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Article(id=1324078520053400372, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078333767594037, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202508191, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1755014400000, receivedDateStr=2025-08-13, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614519369, onlineDateStr=2026-11-02, pubDate=1767974400000, pubDateStr=2026-01-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614519369, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614519369, creator=13701087609, updateTime=1793614519369, updator=13701087609, issue=Issue{id=1324078333767594037, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='1', pageStart='1', pageEnd='192', issueExtLink='null', onlineDate='null', pubDate='1767974400000', pubDateStr='2026-01-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614474956, creator='13701087609', updateTime=1793614571752, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324078739914621270, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078333767594037, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324078739914621271, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078333767594037, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=166, endPage=172, ext={EN=ArticleExt(id=1324078520388944693, articleId=1324078520053400372, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Epidemiological characteristics of pulmonary tuberculosis in Qinghai Province from 2005 to 2024, columnId=1228016573156360233, journalTitle=Modern Preventive Medicine, columnName=Disease Control and Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the reported incidence of pulmonary tuberculosis (TB) in Qinghai Province from 2005 to 2024, and to provide a scientific basis for developing adaptive TB prevention and control strategies.

Methods

Data on reported TB cases in Qinghai, categorized by year, sex, occupation, age group, and region, were extracted from the infectious disease surveillance module of the China Information System for Disease Control and Prevention. The joinpoint regression model was used to analyze the temporal trends in the reported incidence under different categories.

Results

From 2005 to 2024, a total of 119 984 TB cases were reported in Qinghai Province, with an average of approximately 5 999 cases annually. The average annual reported incidence rate was 104.12 per 100 000 population. Joinpoint regression analysis indicated no significant overall trend for the entire period. However, the reported incidence showed a slow upward trend from 2005 to 2018 [Annual Percent Change (APC)=4.24%, P<0.001], followed by a significant downward trend from 2018 to 2024 (APC=-10.89%, P=0.001). A turning point occurred in 2018 for both males and females: incidence increased during 2005—2018(male: APC=2.91%, P=0.005; female: APC=6.17%, P<0.001) and decreased markedly during 2018—2024 (male: APC=-11.85%, P<0.001; female: APC=-10.00%, P=0.003). By age group, the 0-14 years group showed a significant increasing trend [Average Annual Percent Change (AAPC)=5.05%, P<0.001], while the ≥65 years group showed a significant decreasing trend (AAPC=-2.47%, P=0.042). Regarding occupational distribution, farmers constituted the highest proportion at 42.16%,followed by herdsmen (24.08%), and students (11.93%). The reported incidence among herdsmen and students showed increasing trends from 2005 to 2024. Among the prefectures, Xining City and Haixi Prefecture showed decreasing trends(Xining: AAPC=-4.84%, P<0.001; Haixi: AAPC=-5.23%, P<0.001), while Huangnan Prefecture showed an increasing trend(AAPC=3.87%, P=0.003).

Conclusion

The reported incidence of pulmonary tuberculosis in Qinghai Province showed an initial increase followed by a decrease between 2005 and 2024. Sustained efforts are needed to enhance etiological detection capacity,strengthen active screening in key regions and high-risk populations, and improve TB surveillance and early warning capabilities among students/children to further reduce the disease burden.

, authors=Hui-he WU1, 2, Yu-jia WEI3, Yi-min WANG1, authorsList=Hui-he WU, Yu-jia WEI, Yi-min WANG, authorCompany=null, correspAuthors=Yu-jia WEI, Yi-min WANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324078522981024570, articleId=1324078520053400372, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=2005—2024年青海省肺结核流行特征分析, columnId=1228016573844226129, journalTitle=现代预防医学, columnName=疾病预防控制, runingTitle=null, highlight=null, articleAbstract=
目的

分析2005—2024年青海省肺结核报告发病率，为制定适应性结核病防控策略提供科学依据。

方法

从中国疾病预防控制信息系统中传染病监测模块导出青海省分年份、性别、职业、年龄组和地区分类的肺结核病报告发病数据，采用joinpoint回归模型分析不同分类下报告发病率的时间变化趋势。

