2011-2016年湖北省肺结核发病的时空聚集性分析  

Analysis on spatial-temporal specific incidence of pulmonary tuberculosis in Hubei from 2011 to 2016

作　　者：张玉[1] 叶建君[2] 黄飞[3] 杨成凤[1] 童叶青[2] 皮琦[1] 卢星星[1] 张梦娴 侯双翼[1] 

机构地区：[1]湖北省疾病预防控制中心结核病防治研究所,武汉430079 [2]湖北省疾病预防控制中心传染病防治研究所 [3]中国疾病预防控制中心结核病预防控制中心

出　　处：《中国防痨杂志》2017年第9期1001-1009,共9页Chinese Journal of Antituberculosis

摘　　要：目的分析2011-2016年湖北省肺结核和涂阳肺结核报告发病的时空及发病聚集区域分布特征. 方法 采用空间统计学方法,利用2011-2016年湖北省肺结核报告发病数据,以县（区）为水平,采用全局及局部空间自相关统计量（Moran I,即Moran I指数）分析肺结核发病的空间聚集性,采用SaTScan分析发病的时空聚集性. 结果 2011-2016年湖北省肺结核报告发病率从88.11/10万（50 430/57 237 695）下降至74.70/10万（43 712/58 515 000）,年均报告发病率为81.86/10万（47 378/57 878 787）.涂阳肺结核报告发病率从44.41/10万（25 421/57 237 695）下降至26.89/10万（15 736/58 515 000）,年均报告发病率为33.08/10万（19 149/57 878 787）;各年度和年均肺结核、涂阳肺结核报告发病整体上呈现空间自相关（空间自相关系数Moran I取值均为0.15-0.70,P值均〈0.001）.局部空间自相关分析结果显示,肺结核和涂阳肺结核高-高聚集区域均位于鄂西南恩施州和鄂东南咸宁市部分县,高-低聚集区域位于鄂东部黄冈市团风县.时空扫描分析的结果显示,肺结核一级聚集区在鄂西南,二级聚集区在鄂东南和鄂东北地区,聚集时间均为2011-2013年,对数似然比（log likelihood ratio,LLR）为60.37-1309.47,P值均〈0.001.涂阳肺结核一级聚集区域为鄂东南,聚集时间为2011-2013年,二级聚集区分别位于鄂西南恩施州、鄂北部以及鄂东地区,聚集时间分别为2011-2013年、2011年、2011-2012年, LLR为244.32-462.38,P值均〈0.001.结论 湖北省肺结核和涂阳肺结核报告发病率存在空间和时空聚集区域,鄂西南和鄂东南山区是湖北省肺结核防控的重点地区.Objective To analyze and understand the distribution characters of spatial-temporal specific incidence of pulmonary tuberculosis （PTB） and sputum smear-positive PTB in Hubei province, China, from 2011 to 2016. Methods The county-based surveillance data of PTB and sputum smear-positive PTB in Hubei from 2011 to 2016 were used to calculate the overall and local spatial related indicators （Moran＇s I）.The spatial autocorrelation of PTB was analyzed by using ArcGIS and SaTScan software was utilized to identify geographic areas and time period of potential clusters. Results From 2011 to 2016, the reported incidence rate of PTB decreased from 88.11/100 000 （50 430/57 237 695） to 74.70/100 000 （43 712/58 515 000）, the average annual incidence rate was 81.86/100 000 （47 378/57 878 787）.The reported incidence rate of smear-positive PTB decreased from 44.41/100 000 （25 421/57 237 695） to 26.89/100 000 （15 736/58 515 000）, the average annual incidence rate was 33.08/100 000 （19 149/57 878 787）.The reported incidence of PTB and smear-positive PTB in each year and on annual average presented significant spatial autocorrelation （Moran＇s I values ranged from 0.15 to 0.70, all P〈0.001）.The local autocorrelation analysis results showed that the high-high aggregation areas with high incidence of PTB and smear-positive PTB located in Enshi in the southwestern part of Hubei and some counties of Xianning in the southeastern part of Hubei;and the high-low aggregation areas located in Tuanfeng County of Huanggang in the eastern part of Hubei.The spatial-temporal analysis results showed that the first clustering of high PTB incidence areas were most likely in the southwestern part of Hubei, and the secondary cluster of PTB incidence areaslocated in the southeastern and northeastern part of Hubei from 2011 to 2013, the log likelihood ratio （LLR） values ranged from 60.37 to 1309.47, P〈0.001.The first clustering with high smear-positive PTB incidence areas were most likely in the sou-theastern

关 键 词：结核 肺 时空聚类分析 地理信息系统 湖北省 

分 类 号：R521[医药卫生—内科学]