山东省潍坊市2013—2020年肾综合征出血热流行特点及影响因子研究  

Epidemiological characteristics and influencing factors of hemorrhagic fever with renal syndrome in Weifang City,Shandong Province,2013-2020

作　　者：赵宛莹 郭雪艳[2] 王鸿宇 石昊宁 吴学谦 杨彦清 梁倩 吴兴露 侯祥[4] 刘起勇[5] 李京[1] ZHAO Wan-ying;GUO Xue-yan;WANG Hong-yu;SHI Hao-ning;WU Xue-qian;YANG Yan-qing;LIANG Qian;WU Xing-lu;HOU Xiang;LIU Qi-yong;LI Jing(School of Public Health,Weifang Medical University,Weifang,Shandong 261053,China;不详)

机构地区：[1]潍坊医学院公共卫生学院,山东潍坊261053 [2]潍坊市疾病预防控制中心 [3]潍坊医学院护理学院 [4]陕西省动物研究所 [5]中国疾病预防控制中心传染病预防控制所

出　　处：《现代预防医学》2023年第14期2651-2655,2682,共6页Modern Preventive Medicine

基　　金：山东省重点研发计划项目(2019GSF111067);山东省中医药科技项目(M-2022235);潍坊市科技发展计划(医学类)项目(2021YX047);潍坊医学院大学生创新创业训练计划(X2022242,X2022092,X2022105,X2022111)。

摘　　要：目的分析山东省潍坊市2013—2020年肾综合征出血热(hemorrhagic fever with renal syndrome,HFRS)流行特点及其规律,探讨HFRS在流行过程中气候及经济因素的作用,为有针对性地制定防控措施提供理论依据。方法采用描述性流行病学分析HFRS发病特征,采用广义相加模型、结构方程模型及小波分析,对潍坊市HFRS的发生与宿主动物、气候及经济因素的关系进行分析。结果潍坊市2013—2020年HFRS报告发病1965例,其中男性多于女性,性别比为2.76∶1;发病年龄以40~69岁为主,占发病总数69.11%;职业分布主要集中在农民,工人和学生,农民所占比重高达87.84%;发病数表现出明显的季节性,10—12月份是发病高峰期。小波分析结果显示,HFRS的发生可能分为两个阶段,在2013—2016年间,HFRS的发生主要以小家鼠为宿主,自2017年开始,褐家鼠变为主要动物宿主。广义相加模型分析结果表明,月平均气温、月平均相对湿度和HFRS发病数之间均呈现显著的非线性关系(月平均气温:F=16.758,P<0.01;月平均相对湿度:F=5.816,P<0.01)。温度在12℃以下时,气温和HFRS的发病数呈正相关,温度高于12℃时,二者呈负相关;当相对湿度低于68%时,HFRS发病数与相对湿度之间呈现正相关,相对湿度高于68%时,两者之间呈现负相关;上一个月的粮食总产量与HFRS发病数之间呈线性关系(F=4.836,P<0.05),两者表现为负相关。结构方程模型结果表明气候和GDP皆对HFRS有直接的负向影响,气候作为潜变量包括了气温和相对湿度两个因子。结论自2013年以来,潍坊市HFRS报告病例数呈逐年下降趋势,气候改变和经济发展均可对HFRS的发生造成影响,对此应采取有针对性的防控措施,以减少HFRS的流行。Objective To examine the epidemiological traits and regularities of hemorrhagic fever with renal syndrome(HFRS)from 2013 to 2020 in Weifang,Shandong Province,to address how economic and environmental factors affect HFRS prevalence and to present a theoretical framework for the deliberate development of prevention and control approaches.Methods Utilizing descriptive epidemiology,the incidence of HFRS was examined for its features.A generalized additive model,a structural equation model,and wavelet analysis were used to analyze the relationship between the occurrence of HFRS and host animals,climate,and economic factors in Weifang.Results There were a total of 1965 cases of HFRS recorded in Weifang between 2013 and 2020,with a sex ratio of 2.76:1 favoring male cases.Most incidences,or 69.11%of all incidences,were among people aged 40 to 69.The occupational distribution was mainly concentrated among farmers,workers,and students,among which farmers accounted for 87.84%.The number of incidences showed obvious seasonality,with a peak incidence from October to December.The results of wavelet analysis showed that the occurrence of HFRS may be divided into two phases.During 2013—2016,HFRS occurred mainly in mus musculus as hosts and since 2017,Rattus norvegicus became the main host animal.The results of the generalized summation model analysis showed a significant nonlinear relationship between monthly mean temperature,monthly mean relative humidity,and the number of HFRS incidences(Monthly mean temperature:F=16.758,P<0.01;Monthly mean relative humidity:F=5.816,P<0.01).There was a positive correlation between air temperature and the number of HFRS incidences when the temperature was below 12°C,and a negative correlation when the temperature was above 12°C.When the relative humidity was lower than 68%,there was a positive correlation between the number of HFRS incidences and relative humidity.When the relative humidity was higher than 68%,there was a negative correlation between them.A linear relationship between total

关 键 词：肾综合征出血热 流行特征 广义相加模型 结构方程模型 小波分析 

分 类 号：R512.8[医药卫生—内科学] R181.3[医药卫生—临床医学]