)215(6.7)231(7.2)79(2.5)111(3.5)17(0.5)32(1.0)20(0.6)44(1.4)197(6.2)
20173 3552 341(69.8)244(7.3)214(6.4)65(1.9)122(3.6)16(0.5)18(0.5)9(0.3)48(1.4)278(8.3)
20182 8491 937(68.0)199(7.0)229(8.0)67(2.4)117(4.1)21(0.7)23(0.8)17(0.6)50(1.8)189(6.6)
20192 9572 096(70.9)179(6.1)201(6.8)37(1.3)150(5.1)26(0.9)24(0.8)21(0.7)77(2.6)146(4.9)
20202 6341 965(74.6)183(6.9)111(4.2)20(0.8)122(4.6)19(0.7)21(0.8)25(0.9)64(2.4)104(3.9)
20212 4901 890(75.9)165(6.6)114(4.6)17(0.7)99(4.0)27(1.1)20(0.8)24(1.0)35(1.4)99(4.0)
20222 2691 688(74.4)165(7.3)147(6.5)21(0.9)82(3.6)16(0.7)17(0.7)18(0.8)38(1.7)77(3.4)
总计32 31923 375（72.3）1 974（6.1）2 057（6.4）615（1.9）1 156（3.6）216（0.7）287（0.9）177（0.5）553（1.7）1 909（5.9）
), ArticleFig(id=1241680451870454352, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522857629512578, language=CN, label=表3, caption=

2012—2022年桂林市肺结核报告发病患者职业分布情况［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）总计农民离退人员家务及待业工人学生教师商业服务医务人员干部职员其他
20123 2712 300(70.3)158(4.8)241(7.4)98(3.0)117(3.6)25(0.8)41(1.3)8(0.2)53(1.6)230(7.0)
20133 0812 311(75.0)138(4.5)182(5.9)63(2.0)79(2.6)20(0.6)30(1.0)15(0.5)45(1.5)198(6.4)
20143 1452 321(73.8)170(5.4)206(6.6)79(2.5)88(2.8)16(0.5)39(1.2)13(0.4)45(1.4)168(5.3)
20153 0692 273(74.1)158(5.1)181(5.9)69(2.2)69(2.2)13(0.4)22(0.7)7(0.2)54(1.8)223(7.3)
20163 1992 253(70.4)215(6.7)231(7.2)79(2.5)111(3.5)17(0.5)32(1.0)20(0.6)44(1.4)197(6.2)
20173 3552 341(69.8)244(7.3)214(6.4)65(1.9)122(3.6)16(0.5)18(0.5)9(0.3)48(1.4)278(8.3)
20182 8491 937(68.0)199(7.0)229(8.0)67(2.4)117(4.1)21(0.7)23(0.8)17(0.6)50(1.8)189(6.6)
20192 9572 096(70.9)179(6.1)201(6.8)37(1.3)150(5.1)26(0.9)24(0.8)21(0.7)77(2.6)146(4.9)
20202 6341 965(74.6)183(6.9)111(4.2)20(0.8)122(4.6)19(0.7)21(0.8)25(0.9)64(2.4)104(3.9)
20212 4901 890(75.9)165(6.6)114(4.6)17(0.7)99(4.0)27(1.1)20(0.8)24(1.0)35(1.4)99(4.0)
20222 2691 688(74.4)165(7.3)147(6.5)21(0.9)82(3.6)16(0.7)17(0.7)18(0.8)38(1.7)77(3.4)
总计32 31923 375（72.3）1 974（6.1）2 057（6.4）615（1.9）1 156（3.6）216（0.7）287（0.9）177（0.5）553（1.7）1 909（5.9）
), ArticleFig(id=1241680453384598107, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522857629512578, language=EN, label=Table 4, caption=

Spatial autocorrelation analysis of reported incidence rate of pulmonary tuberculosis in Guilin from 2012 to 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
时间（年）Moran I指数Z得分P值
20120.080 7630.836 4890.403
20130.019 2480.486 7140.626
20140.131 6521.114 0510.265
20150.029 7650.549 5030.583
2016-0.097 317-0.145 1050.885
20170.210 1910.595 3570.111
2018-0.094 104-0.122 5080.902
2019-0.225 003-0.832 9840.405
2020-0.300 354-1.233 0110.218
2021-0.117 748-0.250 7830.802
20220.062 3110.764 6610.444
年均0.001 6680.394 4050.693
), ArticleFig(id=1241680453506232931, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522857629512578, language=CN, label=表4, caption=

