Please wait a minute...
文章检索
预防医学  2026, Vol. 38 Issue (4): 343-347    DOI: 10.19485/j.cnki.issn2096-5087.2026.04.005
  结核病主动发现与预防性干预专题 本期目录 | 过刊浏览 | 高级检索 |
2014—2023年嘉善县老年肺结核患者就诊延迟和确诊延迟分析
朱颖, 凌羽晓, 祝惠红
嘉善县疾病预防控制中心(嘉善县卫生监督所),浙江 嘉善 314100
Delay in healthcare-seeking and definitive diagnosis among elderly patients with pulmonary tuberculosis in Jiashan County from 2014 to 2023
ZHU Ying, LING Yuxiao, ZHU Huihong
Jiashan County Center for Disease Control and Prevention (Jiashan County Institute of Public Health Supervision), Jiashan, Zhejiang 314100, China
全文: PDF(791 KB)  
输出: BibTeX | EndNote (RIS)      
摘要 目的 分析2014—2023年浙江省嘉善县老年肺结核患者就诊延迟、确诊延迟现状及影响因素,为完善肺结核防控策略提供依据。方法 通过中国疾病预防控制信息系统结核病管理信息系统收集2014—2023年嘉善县登记的≥60岁肺结核患者资料,包括年龄、现住址等人口学信息和首诊单位、病原学结果等诊疗信息,分析就诊延迟率、确诊延迟率;采用多因素logistic回归模型分析老年肺结核患者就诊延迟、确诊延迟的影响因素。结果 纳入2014—2023年嘉善县登记老年肺结核患者508例,年龄MQR)为71.00(12.00)岁。男性403例,占79.33%;女性105例,占20.67%。就诊延迟273例,就诊延迟率为53.74%,2014—2023年呈上升趋势(P<0.05);确诊延迟73例,确诊延迟率为14.37%,2014—2023年趋势无统计学意义(P>0.05)。多因素logistic回归分析结果显示,首诊单位地址在嘉善县(OR=4.453, 95%CI:3.007~6.593)和病原学阴性(OR=1.738, 95%CI: 1.112~2.717)的老年肺结核患者就诊延迟风险高;首诊单位地址在嘉善县(OR=7.728, 95%CI: 3.550~16.820)和现住址为姚庄镇(OR=5.318, 95%CI: 2.012~14.056)、陶庄镇(OR=3.848, 95%CI: 1.299~11.404)的老年肺结核患者确诊延迟风险高。结论 2014—2023年嘉善县老年肺结核就诊延迟率较高且呈上升趋势,确诊延迟率较低;首诊单位地址、病原学结果和现住址是其主要影响因素。
服务
把本文推荐给朋友
加入引用管理器
E-mail Alert
RSS
作者相关文章
朱颖
凌羽晓
祝惠红
关键词 肺结核老年人就诊延迟确诊延迟影响因素    
AbstractObjective To analyze the status and influencing factors of healthcare-seeking delay and definitive diagnosis delay among elderly patients with pulmonary tuberculosis in Jiashan County, Zhejiang Province from 2014 to 2023, so as to provide evidence for improving tuberculosis prevention and control strategies. Methods Data on pulmonary tuberculosis patients aged ≥60 years registered in Jiashan County from 2014 to 2023 were collected through the Tuberculosis Information Management System of the Chinese Disease Prevention and Control Information System. The data included demographic information such as age and current address, as well as diagnostic and treatment information, including first-diagnosed hospital and etiological results. The rates of healthcare-seeking delay and definitive diagnosis delay were analyzed. Factors affecting delay in healthcare-seeking and definitive diagnosis among elderly patients with pulmonary tuberculosis were analyzed using a multivariable logistic regression model. Results A total of 508 elderly patients with pulmonary tuberculosis registered in Jiashan County from 2014 to 2023 were included. The median age was 71.00 (interquartile range, 12.00) years. There were 403 males (79.33%) and 105 females (20.67%). There were 273 patients with healthcare-seeking delay, with a healthcare-seeking delay rate of 53.74%, showing an increasing trend from 2014 to 2023 (P<0.05). There were 73 patients with definitive diagnosis delay, with a definitive diagnosis delay rate of 14.37%, and no statistically significant trend was observed during the same period (P>0.05). Multivariable logistic regression analysis showed that elderly patients with pulmonary tuberculosis whose first-visit institution was located in Jiashan County (OR=4.453, 95%CI: 3.007-6.593) and those with negative etiological results (OR=1.738, 95%CI: 1.112-2.717) had a higher risk of healthcare-seeking delay. Patients with first-diagnosed hospital located in Jiashan County (OR=7.728, 95%CI: 3.550-16.820) and those with current address in Yaozhuang Town (OR=5.318, 95%CI: 2.012-14.056) or Taozhuang Town (OR=3.848, 95%CI: 1.299-11.404) had a higher risk of definitive diagnosis delay. Conclusions From 2014 to 2023, the healthcare-seeking delay rate among elderly patients with pulmonary tuberculosis in Jiashan County was relatively high and showed an increasing trend, while the definitive diagnosis delay rate was relatively low. First-diagnosed hospital location, etiological results, and current address were the main influencing factors.
