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结核与肺部疾病杂志 ›› 2025, Vol. 6 ›› Issue (5): 579-586.doi: 10.19983/j.issn.2096-8493.20250093

• 论著 • 上一篇    下一篇

2022—2024年北京市大兴区肺结核合并糖尿病及高血压患者的流行特征及治疗转归情况

侯文俊1, 田飞飞1,2, 张时雨1, 张耀文1, 豆亚美1, 薛涵1, 崔虹艳1()   

  1. 1北京市大兴区疾病预防控制中心结核病防制科, 北京 102600
    2中国疾病预防控制中心中国现场流行病学培训项目, 北京 100050
  • 收稿日期:2025-06-25 出版日期:2025-10-20 发布日期:2025-10-15
  • 通信作者: 崔虹艳 E-mail:cui.871120@163.com
  • 基金资助:
    北京市大兴区预防医学会科研项目(XHKY202409)

Epidemiological characteristics and treatment outcomes of pulmonary tuberculosis patients with diabetes and hypertension in Daxing District, Beijing from 2022 to 2024

Hou Wenjun1, Tian Feifei1,2, Zhang Shiyu1, Zhang Yaowen1, Dou Yamei1, Xue Han1, Cui Hongyan1()   

  1. 1Tuberculosis Prevention and Control Division, Daxing Center for Disease Control and Prevention, Beijing 102600, China
    2Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
  • Received:2025-06-25 Online:2025-10-20 Published:2025-10-15
  • Contact: Cui Hongyan E-mail:cui.871120@163.com
  • Supported by:
    Research Project of Beijing Daxing District Preventive Medicine Association(XHKY202409)

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摘要：

目的: 描述大兴区2022—2024年登记肺结核患者合并糖尿病及高血压的流行病学特征,分析治疗转归的影响因素,为肺结核与慢性病共病防治提供依据。方法: 通过“中国疾病预防控制信息系统”子系统“结核病管理信息系统”收集大兴区2022—2024年登记的肺结核患者信息,结合基本公共卫生服务信息系统、医院信息系统、居民电子健康档案、问卷,调查合并糖尿病及高血压情况,对其流行特征与治疗转归情况进行分析。结果: 共992例肺结核患者纳入分析,12.10%(120/992)合并糖尿病,17.14%(170/992)合并高血压,16.73%(166/992)合并糖尿病和高血压。男性[14.63%(90/615)、19.03%(117/615)、18.37%(113/615)]、农民[15.26%(18/118)、32.20%(38/118)、25.42%(30/118)]、本地[12.36%(91/736)、20.25%(149/736)、19.97%(147/736)]、病原学阳性[14.87%(88/592)、18.24%(108/592)、20.27%(120/592)]的肺结核患者合并糖尿病、高血压、糖尿病和高血压比例均较高,45~64岁年龄组肺结核合并糖尿病[15.50%(42/271)],≥65岁年龄组肺结核合并高血压[36.30%(102/281)]、合并糖尿病和高血压[30.25%(85/281)]比例较高。复治患者合并糖尿病[27.59%(16/58)],初治患者合并高血压[17.67%(165/934)]、合并糖尿病和高血压[17.24%(161/934)]比例较高。肺结核合并糖尿病患者治疗疗程最长[371.00(274.25,398.00)d],肺结核合并高血压患者治疗疗程最短[234.00(192.00,321.75)d](Z=48.189,P<0.001)。多因素logistic回归分析结果显示,≥65岁年龄组(OR=3.105,95%CI:1.378~7.113)、复治(OR=6.372,95%CI:2.074~19.663)、合并糖尿病(OR=4.717,95%CI:1.529~14.078)的患者发生不良结局的风险较高,疗程长(OR=0.980,95%CI:0.976~0.984)发生不良结局的风险较低。结论: 大兴区合并糖尿病和高血压的肺结核患者集中在男性、年龄较大、农民、本地、病原学阳性,合并糖尿病患者有复治、治疗疗程长的特点,肺结核合并高血压患者有初治、治疗疗程短的特点。年龄大、复治、合并糖尿病、治疗疗程短的肺结核患者发生不良结局的风险较高。

关键词: 结核, 肺, 糖尿病, 高血压, 共病现象, 治疗结果

Abstract:

Objective: To describe the epidemiological characteristics of pulmonary tuberculosis patients comorbid with diabetes mellitus and hypertension in Daxing from 2022 to 2024, and analyze the influencing factors of treatment outcomes, and provide a basis for the prevention and treatment of PTB and chronic disease comorbidity. Methods: Information on PTB patients notified in Daxing from 2022 to 2024 was extracted from the National Tuberculosis Management Information System. The data on diabetes mellitus and hypertension were investigated through the basic public health service information system, Hospital Information System, residents’ electronic health records, and questionnaires. Results: A total of 992 pulmonary tuberculosis patients were included in the analysis. Among them, 12.10% (120/992) had comorbid diabetes, 17.14% (170/992) had comorbid with hypertension, 16.73% (166/992) had both diabetes and hypertension. Higher proportions of comorbid with diabetes, hypertension, and both diabetes mellitus and hypertension were observed among males (14.63% (90/615), 19.03% (117/615), 18.37% (113/615)), farmers (15.26% (18/118), 32.20% (38/118), 25.42% (30/118)), local residents (12.36% (91/736), 20.25% (149/736), 19.97% (147/736)), and pathogen-positive (14.87% (88/592), 18.24% (108/592), 20.27% (120/592)) patients. The proportion of PTB patients with diabetes (15.50% (42/271)) was higher in the group aged 45-64, while the proportions of PTB patients with comorbid hypertension (36.30% (102/281)) and with diabetes mellitus and hypertension (30.25% (85/281)) were higher in the group aged ≥65. The re-treated patients had a higher proportion of comorbid diabetes (27.59% (16/58)), while new patients had higher proportions of hypertension (17.67% (165/934)), and with both diabetes mellitus and hypertension (17.24% (161/934)). The treatment course was the longest for patients combined diabetes (371.00 (274.25, 398.00) days), and shortest for those comorbid with hypertension (234.00 (192.00, 321.75) days)(Z=48.189, P<0.001). Multivariate logistic regression analysis showed that patients in the ≥65-years group (OR=3.105, 95%CI: 1.378-7.113), retreated patients (OR=6.372, 95%CI: 2.074-19.663), and those with comorbid diabetes (OR=4.717, 95%CI: 1.529-14.078) had a higher risk of adverse outcomes, while a longer treatment course (OR=0.980, 95%CI: 0.976-0.984) was associated with a lower risk of adverse outcomes. Conclusion: Pulmonary tuberculosis patients with diabetes and hypertension in Daxing District are predominantly male, older, farmer, local residents, and pathogen-positive. Patients with diabetes are more likely to be retreated and have longer treatment course, while patients with hypertension are more likely to be new treated and have shorter treatment course. Elder, retreatment, combined diabetes, and short treatment course are associated with higher risk of adverse outcomes.

Key words: Tuberculosis, pulmonary, Diabetes, Hypertension, Comorbidity, Treatment outcome

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