结果

2005—2024年青海省累积报告肺结核患者119 984例，年均报告约5 999例，平均报告发病率为104.12/10万。Joinpoint回归分析显示：2005—2024年青海省肺结核报告发病率无明显变化趋势，其中2005—2018年报告发病率呈缓慢上升趋势[年度变化百分比（annual percentage change,APC）=4.24%，P<0.001]；2018—2024年呈显著下降趋势（APC=-10.89%，P=0.001）。男性和女性报告发病率均在2018年出现转折点，即在2005—2018年上升（男性APC=2.91%，P=0.005；女性APC=6.17%，P<0.001），在2018—2024年大幅下降（男性APC=-11.85%，P<0.001；女性APC=-10.00%，P=0.003）。各年龄分组中，0~14岁组报告发病率呈现上升趋势[平均年度变化百分比（average annual percentage change，AAPC）=5.05%，P<0.001]，65岁以上组报告发病率呈现下降趋势（AAPC=-2.47%，P=0.042）。职业分布中农民占比最高,为42.16%，后依次是牧民的24.08%、学生的11.93%。2005—2024年牧民、学生肺结核报告发病率呈上升趋势。各市（州）中西宁市、海西州报告发病率呈下降趋势（西宁AAPC=-4.84%，P<0.001）、（海西AAPC=-5.23%，P<0.001），黄南州呈上升趋势（AAPC=3.87%，P=0.003）。

结论

2005—2024年青海省肺结核报告发病率呈现先上升后下降趋势，需持续提升病原学检测能力、加强重点地区及高危人群主动筛查，提高学生/儿童肺结核监测预警能力，以进一步降低疫情负担。

, authors=武慧荷1, 2, 魏於家3, 王益民1, authorsList=武慧荷, 魏於家, 王益民, authorCompany=null, correspAuthors=魏於家, 王益民, authorNote=

武慧荷（1993—），女，硕士在读，研究方向：传染性疾病控制

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王益民，E-mail:
魏於家，E-maii:
王益民与魏於家为共同通信作者
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Differences in blood miRNAs expression between Tibetan tuberculosis patients and healthy People in Qinghai province and effects of altitude changes on miRNA expression of patients[J]. Chinese High Altitude Medicine and Biology, 2018, 39(3): 158-164. (In Chinese), articleTitle=Differences in blood miRNAs expression between Tibetan tuberculosis patients and healthy People in Qinghai province and effects of altitude changes on miRNA expression of patients, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1324078523203322683, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078520053400372, xref=1., ext=[AuthorCompanyExt(id=1324078523211711292, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078520053400372, companyId=1324078523203322683, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China), AuthorCompanyExt(id=1324078523220099901, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078520053400372, companyId=1324078523203322683, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.兰州大学公共卫生学院，甘肃 兰州 730000)]), AuthorCompany(id=1324078523283014462, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078520053400372, xref=2., ext=[AuthorCompanyExt(id=1324078523295597375, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078520053400372, companyId=1324078523283014462, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.青海省人民医院控制感染科，青海 西宁 810000)]), AuthorCompany(id=1324078523358511936, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078520053400372, xref=3., ext=[AuthorCompanyExt(id=1324078523366900545, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078520053400372, companyId=1324078523358511936, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.青海省疾病预防控制中心结核病防治科，青海 西宁 810000)])], figs=[ArticleFig(id=1324078524805546842, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078520053400372, language=EN, label=Figure 1, caption=Joinpoint regression analysis of the overall and sex-specific reported incidence of pulmonary tuberculosis in Qinghai Province,2005—2024, figureFileSmall=AJ3ZNvFYNobGK/ULekgm/g==, figureFileBig=Q/o+JmTCjG/ZsKULk+hOPw==, tableContent=null), ArticleFig(id=1324078524876850011, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078520053400372, language=CN, label=图1, caption=2005—2024年青海省肺结核报告发病总体及分性别joinpoint分析

注：*P<0.05。

, figureFileSmall=AJ3ZNvFYNobGK/ULekgm/g==, figureFileBig=Q/o+JmTCjG/ZsKULk+hOPw==, tableContent=null), ArticleFig(id=1324078525103342428, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078520053400372, language=EN, label=Table 1, caption=

Overall situation of reported pulmonary tuberculosis incidence in Qinghai Province, 2005—2024

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）肺结核报告数（例）病原学阳性数（例）病原学阴性数（例）无病原学结果数（例）报告发病率（/10万）病原学阳性率（%）
20055 1312 5931 2941 24495.3950.54
20064 1122 1011 02798475.7351.09
20074 8822 3921 4651 02589.0949.00
20084 9702 2461 5271 19790.0445.19
20095 5492 7361 4311 382100.1149.31
20105 1922 6401 3281 22493.1650.85
20115 5042 6921 5821 23097.8248.91
20126 6212 6772 1641 780116.5340.43
20136 2712 3482 3741 549109.4137.44
20146 1231 4422 8611 820105.9723.55
20157 4641 3624 2291 873127.9418.25
20167 8871 3154 6111 961134.0316.67
20178 3131 3685 1541 791140.1916.46
20188 9941 6605 1812 153150.3118.46
20198 1152 2624 2371 616134.5327.87
20205 7052 3412 69866693.8541.03
20215 2941 9562 69464489.3736.95
20223 5871 6711 52938760.3946.58
20235 5523 2201 99134193.3258.00
20244 7183 0431 49917679.4364.50
), ArticleFig(id=1324078525174645597, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078520053400372, language=CN, label=表1, caption=