2012—2022年桂林市肺结核报告发病率空间自相关分析

, figureFileSmall=null, figureFileBig=null, tableContent=
时间（年）Moran I指数Z得分P值
20120.080 7630.836 4890.403
20130.019 2480.486 7140.626
20140.131 6521.114 0510.265
20150.029 7650.549 5030.583
2016-0.097 317-0.145 1050.885
20170.210 1910.595 3570.111
2018-0.094 104-0.122 5080.902
2019-0.225 003-0.832 9840.405
2020-0.300 354-1.233 0110.218
2021-0.117 748-0.250 7830.802
20220.062 3110.764 6610.444
年均0.001 6680.394 4050.693
), ArticleFig(id=1241680453653033584, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522857629512578, language=EN, label=Table 5, caption=

Incidence of registered pulmonary tuberculosis in Guilin from 2012 to 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）报告发病数报告发病率（1/10万）
肺结核病原学阳性利福平耐药肺结核病原学阳性利福平耐药中标率世标率
20123 2711 752—68.5924.20—65.5559.28
20133 081991—63.7920.52—60.3553.85
20143 145974—64.5519.99—60.6753.71
20153 069883—62.5217.99—58.8052.28
20163 199785—64.4815.82—59.9053.29
20173 355825966.9816.470.1863.3756.80
20182 8498391456.3316.590.2852.8347.51
20192 9571 1712958.1523.030.5755.7650.01
20202 6341 2673351.5224.780.6548.9543.68
20212 4901 4084350.5028.550.8747.1941.71
20222 2691 2373045.9925.070.6140.4535.89
年均59.4021.180.5355.8049.82
Z值8.0801.9353.5257.9287.858
P值0.0040.1640.0600.0050.005
), ArticleFig(id=1241680453770474105, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522857629512578, language=CN, label=表5, caption=

2012—2022年桂林市登记肺结核发病情况

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）报告发病数报告发病率（1/10万）
肺结核病原学阳性利福平耐药肺结核病原学阳性利福平耐药中标率世标率
20123 2711 752—68.5924.20—65.5559.28
20133 081991—63.7920.52—60.3553.85
20143 145974—64.5519.99—60.6753.71
20153 069883—62.5217.99—58.8052.28
20163 199785—64.4815.82—59.9053.29
20173 355825966.9816.470.1863.3756.80
20182 8498391456.3316.590.2852.8347.51
20192 9571 1712958.1523.030.5755.7650.01
20202 6341 2673351.5224.780.6548.9543.68
20212 4901 4084350.5028.550.8747.1941.71
20222 2691 2373045.9925.070.6140.4535.89
年均59.4021.180.5355.8049.82
Z值8.0801.9353.5257.9287.858
P值0.0040.1640.0600.0050.005
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2012—2022年桂林市肺结核流行特征分析
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王林燕 1 , 邓玄 2 , 曾西 1 , 谭超 1
现代预防医学 | 流行病与统计方法 2024,51(3): 422-427
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现代预防医学 | 流行病与统计方法 2024, 51(3): 422-427
2012—2022年桂林市肺结核流行特征分析
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王林燕1, 邓玄2, 曾西1, 谭超1
作者信息
  • 1.桂林医学院公共卫生学院，广西 桂林 541199
  • 2.桂林市疾病预防控制中心，广西 桂林 541001

    • 王林燕（1998—），女，硕士在读，研究方向：公共卫生专业；

    邓玄（1977—），男，副主任医师，研究方向：结核病预防控制工作；

通讯作者:

谭超，E-mail：
Analysis of epidemic characteristics of pulmonary tuberculosis in Guilin from 2012 to 2022
Lin-yan WANG1, Xuan DENG2, Xi ZENG1, Chao TAN1
Affiliations
  • School of Public Health, Guilin Medical College, Guilin, Guangxi 541199, China
出版时间: 2024-02-10 doi: 10.20043/j.cnki.MPM.202306462
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摘要
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目的

了解2012—2022年广西壮族自治区桂林市肺结核流行特征，为桂林市肺结核的预防控制提供理论依据。

方法

收集中国疾病预防控制信息系统（结核病监测报告管理系统）报告的2012—2022年广西壮族自治区桂林市肺结核病例的相关信息，对2012—2022年桂林市肺结核病例在时间、地区、人群的分布特征及发病趋势进行χ2及χ2趋势分析，对地区年均肺结核报告发病率、病原学阳性率进行可视化分析。