Key wordspulmonary tuberculosis    the elderly    healthcare-seeking delay    definitive diagnosis delay    influencing factor
收稿日期: 2026-01-09      修回日期: 2026-03-13      出版日期: 2026-04-10
中图分类号:  R521  
作者简介: 朱颖,本科,主管医师,主要从事传染病防制工作
通信作者: 凌羽晓,E-mail:lyx215023@163.com   
引用本文:   
朱颖, 凌羽晓, 祝惠红. 2014—2023年嘉善县老年肺结核患者就诊延迟和确诊延迟分析[J]. 预防医学, 2026, 38(4): 343-347.
ZHU Ying, LING Yuxiao, ZHU Huihong. Delay in healthcare-seeking and definitive diagnosis among elderly patients with pulmonary tuberculosis in Jiashan County from 2014 to 2023. Preventive Medicine, 2026, 38(4): 343-347.
链接本文:  
https://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2026.04.005      或      https://www.zjyfyxzz.com/CN/Y2026/V38/I4/343
[1] World Health Organization.Global tuberculosis report 2025[R].Geneva:WHO,2025
[2] 滕人聪,李涛,李玉红,等.2015—2021年全国65岁及以上老年肺结核患者登记情况分析[J].中国防痨杂志,2023,45(4):367-371.
[3] WANG L X,ZHANG H,RUAN Y Z,et al.Tuberculosis prevalence in China,1990-2010;a longitudinal analysis of national survey data[J].Lancet,2014,383(9934):2057-2064.
[4] SCHILDKNECHT K R,PRATT R H,FENG P I,et al.Tuberculosis:United States,2022[J].MMWR Morb Mortal Wkly Rep,2023,72(12):297-303.
[5] LING Y X,WANG W,CHEN S H,et al.Effect of population aging on pulmonary tuberculosis burden in Zhejiang Province,China:a population-based study[J/OL].Front Public Health,2025,13[2026-03-13].https://doi.org/10.3389/fpubh.2025.1647139.
[6] CARAUX-PAZ P,DIAMANTIS S,DE WAZIERES B,et al.Tuberculosis in the elderly[J/OL].J Clin Med,2021,10(24)[2026-03-13].https://doi.org/10.3390/jcm10245888.
[7] LEE C H,WANG J Y,LIN H C,et al.Treatment delay and fatal outcomes of pulmonary tuberculosis in advanced age:a retrospective nationwide cohort study[J/OL].BMC Infect Dis,2017,17(1)[2026-03-13].https://doi.org/10.1186/s12879-017-2554-y.
[8] 李欣霖,万彬,赵霞,等.中国肺结核患者就诊延迟情况的Meta分析[J].中国防痨杂志,2025,47(11):1442-1453.
[9] 马琼锦,严慧琴,吴蕴华,等.闵行区肺结核就诊延误、诊断延误和发现延误的影响因素分析[J].预防医学,2025,37(1):59-64.
[10] LI T,DU X,KANG J J,et al.Patient,diagnosis,and treatment delays among tuberculosis patients before and during COVID-19 epidemic-China,2018-2022[J].China CDC Weekly,2023,5(12):259-265.
[11] GE R,ZHU G Y,TIAN M,et al.Analysis on time delay of tuberculosis among adolescents and young adults in Eastern China[J/OL].Front Public Health,2024,12[2026-03-13].https://doi.org/10.3389/fpubh.2024.1376404.
[12] ZHANG G Q,YU Y M,ZHANG W Q,et al.Influence of COVID-19 for delaying the diagnosis and treatment of pulmonary tuberculosis-Tianjin,China[J/OL].Front Public Health,2022,10[2026-03-13].https://doi.org/10.3389/fpubh.2022.937844.
[13] 陈晓蕾,陶桃,凡鹏飞,等.2019—2023年丽水市老年肺结核患者就诊延迟情况及影响因素分析[J].中国防痨杂志,2024,46(11):1380-1387.
