Petitjean R, Lert F, Lotte A, Burghard G
Rev Mal Respir. 1984;1(2):93-7.
The authors report an "analytic epidemiological" study, showing the risk of relapse in tuberculous patients in the Bas-Rhin in 1967 to 1977. This was possible thanks to statutory notification of tuberculous cases, with an index updated by annual returns. The study relates to French subjects notified as new cases of all forms of active tuberculosis between 1967 to 1975, going out the active file on or before 31.12.1976, and followed until 31.12.1977 after the cessation of chemotherapy. Amongst those gone out the active list, 5% were lost to follow up, 15% died, and 80% were alive (and bacteriologically inactive) at the end of treatment. In this latter group cases of relapse were observed between 1969 and 1977. Thus, 3,327 patients were at risk a relapse during the first year, and when the study was completed after 8 years, 76 relapses were observed. Two methods were used to calculate the risk of relapse. The first reported the number of relapses (76) to the number of people-years (14,500 for the 3,327 patients). The mean annual risk was 5,24%. The role of certain risk factors for a relapse could be identified more precisely: Sex, 5,43% in men and 3,19% in women, Age, 4,76% before 55, 8.36% after, Initial bacteriology 5,9% for positive cases and 3,27% for negative cases. Use of Rifampicin, 3,9% for users, 5,8% for non-users. The second calculation was based on actuarial method, giving the annual and cumulative risk as a function of the exposed population each year, for the period of the study.(ABSTRACT TRUNCATED AT 250 WORDS)
作者报告了一项“分析性流行病学”研究,展示了1967年至1977年下莱茵省结核病患者的复发风险。这之所以成为可能,得益于结核病病例的法定通报,以及通过年度报告更新的索引。该研究涉及1967年至1975年间被通报为各种形式活动性结核病新病例的法国受试者,这些病例在1976年12月31日或之前从活动性档案中剔除,并在化疗停止后一直随访至1977年12月31日。在那些从活动性名单中剔除的患者中,5%失访,15%死亡,80%在治疗结束时存活(且细菌学检查无活动迹象)。在后一组中,1969年至1977年间观察到复发病例。因此,第一年有3327名患者有复发风险,8年后研究结束时,观察到76例复发。使用了两种方法计算复发风险。第一种方法是将复发数(76例)与总人年数(3327名患者为14500人年)进行对比。年平均风险为5.24%。某些复发风险因素的作用能更精确地确定:性别,男性为5.43%,女性为3.19%;年龄,55岁之前为4.76%,之后为8.36%;初始细菌学检查,阳性病例为5.9%,阴性病例为3.27%;使用利福平,使用者为3.9%,未使用者为5.8%。第二种计算基于精算方法,给出了研究期间每年暴露人群的年度和累积风险。(摘要截断于250字)