采用两维图论聚类法分析中国直肠肛门闭锁／狭窄的空间分布  

Using two-dimensional graphic cluster method to study the geographic distribution pattern of patients with anorectal atresia/ stenosis, in China

作　　者：乔良[1] 朱军[2] 袁萍[1] 代礼[2] 王艳萍[2] 周光宣[2] 韩颖[1] 刘潇霞[1] 张驯[1] 曹奕[1] 

机构地区：[1]四川大学华西公共卫生学院流行病学教研室,四川成都610041 [2]四川大学华西第二医院中国出生缺陷监测中心

出　　处：《中华流行病学杂志》2009年第2期163-166,共4页Chinese Journal of Epidemiology

基　　金：国家“十一五”科技支撑计划资助项目（2006BAI05A01）

摘　　要：目的探讨中国直肠肛门闭锁／狭窄的地理空间分布规律，为病因研究提供线索。方法利用2001-2005年中国出生缺陷监测网以医院为基础在全国对孕28周至产后7d的围产儿进行监测的数据，采用两维图论聚类分析对全国监测点按直肠肛门闭锁／狭窄的发生率进行空间归类。结果中国直肠肛门闭锁／狭窄总发生率为3.17／万，东部地区发生率高于中、西部，差异有统计学意义（z值分别为2.50、3.69；P值分别为O.012、〈0.001）。全国监测点可聚为6类：第1类监测点主要分布于黑龙江、吉林、辽宁；第Ⅱ类主要分布于福建、广东、海南、广西以及湖南和江西的南部；第Ⅲ类主要分布于北京、天津、河北、山东、江苏和安徽北部；第Ⅳ类主要分布于浙江、上海、安徽、江苏的南部和湖南、江西的北部及湖北、河南、山西、内蒙古；第V类主要分布于宁夏、甘肃、青海；第Ⅵ类主要分布于陕西、四川、重庆、云南、贵州、新疆、西藏。结论聚类结果明确了中国直肠肛门闭锁／狭窄的空间分布特征及其规律，对于进一步分析直肠肛门闭锁／狭窄的环境影响因素和区域化监测具有重要的指导意义。Objective To investigate the geographic distribution pattern of patients with anorectal atresia/stenosis in China, in order to provide clue for research on its etiology. Methods Data were collected from Chinese Birth Defects Monitoring Network （CBDMN） , which was a hospital-based congenital malformations registry system. From 2001 to 2005, all fetuses with more than 28 weeks of gestation and neonates up to 7 days of age, were monitored. Two-dimensional graphic cluster method was used to divide monitoring stations into different classes with the incidence rates of anorectal atresia/stenosis. Results The overall incidence of anorectal atresia/stenosis was 3.17 per 10000 during 2001 to 2005. The incidence was higher in Eastern than that in Mid or Western parts of China and the difference was statistically significant （z=2.50, 3.69; P=0.012, 〈0.001）. The monitoring stations were grouped into 6 classes. Class I was with Helongjiang, Jilin and Liaoling; Class Ⅱ was with Fujian, Guangdong, Hainan, Guangxi, and South Hunan and Jiangxi; Class Ⅲ was with Beijing, Tianjin, Hebei, Shandong, and North Jiangsu and Anhui; Class IV was with Zhejiang, Shanghai, South Anhui and Jiangsu, North Hunan and Jiangxi, Hubei, Henan, Shanxi and Inner Mongolia, Class V was with Ningxia, Gansu and Qinghai; and Class Ⅵ was with Shaanxi, Sichuan, Chongqing, Yunnan, Guizhou, Xinjiang and Tibet. Conclusion Our findings discovered the geographic distribution patterns of patients with anorectal atresia/stenosis in China. It is important to further analyze the relevant environmental factors attached to it so a better regional monitoring system for anorectal atresia/stenosis can be operated.

关 键 词：直肠肛门闭锁/狭窄 两维图论聚类 中国 地理空间分布 

分 类 号：R726.5[医药卫生—儿科]