2009-2019年天津市肺结核发病季节性和空间分布特征分析  

Seasonal characteristics and spatial clustering of tuberculosis during 2009 to 2019 in Tianjin

作　　者：李晓蓉[1] 庞学文[1] 王春花[2] LI Xiaorong;PANG Xuewen;WANG Chunhua(Department of Research,Tianjin Tuberculosis Control Center,Tianjin 300011,China;Reference Laboratory,Tianjin Tuberculosis Control Center,Tianjin 300011,China)

机构地区：[1]天津市结核病控制中心研究室,天津300011 [2]天津市结核病控制中心参比实验室,天津300011

出　　处：《热带医学杂志》2025年第1期104-109,I0003,共7页Journal of Tropical Medicine

基　　金：天津市结核病控制中心科技项目(JHKJ202101);天津市卫生健康委员会科技项目(TJWJ2021QN075);天津市科技计划项目(22KPHDRC00180);天津市津门医学英才项目(TJSJMYXYC-D2-017)。

摘　　要：目的对2009-2019年天津市肺结核发病的季节性和空间分布特征进行分析,为制定有效的肺结核防控措施提供理论依据。方法通过中国疾病预防控制信息系统中的结核病管理信息系统收集天津市2009-2019年确诊登记的肺结核患者病案信息,从综合管理系统中收集各区常住人口数。采用季节指数法和集中度法分析肺结核发病的季节性特征;采用改良圆形分布法计算肺结核发病的高峰日和发病高峰期;应用ArcGIS对天津市肺结核发病的空间分布特征进行分析。结果2009-2019年天津市肺结核平均发病率为23.93/10万,北辰区最高(31.27/10万),其次是河东区(30.43/10万)和红桥区(30.11/10万)。集中度法求得天津市2009-2019年肺结核发病的M值为0.040(0.009~0.100),表明季节性较差。上半年4月、下半年7月季节指数最高,2月和10月季节指数最低。改良圆形分布法求得上下半年发病高峰日分别为4月29日和7月27日,发病高峰期分别为2月21日-7月5日和5月10日-10月13日,经雷氏Z值检验,平均角峰值差异均有统计学意义(P<0.001)。三维趋势分析显示,发病率总体上东西方向呈明显的中间低两边高的“U”型,南北方向呈北高南低的弧形变化趋势;全局Moran's I指数为0.284,P值为0.021,提示整体存在正向空间自相关,呈聚集分布;局部空间自相关分析结果显示,天津市2009-2019年肺结核发病热点区域主要集中在河北区、北辰区、红桥区和河西区,冷点区为静海区。结论4月和7月是天津市肺结核发病的高峰期,发病热点区主要位于市内六区、东丽区和北辰区,是天津市肺结核防控的重点区域。Objective To analyze the seasonal and spatial clustering characteristics of tuberculosis incidence in Tianjin from 2009 to 2019,and provide theoretical basis for developing tuberculosis prevention and control strategies and taking effective prevention and control measures.Methods The tuberculosis management information system in the China Disease Control and Prevention Information System was used to collect the medical records of tuberculosis patients in Tianjin from 2009 to 2019,and the number of permanent residents in each district was collected from the integrated management system.Seasonal index,concentration degree and modified circular distribution method were used to analyze the seasonal distribution characteristics,distribution intensity,peak days of tuberculosis incidence.ArcGIS was used to analyze the spatial clustering of tuberculosis.Results The average incidence of pulmonary tuberculosis in Tianjin was 23.93/100000,with the highest incidence rate in Beichen district(31.27/100000),followed by Hedong district(30.43/100000)and Hongqiao district(30.11/100000).The M value of tuberculosis incidence in Tianjin from 2009 to 2019 was 0.040(0.009-0.100),indicating that the seasonality was poor.The seasonal index was large from March to May,which was the peak season for tuberculosis,and the seasonal index was the smallest in February.The peak incidence days in the first and second half of the year were April 29 and July 27,respectively,and the peak incidence periods were February 21-July 5 and May 10-October 13,respectively.The three dimensional trend analysis showed that the incidence rate in the east-west direction was obviously low in the middle and high in the two sides,and in the north-south direction it was high in the north and low in the south direction.The global Moran index was 0.284 and the P value was 0.021,indicating that there was positive spatial autocorrelation and aggregation distribution,and the results of local spatial autocorrelation analysis showed that the hot spots of tuberculosis in Tian

关 键 词：结核 集中度 圆形分布法 季节特征 空间自相关分析 

分 类 号：R521[医药卫生—内科学]