热带病与寄生虫学

热带病与寄生虫学 ›› 2025, Vol. 23 ›› Issue (6): 324-329.

• 结核病防控专题 • 上一篇    下一篇

2021—2024年我国结核病预防性治疗现状及完成情况影响因素分析

李锦浩1，文雅欣1，葛芳君1，胡冬梅1，徐彩红1, 2   

  1. 1. 中国疾病预防控制中心（中国预防医学科学院）结核病预防控制中心，北京102206；
    2. 传染病溯源预警与智能决策全国重点实验室

  • 收稿日期:2025-10-28 出版日期:2025-12-20 发布日期:2026-01-22
  • 通信作者: 徐彩红，E-mail: xuch@chinacdc.cn
  • 作者简介:李锦浩，男，硕士在读，主要研究方向：结核病防控。E-mail: z714829125@163.com
  • 基金资助:
    国家重点研发计划项目（2024YFC2311204、2024YFC2310905）

Current status of preventive treatment for tuberculosis and factors affecting its completion rate in China, 2021-2024

LI Jinhao1, WEN Yaxin1, GE Fangjun1, HU Dongmei1, XU Caihong1, 2    

  1. 1. National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention (Chinese Academy of Preventive Medicine), Beijing 102206, China; 2. National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases
  • Received:2025-10-28 Online:2025-12-20 Published:2026-01-22

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摘要： 目的 了解当前我国结核病预防性治疗（tuberculosis preventive treatment, TPT）的现状与趋势，为优化TPT策略提供参考。方法 从中国结核病监测报告中获取2021—2024年全国31个省份和新疆生产建设兵团的TPT相关资料，对TPT的接受人数、治疗方案、治疗完成情况等进行分析。采用方便抽样法选取河南、江苏和新疆作为调查省份，匿名收集三省2023—2024年接受TPT的结核分枝杆菌潜伏感染（简称结核潜伏感染）者相关资料，使用Firth惩罚最大似然估计对TPT完成情况的影响因素进行分析。结果 2021—2024年，全国共有214 803人接受TPT，各年分别为37 419、37 514、52 836、87 034人；2022—2024年，全国共有137 891人使用TPT短程方案，各年分别为29 723、41 623、66 545人；2021—2023年，全国共有88 670人完成TPT疗程，完成率为69.40%，各年完成率分别为60.86%、65.71%、78.06%。2022—2024年，学生密接者在接受TPT人群中占比最高（42.06%，74 605/177 384）；羁押场所新近感染者的TPT短程方案使用率最高（93.14%，2 824/3 032）。2021—2024年，接受TPT人数前3位的省份是四川（20 265人，占9.43%）、贵州（18 631人，占8.67%）和江苏（17 839人，占8.30%）；2022—2024年，共有19个省份TPT短程方案使用率超80.00%，其中海南最高（99.57%，689/692）。在TPT完成情况的影响因素调查方面，共获取853例接受TPT的结核潜伏感染者相关资料，其中792例完成了疗程，完成率为92.85%。多因素分析显示，在基层医疗卫生机构接受TPT的疗程完成率高于疾病预防控制中心（OR=4.90，95%CI：1.32～18.05），以Vaccae作为TPT方案的疗程完成率高于3H2P2（OR=4.86，95%CI：1.03～27.14）。结论 近年来我国TPT规模和TPT短程方案使用人数均快速提升，但不同人群和不同省份间仍存在较大差距。未来应进一步扩大TPT覆盖范围，优化TPT短程方案推广机制，全面提升TPT的可及性、规范性和依从性。

关键词: 结核病, 结核潜伏感染, 预防性治疗, 影响因素

Abstract: Objective To understand the current status and trends of tuberculosis preventive treatment (TPT) in China from 2021 to 2024, so as to provide a reference for optimizing TPT strategies. Methods Relevant data on TPT from 2021 to 2024 were extracted from the National Tuberculosis Surveillance Report for 31 provinces and the Xinjiang Production and Construction Corps across China. The analysis covered the number of people who undergone TPT, treatment regimens, and completion rates. Henan, Jiangsu, and Xinjiang were selected as the survey provinces using convenience sampling method. Relevant anonymous data on latent tuberculosis infection (LTBI) patients who received TPT from 2023 to 2024 were collected across the three provinces. A Firth's penalized maximum likelihood estimation approach was used to identify the influencing factors associated with TPT completion. Results From 2021 to 2024, a total of 214 803 individuals received TPT, with annual numbers of 37 419, 37 514, 52 836, and 87 034, respectively. Between 2022 and 2024, a total of 137 891 individuals received short-course regimens, corresponding to 29 723, 41 623, and 66 545 individuals per year. From 2021 to 2023, a total of 88 670 individuals completed the TPT, with completion rates of 60.86%, 65.71%, and 78.06%, respectively. Among those who received TPT between 2022 and 2024, the highest proportion were students with close contact (42.06%, 74 605/177 384), and the highest utilization rate of the short-course regimen was among newly infected individuals in detention facilities (93.14%, 2 824/3 032). The top three provinces for TPT uptake from 2021 to 2024 were Sichuan (n=20 265; 9.43%), Guizhou (n=18 631; 8.67%), and Jiangsu (n=17 839; 8.30%). From 2022 to 2024, 19 provinces achieved a short-course utilization rate above 80.00%, with the highest in Hainan (99.57%, 689/692). In terms of the survey on influencing factors of TPT completion status, relevant data were collected from 853 cases of LTBI patients who received TPT, among whom 792 cases completed the full course, resulting in an overall completion rate of 92.85%. Multivariate analysis demonstrated that individuals receiving TPT at grassroots medical institutions had higher completion rates than those at disease prevention and control centers (OR=4.90, 95%CI: 1.32-18.05). Additionally, the course completion rate was significantly higher for the TPT regimen using Vaccae than for 3H2P2 (OR=4.86, 95%CI: 1.03-27.14). Conclusion In recent years, China has made substantial progress in scaling up TPT, with rapid expansion of short-course regimens. However, considerable disparities persist across regions and populations. Future efforts should focus on further expanding TPT coverage, optimizing the promotion mechanisms for the short-course regimen, and enhancing the accessibility, standardization, and adherence to TPT.

Key words: Tuberculosis, Latent tuberculosis infection, Preventive treatment, Influencing factors

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