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臺北市登錄之結核病發生率及其共生疾病分析

Incidence and Comorbidity of Registered Cases of Tuberculosis in Taipei City, 1994-2002

摘要


目的:本研究主要目的為探討臺北市近年來結核病發生率趨勢及相關共生疾病分析。方法:蒐集1993-1996年臺北市立慢性病防治院公共衛生護士結核病個案管理卡,分析結核病患者及相關共生疾病之人數並計算發生率,另收集1994-2002年間,完成中心登記之結核病個案,以瞭解臺北市結核病發生之狀況及趨勢。結果:在結核病流行趨勢上,發現在研究期間各年齡層結核病發生率都呈現上升的趨勢,其中以大於65歲族群增加最為顯著,從1994年每10萬人口224.42人增加到2002年404.37人,增幅為80.2%,其次是25-34歲族群從33.97人增加到58.73人,增幅為72.9%;最有趣的發現是在較早期1994-1996年代,結核病發生率的雙峰現象並不太明顯,但到2000-2002年時結核病發生率的二個尖峰型態變得更加明顯,一個在25-34歲年齡層,另一在大於65歲年齡層。此外,研究發現2,624位結核病患者有11位(0.42%)併有愛滋病毒感染,2,841位結核病患者有482位(17.0%)併有糖尿病,1,630位結核病患者有9位(0.55%)併有紅斑性狼瘡,1,576位結核病患者有40位(2.54%)併有末期腎臟病,4,030位結核病患者有56位(1.39%)併有癌症,2,699位結核病患者有77位(2.85%)併有塵肺症。結論:臺北市結核病發生率已形成一個雙峰分佈,推估25-34歲年齡層的高峰可能受到愛滋病毒感染者的影響,而另一高峰大於65歲年齡層可能受到糖尿病、末期腎臟病、癌症及塵肺症患者的衝擊,更重要的是結核病在這些免疫缺乏的患者身上常出現不典型的臨床表現,因而造成診斷上的延遲,對疾病預後造成不良影響,因此臨床醫師,特別是在愛滋病中心、糖尿病中心、癌症中心、腎臟科及胸腔科醫師在臨床上對於這些免疫缺乏病患是否同時感染結核菌要保持高度的警覺性。另外要儘速更新臺北市結核病監測系統,適時加入HIV檢驗結果及特定危險因子等項目,以提供未來一個較佳的發生率估計資料庫並指引未來防治新方向。

關鍵字

共生疾病 發生率 結核病 臺北市

並列摘要


Background and Purpose: This retrospective study evaluated tuberculosis (TB) trends and related comorbidities in Taipei. Methods: Data from the Tuberculosis Registry Center on all recorded TB cases from 1994 through 2002 was used to analyze incidence trends in Taipei. The management cards for all TB patients from 1993 to 1996 obtained from Taipei Municipal Chronic Disease Hospital were also reviewed to calculate the number of patients who had comorbidities. Results: The results show an increasing trend with a clear predominance of cases occurring in patients aged 25 to 34 years and those 65 and over. This bimodal pattern became more apparent in 2000 to 2002. In regard to persons who have comorbidities, HIV+ accounted for 11 out of 2,624 TB patients (0.42%), diabetes mellitus (DM) was present in 482 out of 2,841 (16.97%), systemic lupus erythematosus (SLE) was present in nine out of 1,630 (0.55%), end-stage renal disease was present in 40 out of 1,576 (2.54%), cancer was present in 56 out of 4,030 (1.39%), and silicosis was present in 77 out of 2,699 (2.85%). Conclusions: The study clearly shows that immunocompromised patients had a strong influence on TB trends. However, the manifestations of TB in these patients were highly variable. The clinician must always be vigilant about the possibility of TB infection, especially in Taipei where TB is endemic. Additionally, we also suggest updating the Taipei TB surveillance system to collect data on HIV status and specific risk factors, which will enable TB control programs to become more effective.

並列關鍵字

comorbidities incidence prevalence tuberculosis Taipei City

被引用紀錄


王碩薇(2012)。東台灣某地區醫院之密切接觸者潛隱性結核感染之研究探討〔碩士論文,長榮大學〕。華藝線上圖書館。https://doi.org/10.6833%2fCJCU.2012.00043
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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