结果

2012—2022年间，桂林市累积报告肺结核病例32 319例，年均报告发病率为59.40/10万。肺结核报告发病率从2012年的68.59/10万下降至2022年的45.99/10万，年递降率为4.08% （Z=8.080，P=0.004）。病原学阳性病例12 132例，占37.53%。桂林市各年龄段肺结核发病率均呈下降趋势，年龄越大发病率越高（Z=21.017，P<0.001）。男性和女性报告发病率基本稳定为3：1，男性报告发病率高于女性（χ2=25.87，P<0.001）。患者职业以农民为主，23 375例，占72.32%。桂林市一半以上县（区）的肺结核报告发病率均高于全市年均水平，荔浦县最高，为88.96/10万；大部分县（区）的病原学阳性率均高于全市年均水平，其中平乐县最高，为31.65/10万。

结论

2012—2022年桂林市肺结核报告发病率总体呈下降趋势，其高发人群特征为年龄65岁及以上，性别为男性，职业为农民，居住地为桂林市南部地区。

肺结核  /  流行特征  /  发病趋势  /  GIS
Objective

To investigate the epidemic characteristics of pulmonary tuberculosis in Guilin, Guangxi Zhuang Autonomous region from 2012 to 2022, and to provide theoretical basis for the prevention and control of pulmonary tuberculosis in Guilin.

Methods

The relevant information of pulmonary tuberculosis cases reported by China Disease Prevention and Control Information system (Tuberculosis Surveillance and Report Management system) from 2012 to 2022 in Guilin, Guangxi Zhuang Autonomous region was collected. The distribution characteristics and incidence trend of pulmonary tuberculosis in Guilin from 2012 to 2022 were analyzed by chi-square and chi-square trend, and the average annual reported incidence and etiological positive rate of pulmonary tuberculosis were visually analyzed.

Results

From 2012 to 2022, a total of 32 319 cases of pulmonary tuberculosis were reported in Guilin, with an average annual incidence of 59.40/100 000. The reported incidence of tuberculosis decreased from 68.59/100 000 in 2012 to 45.99/100 000 in 2022, with an annual decline rate of 4.08%. In total 12 132 cases were etiologically positive, accounting for 37.53%. The incidence of pulmonary tuberculosis decreased in all age groups in Guilin. The incidence increased with age (Z=21.017, P < 0.001). The reported incidence of males and females was basically stable at 3:1, and the reported incidence of males was higher than that of females (χ2=25.87, P < 0.001). Farmers were the main occupations of patients (23 375 cases), accounting for 72.32%. The reported incidence rate of pulmonary tuberculosis in more than half of the counties (districts) in Guilin was higher than the annual average level of the whole city, with Lipu county (88.96/100 000) being the highest. The etiological positive rate of most counties (districts) was higher than the average annual level of the whole city, with Pingle county (31.65/100 000) being the highest.

Conclusion

The reported incidence of pulmonary tuberculosis in Guilin shows an overall downward trend from 2012 to 2022. The high incidence of pulmonary tuberculosis is characterized by age 65 and above, male, occupation as farmer, and the place of residence in the south of Guilin.

