2010-2021年我国肺结核分布动态及收敛性研究  

Dynamic evolution and convergence of pulmonary tuberculosis in China,2010-2021

作　　者：陈洁婷[1,2] 刘婷婷 宋志龙 朱燕 宋天敕 吴向未 Chen Jieting;Liu Tingting;Song Zhilong;Zhu Yan;Song Tianchi;Wu Xiangwei(Medical College of Shihezi University,Shihezi 832003,Xinjiang,China;Xinjiang Normal University,Urumqi 830054,Xinjiang,China;Shihezi Zhongjiang Huayuan Agricultural Science and Technology Co.,Ltd.,Shihezi 832000,Xinjiang,China)

机构地区：[1]石河子大学医学院,新疆石河子832003 [2]新疆师范大学,新疆乌鲁木齐830054 [3]石河子中疆华源农业科技有限责任公司,新疆石河子832000

出　　处：《疾病监测》2025年第3期295-301,共7页Disease Surveillance

基　　金：石河子大学2023年大学生研究训练计划项目(No.SRP2023097);石河子大学科研基金资助项目(No.ZZZC202148);天山英才科技创新团队(No.2023TSYCTD0020)。

摘　　要：目的 分析我国(不含香港特别行政区、澳门特别行政区和台湾地区,下同)肺结核发病率的时空演变规律与收敛性特性,为制定精准高效的肺结核防治策略提供科学依据。方法 基于2010—2021年31个省份的肺结核发病率数据,采用核密度估计、标准差椭圆和收敛模型,分析了全国肺结核发病率动态演进、空间分布偏离特征及其收敛趋势。结果 观测期间全国肺结核年均下降速率为2.68%[年度变化百分比(APC)=-2.68%,P<0.001],其中2010—2018年为稳定下降阶段[平均年度变化百分比(AAPC)=-2.54%,P<0.001],2018—2021年为急剧下降阶段(AAPC=-8.11%,P=0.022);全国和东部地区肺结核发病率区域间绝对差异缩小,中部和西部地区绝对差异略微增大;标准差椭圆面积由2010年的486.88 km^(2)扩张至2021年的493.25 km^(2),长轴增加了56.94 km,短轴缩短了34.09 km,扁率增加了0.06,方位角减小了0.40°,椭圆重心位于我国西、南方向;全国及东、西部地区存在绝对β收敛和条件β收敛,中部和东北地区仅存在条件β收敛,此外,卫生机构床位数(β=0.00)和平均气温(β=-0.03)对全国的肺结核发病率收敛具有显著负向影响,人均医疗卫生财政支出(β=0.00)对发病率的收敛具有显著正向影响。结论 我国肺结核发病率呈下降趋势,地区间存在不均衡态势;空间分布正在向西北和东南方向扩展。全国、东部和西部地区发病率之间的差异正在减少,同时,每万人拥有卫生技术人员、卫生机构床位数、人均医疗卫生财政支出和平均气温等因素正抑制不同地区肺结核发病率增长。Objective To analyze the spatiotemporal evolution and convergence characteristics of pulmonary tuberculosis(TB) incidence in China(except Hong Kong,Macao Special Administrative Regions and Taiwan region,the same below),and provide evidence for the development of precise and effective pulmonary TB prevention and control strategies.Methods Based on the incidence data of pulmonary TB from 31 provinces in China between 2010 and 2021,this study used kernel density function,standard deviation ellipse,and spatial convergence models to analyze the dynamic evolution,spatial distribution deviation and convergence of incidence rates of pulmonary TB in China.Results During the study period,the average annual decline rate of pulmonary TB incidence was 2.68% in China(annual percent change=-2.68%,P<0.001).This decline was characterized by a steady decrease from 2010 to 2018 [average annual percent change(AAPC)=-2.54%,P<0.001] and a sharp decrease from 2018 to 2021(AAPC=-8.11%,P=0.022).The absolute difference in pulmonary TB incidence between the national average and the eastern region average decreased,while the absolute difference between the central region average and western region average increased slightly.The standard deviation ellipse area expanded from 486.88 km^(2) in 2010 to 493.25km^(2) in 2021,with the major axis increasing by 56.94 km and the minor axis shortening by 34.09 km,indicating an increase in the flattening ratio by 0.06 and a decrease in the azimuth angle by 0.40°,the center of gravity of the ellipse was in the west and south of China.There was absolute β-convergence and conditional β-convergence in TB incidence nationwide,as well as in the eastern and western regions,while only conditional β-convergence existed in the central and northeastern regions.Additionally,the number of beds in health institutions(β=0.00),average temperature(β=-0.03) had significant negative impacts,while medical and health fiscal expenditure per capita(β=0.00) had significant positive impact on the convergence of national

关 键 词：肺结核 发病率 动态演变 收敛 

分 类 号：R211[医药卫生—中医学] R521