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臺北市肺外結核之趨勢:1998至2002

Trends in Extrapulmonary Tuberculosis in Taipei: 1998 to 2002

摘要


目的:臺北市肺外結核病例數已逐年增加,從1998年307例增加到2002年389例,為了評估肺外結核發生的特徵及描述肺外結核涉及的器官情況。方法:本研究以1998~2002年行政院衛生署全國結核病登錄資料庫中取得臺北市1,854位肺外結核個案資料,內容包括人口學變項(年齡、診斷、性別及居住地等)、臨床及檢驗等變項,肺外結核發生率計算是以臺北市各醫療院所通報之肺外結核確診新案數除以臺北市各年齡層人口數計算出肺外結核發生率,並以Poisson迴歸分析評估1998-2002年發生率的時間趨勢。結果:研究期間共有9566位結核病個案,其中1854位(19.38%)有肺外結核,包含男性1,066位,女性788位。肺外結核佔全部結核個案比例最高的族群在0-14歲為31.13% (33/106),其次65+歲21.11% (878/4160)及35-44歲21.08% (238/1129),形成一個有趣的三峰分佈。在時間趨勢方面,肺外結核發生率呈現逐年上升,從1998年的每10萬人口11.72人上升到2002年14.75人,相反地,不同部位肺外結核發生率卻沒有一定的明顯時問趨勢。在年齡趨勢方面,肺外結核發生率隨年齡增加而上升,但不同部位的年齡別發生率有顯著差異,像淋巴結核和腦膜結核發生率均呈現一個雙峰分佈;一個高峰在25-34歲,另一個在65+歲。而助膜、骨頭和關節及生殖泌尿結核發生率隨年齡增加而上升。最常見的肺外結核部位是肋膜結核1103位(59.49%),其次是淋巴結核219位(11.81%);最有趣的發現是淋巴結核較常發生在女性,而肋膜結核較常發生在男性。結論:臺北市肺外結核並非是少見之疾病,佔全部結核病患者的19.38%,而且比例逐年上升,推測可能與臺北市人口老化及結核病患者人口學組成變遷有關;另外,對於不同部位肺外結核的感受性在性別和年齡上有顯著差異。這些研究發現擴大了全球肺外結核流行病學的基礎知識,並加強我們對臺北市肺外結核特徵的瞭解,有助於臨床上早期診斷及適當治療。

並列摘要


Background and Purpose: The number of cases of extrapulmonary tuberculosis in Taipei has increased from 307 in 1998 to 389 in 2002. To evaluate the characteristics and organ involvement of patients with extrapulmonary tuberculosis, a retrospective cross-sectional study was conducted. Methods: Data from all recorded 1,854 extrapulmonary cases from 1998 through 2002 were obtained from the National Tuberculosis Registry Center. Detailed demographic data (including age at diagnosis, sex and residence) and medical records were also collected for each case. Incidence of extrapulmonary tuberculosis was calculated by the number of confirmed new cases at all hospitals in Taipei. Trend lines for extrapulmonary tuberculosis case rates from 1998 to 2002 were fit using Poisson regression with time in years. Results: Of the 9,566 tuberculosis patients, 1,854 (19.38%) had extrapulmonary disease. Incidence of extrapulmonary cases had increased from 11.72 per 100,000 in 1998 to 14.75 per 100,000 in 2002. However, there was no clear trend in the incidence of extrapulmonary disease at any particular anatomical site. Additionally, extrapulmonary case rates increased with age, although there were marked differences in age-specific rates among the various sites. The most common site of extrapulmonary involvement was the pleura (59.49%), followed by the lymph nodes (11.81%). The most interesting study finding was that lymph node involvement was significantly higher in women, while pleural disease was significantly higher in man. Conclusion: In Taipei, extrapulmonary tuberculosis is common, affecting 19.38% of all tuberculosis patients, and the proportion has increased with time. The most probable explanation for this phenomenon is rapid increases in HIV infection rates, the aging of the population and changes in the demographic characteristics of tuberculosis patients. Moreover, there are sex and age differences in the organs most commonly affected. These study findings expand the knowledge base regarding the global epidemiology of extrapulmonary tuberculosis.

被引用紀錄


鄭清方(2012)。糖尿病病患罹患結核病之相對危險性及其相關因素〔碩士論文,亞洲大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0118-1511201215455838
盧中蘭(2017)。南市某醫學中心結核病之趨勢研究:2015-2016〔碩士論文,長榮大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0015-2308201709253500

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