Pulmonary tuberculosis  /  Epidemic characteristics  /  Incidence trend  /  GIS
王林燕, 邓玄, 曾西, 谭超. 2012—2022年桂林市肺结核流行特征分析. 现代预防医学, 2024 , 51 (3) : 422 -427 . DOI: 10.20043/j.cnki.MPM.202306462
Lin-yan WANG, Xuan DENG, Xi ZENG, Chao TAN. Analysis of epidemic characteristics of pulmonary tuberculosis in Guilin from 2012 to 2022[J]. Modern Preventive Medicine, 2024 , 51 (3) : 422 -427 . DOI: 10.20043/j.cnki.MPM.202306462
正文
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结核病是一种由结核分枝杆菌感染引起的的慢性传染病，以肺结核多见，也是全球十大死亡原因之一，据统计每年有超过100万人死于该病[1]。2021年WHO发布的全球结核病报告指出，中国的结核病发病数在30个结核病高负担国家中位居第二[2]。由中国疾病预防控制信息系统传染病信息管理系统(简称网络直报系统)获取数据得知，广西壮族自治区（简称广西）属于我国结核病疫情比较严重的地区，近十年肺结核报告发病率均位于全国前七位，广西甲、乙类传染病报告发病数中结核报告发病数位居前两位[3]。有研究表明桂林市肺结核报告发病率总体呈下降趋势，但是近期公开发表研究较少[4]。本研究旨在通过分析2012—2022年间桂林市肺结核疫情流行特征，为制定肺结核防控措施、完善防治体系提供依据。
1　材料与方法
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1.1　资料来源
桂林市肺结核病例信息及其人口学数据均来源于《中国疾病预防控制信息系统》，病例选择现住址为广西桂林市，发病时间为2012年1月1日—2022年12月31日新发的肺结核临床诊断病例和确诊病例数据；矢量化地图数据来源于网络国家基础地理信息。
1.2　数据分类标准
本文采用2019年中华人民共和国国家卫生和健康委员会发布的分类标准进行统计分析，其修订分类为“利福平耐药、病原学阳性、病原学阴性、无病原学结果”，临床诊断病例和确诊病例的定义遵循中国人民共和国国家卫生和计划生育委员会2017年11月9日发布的《中华人民共和国卫生行业标准》中的《肺结核诊断标准（WS 288-2017）》；研究对象均为各年新发病例。本文的发病数据均由《中国疾病预防控制信息系统》导出，包括年发病率、年龄发病率、性别发病率、地区发病率等。
1.3　统计学分析
利用SPSS 25.0软件描述性分析桂林市2012—2022年肺结核报告发病率、变化趋势、年龄、性别、职业、地区分布等；标化发病率以中国2010年第六次全国人口普查标准人口，Segi世界2000年标准人口作为标准。采用趋势χ2检验分析率的变化趋势，使用χ2 检验比较分类数据；采用ArcGIS 10.8.1软件建立2012—2022年桂林市肺结核发病率地理信息数据库，采用自然断点法对肺结核报告发病率及病原学阳性构成比进行可视化，将肺结核发病率与矢量化电子地图数据连接，本文通过空间自相关分析Moran I指数反映肺结核报告发病率地区分布在研究范围内是否存在异质性。Moran I的取值范围为-1～1，取值为0表示空间分布为随机分布，接近1表示数据聚类分布，接近-1表明数据离散分布。发病率的计算公式有：
设2012年报告发病率为r2012，2022年报告发病率为r2022，本文报告发病率年均递降率计算公式为。
2　结果
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2.1　肺结核报告发病病例的人群分布特征
2.1.1　年龄分布
其中65岁以上肺结核报告率较高，年均发病率高于100/10万，趋势χ2检验结果表示，2012—2022年桂林市肺结核年均报告发病率随年龄的增长总体呈上升趋势（Z=6.332，P=0.012），且各年龄段间差异无统计学意义； 2012—2022年肺结核报告率变化趋势差异有统计学意义的年龄段为25～84岁（均有P值<0.05)。见表1。
2.1.2　性别分布
2012—2022年桂林市报告肺结核病例男性24 181例，年均报告率为86.06/10万，且呈逐年下降趋势（Z=199 593.805，P<0.001）；女性8 138例，年均报告率为30.92/10万，且呈逐年下降趋势（Z=186 599.169，P<0.001）。男性报告发病数高于女性，其大概比例为3：1，χ2检验结果表明，男女报告发病率差异有统计学意义（χ2=25.87,P<0.001）。见表2。
2.1.3　职业分布
2012—2022年桂林市肺结核报告病例职业种类以农民为主，其11年总病例为23 375例，占报告发病总例数72.3%；报告发病例数第二职业为家务及待业，其报告例数为2 057例，占总数的6.4%，其次为离退人员和学生，占比分别为6.1%和3.6%。见表3。
2.2　地区分布
2012—2022年间桂林市17个县（区）均有结核病例上报登记，桂林南部地区报告发病率相对于北部较高，中部各区面积小且发病率最低。荔浦县、阳朔县、全州县、临桂县、恭城瑶族自治县、永福县、平乐县、资源县、灵川县年均登记发病率均高于全市年均水平，以荔浦县、阳朔县、全州县三县为例，其肺结核年均报告发病率分别为88.96/10万、79.94/10万、78.61/10万；灌阳县报告发病率最低，为43.69/10万，见图1。平乐县、全州县、永福县、灵川县、阳朔县、临桂县、恭城瑶族自治县、荔浦县、龙胜各族自治县、兴安县等10个县（区）的病原学阳性率均高于全市年均水平，其中平乐县、全州县、永福县三县最高，分别为31.65/10万、30.24/10万、29.05/10万，七星区最低，为11.98/10万，见图2。以各县区水平为单位，对肺结核报告发病率进行全局Moran I 指数分析，统计结果见表4，显示空间趋势无统计学意义，各年或年均统计P值均大于0.05。