2005—2024年青海省肺结核报告发病总体情况

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）肺结核报告数（例）病原学阳性数（例）病原学阴性数（例）无病原学结果数（例）报告发病率（/10万）病原学阳性率（%）
20055 1312 5931 2941 24495.3950.54
20064 1122 1011 02798475.7351.09
20074 8822 3921 4651 02589.0949.00
20084 9702 2461 5271 19790.0445.19
20095 5492 7361 4311 382100.1149.31
20105 1922 6401 3281 22493.1650.85
20115 5042 6921 5821 23097.8248.91
20126 6212 6772 1641 780116.5340.43
20136 2712 3482 3741 549109.4137.44
20146 1231 4422 8611 820105.9723.55
20157 4641 3624 2291 873127.9418.25
20167 8871 3154 6111 961134.0316.67
20178 3131 3685 1541 791140.1916.46
20188 9941 6605 1812 153150.3118.46
20198 1152 2624 2371 616134.5327.87
20205 7052 3412 69866693.8541.03
20215 2941 9562 69464489.3736.95
20223 5871 6711 52938760.3946.58
20235 5523 2201 99134193.3258.00
20244 7183 0431 49917679.4364.50
), ArticleFig(id=1324078525258531678, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078520053400372, language=EN, label=Table 2, caption=

Results of joinpoint regression analysis on the reported incidence of pulmonary tuberculosis in Qinghai Province, 2005—2024

, figureFileSmall=null, figureFileBig=null, tableContent=
特征AAPC[%,（95%CI）]t值P值时间段（年）APC[%,（95%CI）]t值P值
年报告发病率-0.80(-2.93～1.38)-0.7220.4702005—20184.24（2.24～6.27）4.583<0.001
2018—2024-10.89（-16.25～-5.18）-3.9580.001
病原学阳性占比1.66(-1.81～5.26)0.9300.3522005—20110.34(-4.25～5.15)0.1570.878
2011—2016-20.50(-29.73～-10.07)-4.0540.002
2016—202419.73(15.57～24.03)11.103<0.001
性别
男性-2.00(-4.11～0.15)-1.8250.0682005—20182.91(1.03～4.82)3.3190.005
2018—2024-11.85(-17.25～-6.10)-4.2540.001
女性0.78(-1.48～3.08)0.6680.5042005—20186.17(3.96～8.43)6.066<0.001
2018—2024-10.00(-15.52～-4.11)-3.5450.003
年龄(岁)
0～145.05(2.08～8.1)3.3720.0012005—201712.74(8.96～16.65)7.486<0.001
2017—2024-6.94(-12.44～-1.09)-2.5150.024
15～44-0.08(-2.33～2.21)-0.0730.9422005—20185.38(3.35～7.46)5.737<0.001
2018—2024-10.98(-16.65～-4.92)-3.7650.002
45～64-2.34(-5.96～1.41)-1.2310.2182005—20181.03(-0.39～2.47)1.5710.142
2018—2022-18.19(-28.32～-6.64)-3.3120.006
2022—202411.63(-15.93～48.23)0.8460.414
≥65-2.47(-4.8～-0.09)-2.0290.0422005—20171.34(-1.27～4.03)1.0880.294
2017—2024-8.69(-13.62～-3.47)-3.4880.003
职业
农民占比0.10（-1.19～1.40）0.1520.8802005—2018-1.56（-2.64～-0.47）-3.0520.008
2018—20243.80（-0.03～7.78）2.1150.052
牧民占比2.17（0.23～4.14）2.1990.0282005—201110.47（4.27～17.04）3.6740.002
2011—2024-1.45（-2.88～-0.01）-2.1450.049
学生占比6.52（4.11～9.00）5.400<0.0012005—20179.95（6.81～13.19）6.976<0.001
2017—20240.89（-3.64～5.64）0.4110.687
), ArticleFig(id=1324078526936253279, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078520053400372, language=CN, label=表2, caption=

