某三级综合医院住院患者结核潜伏感染共病分布现状

Current status of distribution of hospitalized patients with latent tuberculosis infection and comorbidities in a tertiary general hospital

  • 摘要:
    目的 分析某三甲综合医院住院患者结核潜伏感染(LTBI)诊断与相关共病分布现状。
    方法 收集中日友好医院2022年1月1日-2023年12月31日14 448例检测结核菌素皮肤试验(TST)或γ-干扰素释放试验(IGRA)的住院患者临床资料并进行评估分析。
    结果 接受检测的住院患者LTBI检出率为23.62%(3413/14448), 其中明确诊断率仅为4.22%(144/3413);88.40%(3017/3413)的LTBI住院患者患有至少一种共病, 排名前5位依次为高血压、高脂血症、糖尿病、恶性肿瘤和风湿免疫性疾病;且随着年龄增长共病数量增加(χ2=291.199, P<0.001);明确诊断LTBI住院患者中最常见的共病类型是风湿免疫性疾病(73/144, 50.69%), 收治在风湿免疫科的患者不足一半(66/144, 45.83%)。
    结论 重视LTBI与共病的双向筛查是规范化管理LTBI的核心前提。

     

    Abstract:
    OBJECTIVE To analyze the diagnosis of latent tuberculosis infection (LTBI) in hospitalized patients of a tertiary general hospital and investigate the current status of related comorbidities.
    METHODS The clinical data were collected from the 14 448 hospitalized patients who received tuberculin skin test (TST) or interferon-gamma release assay (IGRA) in China-Japan Friendship Hospital from Jan. 1, 2022 to Dec. 31, 2023, and the results were assessed.
    RESULTS The detection rate of LTBI was 23.62%(3413/14448) among the hospitalized patients who received the tests, and the rate of definite diagnosis was only 4.22%(144/3413). 88.40%(3017/3413) of the hospitalized patients with LTBI had at least one type of comorbidity, and the top 5 comorbidities were in turn as follows: high blood pressure, hyperlipidemia, diabetes mellitus, malignant tumors and rheumatic immune diseases; the number of comorbidities was increased with the age(χ2=291.199, P<0.001). The rheumatic immune disease (73/144, 50.69%) was the most common type of comorbidity among the hospitalized patients with definite diagnosis of LTBI, and less than half of the patients (66/144, 45.83%) were treated in rheumatology and immunology department.
    CONCLUSION The two-way screening of LTBI and comorbidities is the core premise for the standardized management of LTBI.

     

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