2.3　肺结核报告发病情况
2012—2022年间桂林市肺结核报告发病共32 319例，报告发病率在45.99/10万～68.59/10万之间；病原学阳性肺结核报告发病共12 132例，报告发病率在15.82/10万～28.55/10万之间；2017—2022年报告利福平耐药共158例，报告发病率在0.18/10万～0.87/10万之间，平均中国人口标化发病率（简称中标率）为55.80/10万（Z=7.928，P=0.005），世界人口标化发病率（简称世标率）为49.81/10万（Z=7.858，P=0.005），三者变化趋势基本一致。见表5。
2.4　肺结核报告发病趋势
χ2趋势检验结果表明，2012—2022年桂林市肺结核报告发病率总体呈下降趋势（Z=8.080，P=0.004），年递降率为4.08%；2012—2022年病原学阳性报告率总体趋势差异无统计学意义（Z=1.935，P=0.164）；2017—2022年利福平耐药报告率总体趋势差异无统计学意义（Z=3.525，P=0.06）。见表5。
3　讨论
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研究结果表明，2012—2022年桂林市肺结核年均报告发病率、平均中国人口标化发病率及世界人口标化发病率三者变化趋势基本一致，均呈下降趋势，且低于2006—2021年广西的报告发病率（145.67/10万），粗率较高于2020年中国肺结核报告发病率（59.0/10万）[5]，但标准化后报告发病率低于该水平。2011年广西全区推行的“三位一体”新型结核病防治服务体系，因地制宜，不断规范了肺结核病例的各级管理制度，有效降低了桂林市肺结核发病率[3]；同时新型冠状病毒肺炎的流行也影响了肺结核报告发病率[6]。桂林市肺结核病原学阳性报告发病率由2016年至2021年不断升高，到2022年病原学阳性报告发病率较2021年略微降低，其可能的造成原因为近年来检测设备的升级及诊断流程的不断规范化等[7]。2017—2022年桂林市利福平耐药呈先升高后降低的变化趋势，2021年升至最高点，2021年之后耐药率开始回落，其大概原因可能为前期耐药筛查覆盖面不断扩展，广西多个市区参与了全球基金项目且各年龄段人群主动筛查率提高，后期回落可能原因为本区诊疗体系相对完善后，规范化的耐药管理使得发病率有所下降[3]。
随着医疗技术的进步，现代社会不断步入老龄化阶段，高龄人群的结核病防治工作明显愈加重要[8]。本文结果表明2012—2022年间随年龄增长，肺结核报告发病率持续升高，趋势变化有统计学意义（Z=6.332，P=0.012）；其中65岁以上肺结核报告率较高，其原因可能与老年人基础疾病多、免疫力低下有关[9-10]。提示应贯彻执行国家关于高龄人群的结核防治策略，加强老年人结核基础知识的宣传工作，多开展主动筛查，提高危险人群配合的积极主动性。桂林市2012—2022年肺结核报告发病率男性高于女性，与大多数学者研究结果相似[11-12],本文结果得出男性发病数与女性发病数之比接近3：1，与某些研究一致[13]。造成此结果的原因可能有吸烟[14-15],经济生活压力大，外出机会多，接触面广等[16]。
报告发病率职业情况显示，职业为农民的人群发病率始终居高不下，报告发病例数第二职业为家务及待业，其次为离退人员和学生，分布大致与全国一致[17]。广西作为少数民族自治区，相对于大多数省份经济较为落后，职业为农民比例较高，这与桂林市城镇化水平、农村人民的生活条件、卫生意识等都有关系[18]。
地区分布表明，尽管桂林市肺结核报告发病率逐年下降，但市内一半以上县（区）报告发病率和病原学阳性率仍较高，可能与桂林市城市化水平还较低、人们普遍意识水平不够有关，提示各县（区）卫生院、疾病预防控制中心应当加大结核病的主动筛查力度，扩大范围进行宣传教育[19]。
综上所述，2012—2022年桂林市肺结核报告发病率总体呈下降趋势，其高发的特征年龄为65岁及以上,性别为男性，职业为农民，提示国家和政府部门防治工作可以将该人群作为重点防护人群，积极宣传教育，提高人们积极就医、主动筛查的良好习惯，同时要积极配合国家“三位一体”模式政策[20]，加强监测、优化管理、及时救治，鼓动全民参与。
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doi: 10.20043/j.cnki.MPM.202306462
  • 接收时间：2023-06-24
  • 首发时间：2026-03-19
  • 出版时间：2024-02-10
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  • 收稿日期：2023-06-24
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    1.桂林医学院公共卫生学院，广西 桂林 541199
    2.桂林市疾病预防控制中心，广西 桂林 541001

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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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