2005—2024年青海省肺结核报告发病率joinpoint回归分析结果

, figureFileSmall=null, figureFileBig=null, tableContent=
特征AAPC[%,（95%CI）]t值P值时间段（年）APC[%,（95%CI）]t值P值
年报告发病率-0.80(-2.93～1.38)-0.7220.4702005—20184.24（2.24～6.27）4.583<0.001
2018—2024-10.89（-16.25～-5.18）-3.9580.001
病原学阳性占比1.66(-1.81～5.26)0.9300.3522005—20110.34(-4.25～5.15)0.1570.878
2011—2016-20.50(-29.73～-10.07)-4.0540.002
2016—202419.73(15.57～24.03)11.103<0.001
性别
男性-2.00(-4.11～0.15)-1.8250.0682005—20182.91(1.03～4.82)3.3190.005
2018—2024-11.85(-17.25～-6.10)-4.2540.001
女性0.78(-1.48～3.08)0.6680.5042005—20186.17(3.96～8.43)6.066<0.001
2018—2024-10.00(-15.52～-4.11)-3.5450.003
年龄(岁)
0～145.05(2.08～8.1)3.3720.0012005—201712.74(8.96～16.65)7.486<0.001
2017—2024-6.94(-12.44～-1.09)-2.5150.024
15～44-0.08(-2.33～2.21)-0.0730.9422005—20185.38(3.35～7.46)5.737<0.001
2018—2024-10.98(-16.65～-4.92)-3.7650.002
45～64-2.34(-5.96～1.41)-1.2310.2182005—20181.03(-0.39～2.47)1.5710.142
2018—2022-18.19(-28.32～-6.64)-3.3120.006
2022—202411.63(-15.93～48.23)0.8460.414
≥65-2.47(-4.8～-0.09)-2.0290.0422005—20171.34(-1.27～4.03)1.0880.294
2017—2024-8.69(-13.62～-3.47)-3.4880.003
职业
农民占比0.10（-1.19～1.40）0.1520.8802005—2018-1.56（-2.64～-0.47）-3.0520.008
2018—20243.80（-0.03～7.78）2.1150.052
牧民占比2.17（0.23～4.14）2.1990.0282005—201110.47（4.27～17.04）3.6740.002
2011—2024-1.45（-2.88～-0.01）-2.1450.049
学生占比6.52（4.11～9.00）5.400<0.0012005—20179.95（6.81～13.19）6.976<0.001
2017—20240.89（-3.64～5.64）0.4110.687
), ArticleFig(id=1324078527015945056, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078520053400372, language=EN, label=Table 3, caption=

Region-specific reported incidence and temporal trends of pulmonary tuberculosis in Qinghai Province, 2005—2024

, figureFileSmall=null, figureFileBig=null, tableContent=
市（州）报告病例总数（例）年均报告发病率（/10万）AAPC[%,（95%CI）]t值P值
西宁市25 88959.67-4.84(-6.14～-3.53)-7.596<0.001
玉树州24 087320.032.8(-1.61～7.41)1.3180.203
海东市23 53783.11-0.87(-5.35～3.81)-0.3720.710
果洛州14 872248.831.32(-6.22～9.47)0.3320.740
海南州11 274128.060.16(-2.7～3.11)0.1090.913
黄南州8 094155.693.87(1.33～6.48)3.0070.003
海北州6 46695.51-1.03(-8.79～7.38)-0.2490.803
海西州5 76562.32-5.23(-6.79～-3.64)-6.802<0.001
), ArticleFig(id=1324078527087248225, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078520053400372, language=CN, label=表3, caption=

2005—2024年青海省肺结核分地区报告发病情况及变化趋势

, figureFileSmall=null, figureFileBig=null, tableContent=
市（州）报告病例总数（例）年均报告发病率（/10万）AAPC[%,（95%CI）]t值P值
西宁市25 88959.67-4.84(-6.14～-3.53)-7.596<0.001
玉树州24 087320.032.8(-1.61～7.41)1.3180.203
海东市23 53783.11-0.87(-5.35～3.81)-0.3720.710
果洛州14 872248.831.32(-6.22～9.47)0.3320.740
海南州11 274128.060.16(-2.7～3.11)0.1090.913
黄南州8 094155.693.87(1.33～6.48)3.0070.003
海北州6 46695.51-1.03(-8.79～7.38)-0.2490.803
海西州5 76562.32-5.23(-6.79～-3.64)-6.802<0.001
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2005—2024年青海省肺结核流行特征分析
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武慧荷 1, 2 , 魏於家 3 , 王益民 1
现代预防医学 | 疾病预防控制 2026,53(1): 166-172
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现代预防医学 |疾病预防控制 2026 , 53 (1) : 166 -172
2005—2024年青海省肺结核流行特征分析
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武慧荷1, 2, 魏於家3 , 王益民1
作者信息
  • 1.兰州大学公共卫生学院，甘肃 兰州 730000
  • 2.青海省人民医院控制感染科，青海 西宁 810000
  • 3.青海省疾病预防控制中心结核病防治科，青海 西宁 810000
通讯作者:
王益民，E-mail:
魏於家，E-maii:
王益民与魏於家为共同通信作者
作者简介:

武慧荷（1993—），女，硕士在读，研究方向：传染性疾病控制

Epidemiological characteristics of pulmonary tuberculosis in Qinghai Province from 2005 to 2024
Hui-he WU1, 2, Yu-jia WEI3 , Yi-min WANG1
Affiliations
  • School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China
出版时间: 2026-01-10 doi: 10.20043/j.cnki.MPM.202508191
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摘要
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目的

分析2005—2024年青海省肺结核报告发病率，为制定适应性结核病防控策略提供科学依据。

方法

从中国疾病预防控制信息系统中传染病监测模块导出青海省分年份、性别、职业、年龄组和地区分类的肺结核病报告发病数据，采用joinpoint回归模型分析不同分类下报告发病率的时间变化趋势。

结果

2005—2024年青海省累积报告肺结核患者119 984例，年均报告约5 999例，平均报告发病率为104.12/10万。Joinpoint回归分析显示：2005—2024年青海省肺结核报告发病率无明显变化趋势，其中2005—2018年报告发病率呈缓慢上升趋势[年度变化百分比（annual percentage change,APC）=4.24%，P<0.001]；2018—2024年呈显著下降趋势（APC=-10.89%，P=0.001）。男性和女性报告发病率均在2018年出现转折点，即在2005—2018年上升（男性APC=2.91%，P=0.005；女性APC=6.17%，P<0.001），在2018—2024年大幅下降（男性APC=-11.85%，P<0.001；女性APC=-10.00%，P=0.003）。各年龄分组中，0~14岁组报告发病率呈现上升趋势[平均年度变化百分比（average annual percentage change，AAPC）=5.05%，P<0.001]，65岁以上组报告发病率呈现下降趋势（AAPC=-2.47%，P=0.042）。职业分布中农民占比最高,为42.16%，后依次是牧民的24.08%、学生的11.93%。2005—2024年牧民、学生肺结核报告发病率呈上升趋势。各市（州）中西宁市、海西州报告发病率呈下降趋势（西宁AAPC=-4.84%，P<0.001）、（海西AAPC=-5.23%，P<0.001），黄南州呈上升趋势（AAPC=3.87%，P=0.003）。

结论

2005—2024年青海省肺结核报告发病率呈现先上升后下降趋势，需持续提升病原学检测能力、加强重点地区及高危人群主动筛查，提高学生/儿童肺结核监测预警能力，以进一步降低疫情负担。

肺结核  /  流行特征  /  变化趋势  /  Joinpoint回归模型
Objective

To analyze the reported incidence of pulmonary tuberculosis (TB) in Qinghai Province from 2005 to 2024, and to provide a scientific basis for developing adaptive TB prevention and control strategies.

Methods

Data on reported TB cases in Qinghai, categorized by year, sex, occupation, age group, and region, were extracted from the infectious disease surveillance module of the China Information System for Disease Control and Prevention. The joinpoint regression model was used to analyze the temporal trends in the reported incidence under different categories.

Results

From 2005 to 2024, a total of 119 984 TB cases were reported in Qinghai Province, with an average of approximately 5 999 cases annually. The average annual reported incidence rate was 104.12 per 100 000 population. Joinpoint regression analysis indicated no significant overall trend for the entire period. However, the reported incidence showed a slow upward trend from 2005 to 2018 [Annual Percent Change (APC)=4.24%, P<0.001], followed by a significant downward trend from 2018 to 2024 (APC=-10.89%, P=0.001). A turning point occurred in 2018 for both males and females: incidence increased during 2005—2018(male: APC=2.91%, P=0.005; female: APC=6.17%, P<0.001) and decreased markedly during 2018—2024 (male: APC=-11.85%, P<0.001; female: APC=-10.00%, P=0.003). By age group, the 0-14 years group showed a significant increasing trend [Average Annual Percent Change (AAPC)=5.05%, P<0.001], while the ≥65 years group showed a significant decreasing trend (AAPC=-2.47%, P=0.042). Regarding occupational distribution, farmers constituted the highest proportion at 42.16%,followed by herdsmen (24.08%), and students (11.93%). The reported incidence among herdsmen and students showed increasing trends from 2005 to 2024. Among the prefectures, Xining City and Haixi Prefecture showed decreasing trends(Xining: AAPC=-4.84%, P<0.001; Haixi: AAPC=-5.23%, P<0.001), while Huangnan Prefecture showed an increasing trend(AAPC=3.87%, P=0.003).

Conclusion

The reported incidence of pulmonary tuberculosis in Qinghai Province showed an initial increase followed by a decrease between 2005 and 2024. Sustained efforts are needed to enhance etiological detection capacity,strengthen active screening in key regions and high-risk populations, and improve TB surveillance and early warning capabilities among students/children to further reduce the disease burden.

Pulmonary tuberculosis  /  Epidemiological characteristics  /  Chang trend  /  Joinpoint regression model
武慧荷, 魏於家, 王益民. 2005—2024年青海省肺结核流行特征分析. 现代预防医学, 2026 , 53 (1) : 166 -172 . DOI: 10.20043/j.cnki.MPM.202508191
Hui-he WU, Yu-jia WEI, Yi-min WANG. Epidemiological characteristics of pulmonary tuberculosis in Qinghai Province from 2005 to 2024[J]. Modern Preventive Medicine, 2026 , 53 (1) : 166 -172 . DOI: 10.20043/j.cnki.MPM.202508191
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结核病（tuberculosis）是由结核分枝杆菌引起的慢性传染病，其高发病率与死亡率长期威胁全球公共卫生安全。世界卫生组织数据显示，2023年全球新发结核病例约1 080万例，其中中国占6.8%，位列第三大高负担国家[1]。中国近年来通过制定和实施一系列结核病防治规划和措施，全国肺结核发病率显著降低[2]，但区域差异显著，西部地区肺结核平均报告发病率约为东部的1.6倍[3]，青藏高原地区尤为突出。根据2024年中国结核病监测报告，青海省肺结核报告发病率为79.43/10万，在全国排第三位，仅次于西藏、贵州。本研究基于2005—2024年青海省结核病监测数据，运用joinpoint回归模型对青海省肺结核病的动态趋势开展分析，识别流行趋势的转折点，为制定适应性结核病防控策略提供科学依据。
1　资料与方法
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1.1　资料来源
从中国疾病预防控制信息系统传染病监测模块导出2005—2024年青海省年份、性别、职业、年龄组和地区分类的肺结核病报告病例数。从中国疾病预防控制信息系统基本信息系统导出各年份分地区、分年龄段、分性别人口数。
1.2　方法
为研究肺结核报告发病率及病原学阳性构成比等指标随时间的变化趋势，本研究采用joinpoint回归模型进行趋势分析。该模型通过识别时间序列数据中的“转折点（Joinpoints）”，将整个研究时期划分为若干个连续的线性区间，从而能够更精确地描述趋势的动态变化特征[4]。模型的具体形式如下：
上式中，yi（i=1，2…20）为因变量，本文中为报告发病率和构成比的自然对数; xi（i=1，2…20）表示自变量，为报告发病的年份；i代表第i个观测值；β0为截距，β1为斜率；δk表示分段函数的回归系数；τk表示未知转折点，其中k为转折点个数。
转折点个数的确定采用蒙特卡洛置换检验，软件从0个转折点的模型开始，依次增加转折点数量进行拟合，并通过一系列的假设检验来确定具有统计学意义的最佳转折点个数。在模型拟合后，对每个趋势分段的斜率进行t检验，以判断该时间段内趋势的变化是否具有统计学意义。本研究对不同性别、年龄组报告发病率和病原学阳性构成比、职业构成比进行joinpoint回归分析，计算了其年度变化百分比（annual percentage change，APC）、平均年度变化百分比（average annual percentage change，AAPC）及其95%置信区间（confidence interval,CI），以揭示其复杂的时序变化特征。鉴于对不同地区进行长期趋势比较的目的，并考虑到按地区分层后统计效能的限制，对于各地区报告发病率的分析，主要计算并报告其AAPC，以提供一个概括性的、可用于跨区域直接比较的整体趋势指标。所有joinpoint回归分析均通过美国国家癌症研究所开发的Joinpoint Regression Program 5.3.0软件完成。数据整理清洗利用Excel 2021和R语言4.2.2软件完成。检验水准α=0.05。
1.3　相关定义分类
根据国家对于肺结核传染病报告分类的调整，现行分类为病原学阳性、病原学阴性、无病原学结果、利福平耐药。鉴于数据可获得性，本研究将2005—2024年报告病种再分类如下：2005—2016年的病原学阳性数为“涂阳+仅培阳”数；2017—2018年的病原学阳性数为“利福平耐药+涂阳+仅培阳”数；2019—2024年的病原学阳性数为“利福平耐药+病原学阳性”数。2004—2018年的病原学阴性数为“菌阴”数。2004—2018年的无病原学结果数为“未痰检+结核性胸膜炎”数[3,5]。
2　结果
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2.1　总体情况
2005—2024年青海省共报告肺结核病例119 984例，年均报告约5 999例，2006年报告发病数最低，为4 112例，2018年最高，为8 994例；平均报告发病率为104.12/10万，以2018年报告发病率最高，为150.31/10万，以2022年报告发病率最低，为60.39/10万。见表1。
2005—2024年青海省肺结核报告发病率无明显变化（AAPC=-0.80%，P=0.47），其中，2005—2018年呈缓慢上升趋势（APC=4.24%，P<0.001）；2018—2024年呈急速下降趋势（APC=-10.89%，P=0.001）。2005—2024年病原学阳性率变化趋势不明显（AAPC=1.66%，P=0.35），其中2011—2016年病原学阳性率呈现下降趋势（APC=-20.50%，P=0.002），2016—2024年呈现上升趋势（APC=19.73%，P<0.001）。见图1、表2。
2.2　人群分布
2.2.1　性别分布
2005—2024年青海省报告肺结核病例数中，男性67 739例，女性52 245例，性别比为1.3∶1；男女性报告发病率均无明显变化趋势（男性AAPC=-2.00%，P=0.068;女性AAPC=0.78%，P=0.504），其中男女性报告发病率均在2005—2018年上升（男性APC=2.91%，P=0.005；女性APC=6.17%，P<0.001），2018—2024年大幅下降（男性APC =-11.85%，P<0.001；女性APC=-10.00%，P=0.003）。见图1，表2。
2.2.2　年龄分布
2005—2024年报告肺结核病例数中，0～14岁共4 944例，占比4.12%，平均发病率为20.51/10万；15～44岁共61 251例，占比51.05%，平均发病率为106.97/10万；45～64岁30 540例，占比25.45%，平均发病率为119.69/10万；≥65岁23 249例，占比19.38%，平均发病率为278.35/10万。
2005—2024年0～14岁组报告发病率呈现上升趋势（AAPC=5.05%，P<0.001），其中2005—2017年明显上升（APC=12.74%，P<0.001），2017—2024年下降（APC=-6.94%，P=0.024）；≥65岁组报告发病率呈现下降趋势（AAPC=-2.47%，P=0.042），其中2017—2024年明显下降（APC=-8.69%，P=0.003）。2005—2024年15～44岁组和45～64岁组报告发病率无明显变化。见表2。
2.2.3　职业分布
2005—2024年报告肺结核病例数中农民占比最高，为42.16%（50 585/119 984），其次是牧民的24.08%（28 887/119 984）、学生的11.93%（14 311/119 984）。2005—2024年，牧民和学生占比呈上升趋势（牧民AAPC=2.17%，P=0.028;学生AAPC=6.52%，P<0.001）。见表2。
2.3　地区分布
2005—2024年青海省西宁市、海西州肺结核年平均报告发病率呈下降趋势（西宁AAPC=-4.84%，P<0.001；海西AAPC=-5.23%，P<0.001），黄南州呈上升趋势（AAPC=3.87%，P=0.003），其他地区报告发病率趋势不显著。见表3。
3　讨论
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本研究发现，2005—2024年青海省肺结核报告发病率无明显变化，2005—2018年呈现缓慢上升趋势，与西藏变化趋势相似[6]，2018—2024年报告发病率快速下降，与全国及西部地区趋势一致[3]。该变化特征一方面可能是因为《“十三五”全国结核病防治规划》的八项防治措施实施期间[7]，全省积极开展重点人群主动筛查，加大了就诊人群中患者发现力度，同时各级定点医疗机构推广使用分子生物学检测设备，检测能力迅速提高，积累的病例得以发现，后续国家制定《遏制结核病行动计划(2019—2022年)》[8]，青海省全力落实各项行动计划，肺结核疫情得到控制趋缓。另一方面可能是因为受新冠疫情影响，各地采取了不同的管制措施，对结核病人的就医、治疗随访等方面都产生了不同程度的影响[9]，肺结核报告发病数可能被低估。