[14] 马丽,梁智超,陈阳贵,等.2010—2019年乌鲁木齐市学生结核病病例发现延迟、就诊延迟、确诊延迟分析[J].预防医学,2023,35(1):53-56,60.
[15] ZHANG L,WENG T P,WANG H Y,et al.Patient pathway analysis of tuberculosis diagnostic delay:a multicentre retrospective cohort study in China[J].Clin Microbiol Infect,2021,27(7):1000-1006.
[16] LUO D,CHEN X Y,WANG M,et al.Analyzing spatial delays of tuberculosis from surveillance and awareness surveys in Eastern China[J/OL].Sci Rep,2024,14(1)[2026-03-13].https://doi.org/10.1038/s41598-024-70283-z.
[17] 潘艳,赵庆龙,白云龙,等.2015—2024年吉林省学生肺结核患者就诊延迟情况及影响因素[J].中国卫生工程学,2025,24(5):617-620,623.
[1] 游继存, 田磊, 王鑫佳, 张喜琴. 2015—2024年安吉县病原学阳性肺结核患者治疗转归的影响因素分析[J]. 预防医学, 2026, 38(4): 329-333.
[2] 曾真, 赵丽娜, 单志力, 毛景, 林韩特, 毛玲琼, 李君. 温州市企业职工结核分枝杆菌潜伏感染调查[J]. 预防医学, 2026, 38(4): 334-337.
[3] 张文, 吴成果, 郑登虎, 罗建奎, 罗杰, 孙建, 张理翌, 雷蓉蓉, 廖文平. 南川区老年人群结核分枝杆菌潜伏感染调查[J]. 预防医学, 2026, 38(4): 338-342.
[4] 张曦小雪, 王雪纯, 刘良楹, 武文君, 马玉, 何耀, 刘淼. 老年人认知功能变化轨迹的影响因素分析[J]. 预防医学, 2026, 38(4): 352-356.
[5] 史耀熊, 徐洁, 王筱颖, 胡涛, 方珍. 老年糖尿病患者综合护理联合康复干预效果评价[J]. 预防医学, 2026, 38(4): 410-414.
[6] 吴静, 万金豹, 吴萃, 刘方华, 陈秋艳, 丁承辉, 吴函. 宝山区慢性阻塞性肺疾病高危人群肺通气功能研究[J]. 预防医学, 2026, 38(4): 388-393.
[7] 杨小婷, 索朗央吉, 贡桑扎堆, 王英, 索朗多布杰, 巴桑卓玛. 林芝市35~75岁居民心血管病高危风险筛查结果分析[J]. 预防医学, 2026, 38(4): 394-397.
[8] 赵锦航, 李殿江, 陈伟, 王志勇, 潘志, 刘思浚. 老年2型糖尿病患者自我效能在社会支持与抑郁症状间的中介效应分析[J]. 预防医学, 2026, 38(4): 357-361.
[9] 黄文, 许璐璐, 黄敏钢, 王柯颖, 陈康康, 陈奇峰. 老年人肌少症的影响因素研究[J]. 预防医学, 2026, 38(4): 362-366.
[10] 蒋扬莹, 楼赟, 王方鲁, 陈松华. 2014—2024年诸暨市老年人群肺结核流行特征和时空聚集性分析[J]. 预防医学, 2026, 38(3): 222-225,230.
[11] 杨介者, 周欣, 蒋均, 徐云, 柴程良, 陈琳, 程伟. 浙江省丙型病毒性肝炎病例直接抗病毒药物治疗的影响因素研究[J]. 预防医学, 2026, 38(3): 246-250.
[12] 刘扬, 陈莉莉, 辛辛, 肖绍坦, 李世宏. 浦东新区高校肺结核密切接触学生结核分枝杆菌潜伏感染的影响因素研究[J]. 预防医学, 2026, 38(3): 226-230.
[13] 蔡蓉蓉, 钟浩云, 张秋格, 杨媛媛, 高湘绮, 程庆学. 2007—2024年榆林市肺结核流行特征和时空聚集性分析[J]. 预防医学, 2026, 38(3): 231-236.
[14] 朱凯强, 唐慧玲, 陈依娜, 李卫丹, 张子根. 2015—2024年金华市肺结核流行特征分析[J]. 预防医学, 2026, 38(3): 237-241.
[15] 刘世刚, 樊海霞, 周莹荃. 2014—2023年民勤县肺结核流行特征和时空聚集性分析[J]. 预防医学, 2026, 38(3): 242-245,250.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed