CAJ | 학술논문

目的了解2006-2010年山东省恙虫病的流行特征.方法以2006-2010年山东省疾病报告信息系统中收集的恙虫病患者为研究列象,共1291例.描述恙虫病的人口分布特征,基于地理信息系统( ArcCIS 9.3)软件、空间聚集分析软件(SaTScan 7.0),运用空间专题制图、距离倒数插值、空间自相关分析、空间聚集分析、时间聚集分析及时间趋势下空间变异分析,探讨该病的时空分布特征.结果 1291例患者的发病年龄分布为1～92岁,患者多为55岁以上,占49.5％ (639/1291)；男性占49.6％(640/1291),女性占50.4％(651/1291),男女比为1:1.02;农民、工人、学生及学龄前儿童均有发病,以农民为主,占84.8％ (1095/1291).全局Moran's I指数值为0.324(P＜0.01).8处地点该病发病率的局部Moran's I指数值有统计学意义(P＜0.01),均为“高-高”(H-H)聚集,其中较为重要的地区为钢城、莱城、新泰、东港,发病数分别为38、154、160、105例,局部Moran's I值分别为2.111、1.642、1.277、0 775.各年发病聚集时间分别为:2006年9月23日至11月20日(202例)、2007年10月2日至11月11日(197例)、2008年9月30日至11月7日(302例)、2009年9月25日至11月10日(204例)、2010年10月5日至11月13日(226例),RR值分别为45.55、34.60、50.64、53.09、79.84(P值均＜0.01).共发现以泰安新泰为中心的辐射半径为58.28 km,及以日照东港为中心的辐射半径22.68 km的两处恙虫病聚集区,病例数分别为542、134例,RR分别为4.52、3.96(P值均＜0.01),地貌分别为内陆低山丘陵和沿海丘陵；以临沂蒙阴县为中心的辐射半径为45.82 km的区域,恙虫病年增长率最高,达45.04％,RR =3.68 (P＜0.01).结论山东省恙虫病以中老年农民为主,9月下旬至11月上旬为流行高峰；该病存在正空间相关,存在内陆低山丘陵和沿海丘陵2个聚集区,其中,以临沂蒙阴为中心的区域该病年增长率最高.
목적 료해2006-2010년산동성양충병적류행특정.방법 이2006-2010년산동성질병보고신식계통중수집적양충병환자위연구렬상,공1291례.묘술양충병적인구분포특정,기우지리신식계통( ArcCIS 9.3)연건、공간취집분석연건(SaTScan 7.0),운용공간전제제도、거리도수삽치、공간자상관분석、공간취집분석、시간취집분석급시간추세하공간변이분석,탐토해병적시공분포특정.결과 1291례환자적발병년령분포위1～92세,환자다위55세이상,점49.5％ (639/1291)；남성점49.6％(640/1291),녀성점50.4％(651/1291),남녀비위1:1.02;농민、공인、학생급학령전인동균유발병,이농민위주,점84.8％ (1095/1291).전국Moran's I지수치위0.324(P＜0.01).8처지점해병발병솔적국부Moran's I지수치유통계학의의(P＜0.01),균위“고-고”(H-H)취집,기중교위중요적지구위강성、래성、신태、동항,발병수분별위38、154、160、105례,국부Moran's I치분별위2.111、1.642、1.277、0 775.각년발병취집시간분별위:2006년9월23일지11월20일(202례)、2007년10월2일지11월11일(197례)、2008년9월30일지11월7일(302례)、2009년9월25일지11월10일(204례)、2010년10월5일지11월13일(226례),RR치분별위45.55、34.60、50.64、53.09、79.84(P치균＜0.01).공발현이태안신태위중심적복사반경위58.28 km,급이일조동항위중심적복사반경22.68 km적량처양충병취집구,병례수분별위542、134례,RR분별위4.52、3.96(P치균＜0.01),지모분별위내륙저산구릉화연해구릉；이림기몽음현위중심적복사반경위45.82 km적구역,양충병년증장솔최고,체45.04％,RR =3.68 (P＜0.01).결론 산동성양충병이중노년농민위주,9월하순지11월상순위류행고봉；해병존재정공간상관,존재내륙저산구릉화연해구릉2개취집구,기중,이림기몽음위중심적구역해병년증장솔최고.
Objective To explore the epidemic features of scrub typhus between year 2006 and 2010in Shandong province.Methods Based on the data collected through Diseases Reporting Information System between year 2006 and 2010 in Shandong province,1291 cases of scrub typhus patients were selected.The study described the population distribution features of the scrub typhus patients,and explored the temporal and spatial distribution features of the disease by applying the methods of spatial thematic mapping,inverse distance weighted,spatial autocorrelation analysis,spatial clustering analysis,temporal clustering analysisand spatial variation analysis in temporal trends based on Geographic Information software ( ArcGIS 9.3 ) and Spatial Clustering Software (SatScan 7.0).Results The onset age of the 1291 patients ranged between 1and 92 years old.639 out of 1291 patients were over 55 years old,accounting for 49.5％.A total of 640patients were male and the other 651 patients were female,occupying 49.6％ and 50.4％ respectively.The gender ratio was 1:1.02.Patients were found in farmers, workers, students and preschool children.However,most of the cases were farmers,up to 84.8％ ( 1095/1291 ).Global Moran's I index was 0.324(P ＜0.01 ).The local Moran's I index in 8 locations were proved to have statistical significance ( P ＜0.01 ),all of which were H-H clustering areas.Gangcheng (38 cases),Laicheng ( 154 cases),Xintai ( 160cases) and Donggang (105 cases) were important locations,whose local Moran's I index were 2.111,1.642,1.277 and 0.775 respectively.The clustering period of scrub typhus in respective year were as follows:2006.09.23 -2006.11.20 (202 cases),2007.10.02 - 2007.11.11 ( 197 cases),2008.09.30 -2008.11.07 (302 cases),2009.09.25 -2009.11.10 (204 cases),and 2010.10.05- 2010.11.13 (226cases),whose RR values were separately 45.55,34.60,50.64,53.09 and 79.84 ( P ＜0.01 ).Two spatial clustering area were found in the study.One was the area centered Taian and Xintai with radiation radius at 58.28 km (542 cases) and the other one was the area centered Rizhao and Donggang with radiation radius at 22.68 km ( 134 cases),whose RR values were 4.52 and 3.96 (P ＜0.01 ).The spatial features of the two clustering areas were inland low hills area and coastal hills area.The highest annual growth rate of the disease was 45.04％,found in the area centered Linyi and Mengyin counties,with the radiation radius at 45.82 km.The RR value was 3.68 (P ＜ 0.01 ).Conclusion The majority of the scrub typhus patients were middle-aged and elderly farmers.The epidemic peak was between the last 10 days of September and the first 10 days of November.A positive spatial correlation of the disease was found; and most cases clustered in inland low bills area and costal hills area,especially the area around Linyi and Mengyin,with the highest annual growth rates of the disease.