病原学阳性率在2011—2016年出现下降，2016—2024年则显著上升。前期下降可能与青海省在“十二五”期间推进“三位一体”结核病防治服务模式转型有关，结核病诊疗职责逐步移交至定点医疗机构[10]，影像学等诊断手段的普及快速发现了更多临床诊断病例，但同期高质量的病原学检测能力未能同步跟进。后期病原学阳性率的上升，则主要得益于全省各级定点医疗机构病原学检测能力整体提升，发现和报告病原学阳性病例的比例相应增加。
2005—2024年报告发病率男性高于女性，与相关研究一致[11]。可能与男性社交联系较广，暴露于结核杆菌传播环境机会更多有关，同时吸烟、饮酒、矽肺病等危险因素在男性中更普遍[12]。2005—2024年0～14岁儿童组报告发病率呈上升趋势，这与全国及部分省份研究不一致[13]，且平均发病率高于四川[14]、新疆[15]等地。有研究显示，儿童结核感染是成人继发性结核的重要来源，其疫情状况对远期结核病流行具有预警意义[16]。青海省儿童肺结核报告发病率的上升可能与医疗诊断水平提升有关，也可能与近年来学生肺结核疫情上升有关[17]。提示需继续强化儿童卡介苗接种，对密切接触者要开展主动筛查，必要时进行预防性治疗降低发病风险。≥65岁人群报告发病率整体呈下降趋势，与全国趋势相近[18]，反映青海省在老年人群结核病防控方面取得了一定成效，下一步要继续结合国家基本公共卫生服务项目做好老年人体检结核病筛查工作，减轻老年人疾病负担[19]。
不同职业分布中，位居前三位的为农民、牧民、学生，这与全国占比不同[3]。2005—2024年学生人群占比呈上升趋势，提示学校结核病疫情防控形势严峻。初高中学生由于学业繁忙、免疫功能不完善、卡介苗保护效力减弱等因素，感染结核菌后易发为活动性结核病[20]。此外，青海省结核病家庭内暴露风险高，有研究显示，家庭中既往结核病暴露史可显著增加青少年学生在校发病风险[21]。加之牧区寄宿制学校普遍，一旦出现肺结核病例，很容易引发聚集性疫情。因此要严格参照《中国学校结核病防控指南（2020版）》[22]开展学校疫情处置工作，强化学生病例“早发现、早报告、早治疗”措施，加强健康教育，提高师生防病意识，严防学校结核病疫情扩大。牧民人群占比呈上升趋势，可能因其生活方式独特，长聚居于通风不良的帐篷中，有利于结核菌传播，同时他们居住分散，日常就医和随访难度大，传播链不易被及时阻断，未来需进一步强化针对牧区的、适应其生产生活方式的结核病主动发现策略和精细化健康管理服务。
2005—2024年西宁市、海西州肺结核报告发病率较低且呈下降趋势，可能与这两个地区城镇化程度高、经济相对发达、医疗资源充足有关。黄南州报告发病率高且呈现上升趋势，玉树州、果洛州年平均报告发病率远高于全国全省水平，结核病疫情严重。原因可能有以下几点：一是青海省南部果洛州、玉树州、黄南州平均海拔较高，地理环境艰苦，居民主要以放牧为生，日常营养结构单一，可能会影响人体免疫机能，增加结核菌易感性。二是青海南部地区地广人稀，居住分散，医疗水平有限且医疗可及性差，就诊延迟情况明显[23]，可能加剧结核菌传播风险。三是牧区居民结核病核心知识知晓率较低[24]，防病治病意识不足，不良行为生活习惯持续，可能造成就诊意愿的下降和治疗依从性的不足。四是可能与高原地区藏族人群特有的高表达基因有关，高原低氧诱导高表达的相关基因作用于免疫反应，抑制结核菌感染后免疫应答从而使机体易感[25]。
综上，2005—2024年青海省肺结核报告发病率变化趋势不明显，各项防控策略都得到落实且取得阶段性成效。下一步需针对青海省疫情特点，继续加强实验室建设强化病原学诊断能力，提高学生/儿童肺结核监测预警能力，加大学校聚集性疫情干预，开展重点地区及重点人群的主动筛查并做好治疗管理，持续优化“三位一体”结核病防治服务模式，进一步降低疫情负担。

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2026年第53卷第1期
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doi: 10.20043/j.cnki.MPM.202508191
  • 接收时间：2025-08-13
  • 首发时间：2026-11-02
  • 出版时间：2026-01-10
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  • 收稿日期：2025-08-13
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    1.兰州大学公共卫生学院，甘肃 兰州 730000
    2.青海省人民医院控制感染科，青海 西宁 810000
    3.青海省疾病预防控制中心结核病防治科，青海 西宁 810000

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王益民，E-mail:
魏於家，E-maii:
王益民与魏於家为共同通信作者
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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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