云南省伤寒副伤寒空间分布特征及其气候影响因素研究

Objective To characterize the spatial distribution of typhoid and paratyphoid fever(TPF)in Yunnan province, China and to determine the effectiveness of meteorological factors on the epidemics of TPE Methods Data of reported TPF cases in Yunnan province(2001 -2007)from the China Information System for Diseases Control and Prevention was applied to GIS-based spatial analyses to detect their spatial distribution and clustering of TPF incidence at the county level.Panel data analysis was used to identify the relationships between the TPF incidence and meteorological factors including monthly average temperature, monthly cumulative precipitation and monthly average relative humidity. Results During the study period, the average incidence of TPF in Yunnan province was 23.11/100 000, with majority of the TPF cases emerged in summer and autumn. Although widely distributed, two TPF clusters were detected in Yunnan province based on the spatial analysis:one area around Yuxi city with the average annual incidence as 207.45/100 000 and another at the junctions of Yunnan province with Burma and Laos. Based on results from panel data analysis, the incidence of TFP was shown to be associated with meteorological factors such as temperature,precipitation, relative humidity and one month lag of temperature increase [10 ℃ increase in the monthly average temperature:IRR=1.30(95%CI: 1.24-1.36);10% increase in monthly average relative humidity:IRR= 1.07(95%CI: 1.05-1.09); 100 mm rise in monthly cumulative precipitation:IRR=1.02(95%CI: 1.00-1.03); and 10 ℃ average temperature increase, the last month: IRR=1.73(95%CI: 1.64-1.82)]. Conclusion Areas with high TPF incidence were detected in this study,which indicated the key areas for TPF control in Yunnan province. Meteorological factors such as temperature, precipitation and humidity played a role in the incidence of TPF.     

云南省伤寒副伤寒空间分布特征及其气候影响因素研究

Objective To characterize the spatial distribution of typhoid and paratyphoid fever(TPF)in Yunnan province, China and to determine the effectiveness of meteorological factors on the epidemics of TPE Methods Data of reported TPF cases in Yunnan province(2001 -2007)from the China Information System for Diseases Control and Prevention was applied to GIS-based spatial analyses to detect their spatial distribution and clustering of TPF incidence at the county level.Panel data analysis was used to identify the relationships between the TPF incidence and meteorological factors including monthly average temperature, monthly cumulative precipitation and monthly average relative humidity. Results During the study period, the average incidence of TPF in Yunnan province was 23.11/100 000, with majority of the TPF cases emerged in summer and autumn. Although widely distributed, two TPF clusters were detected in Yunnan province based on the spatial analysis:one area around Yuxi city with the average annual incidence as 207.45/100 000 and another at the junctions of Yunnan province with Burma and Laos. Based on results from panel data analysis, the incidence of TFP was shown to be associated with meteorological factors such as temperature,precipitation, relative humidity and one month lag of temperature increase [10 ℃ increase in the monthly average temperature:IRR=1.30(95%CI: 1.24-1.36);10% increase in monthly average relative humidity:IRR= 1.07(95%CI: 1.05-1.09); 100 mm rise in monthly cumulative precipitation:IRR=1.02(95%CI: 1.00-1.03); and 10 ℃ average temperature increase, the last month: IRR=1.73(95%CI: 1.64-1.82)]. Conclusion Areas with high TPF incidence were detected in this study,which indicated the key areas for TPF control in Yunnan province. Meteorological factors such as temperature, precipitation and humidity played a role in the incidence of TPF.     

基于发热症状监测系统的甲型副伤寒疾病负担分析

目的 评估云南省玉溪市红塔区2008年5月1日至2009年4月30日甲型副伤寒的流行病学负担.方法 在建立基于全人群的发热症状监测系统基础上,分别调查和测算红塔区发热病例的就诊率,就诊病例采样率,样本检测率,检测方法灵敏度和实验室确诊病例报告率等,根据食源型疾病的疾病负担金字塔模型对当地伤寒、副伤寒的实际发病数进行估算和分析.结果 发热症状监测系统一年内共监测红塔区发热病例6642例,采样并检测6570例,采样率为98.92%,检测率为100%.确诊居住在红塔区的甲型副伤寒阳性病例354例.调查发现发热病例就诊率为73.53%,其中10岁以下儿童就诊率为100%.依据参考文献假定血培养法检测甲型副伤寒的灵敏度为70%,病例网络报告率为90%,经倍数校正后估算红塔区甲型副伤寒年发病数为965例(95%CI:745～2284),年发病率为220.33/10万(95%CI:170.1～521.4),其中发病率最高的年龄组为15～44岁组(318.27/10万).结论 玉溪市红塔区甲型副伤寒处于高流行状态,15～44岁组为高发人群,应采取有针对性的防治措施以减缓甲型副伤寒的高发态势.

Abstract：

Objective To evaluate the burden of paratyphoid fever A in Hongta district, Yuxi city, Yunnan province from May 1, 2008 to April 30, 2009 so as to provide information for the development of comprehensive intervention measures. Methods Based on the Fever Syndromic Surveillance System, information as attendance rate of patients with fever, rate of patients being sampled, laboratory testing rate, sensitivity on the detection of blood culture and the rate of case reporting etc. were calculated. According to the pyramid model of food-borne disease on disease burden, the local actual incidence of paratyphoid fever A was estimated and analyzed. Results Under the Fever Syndromic Surveillance System, there were 6642 fever cases being detected, among whom 6570 cases were sampled and undergone testing, with the sampling rate as 98.92% and all the samples received laboratory testing. There were 354 positive cases of paratyphoid fever A reported,all from the Hongta district. Data showed that the attendance rate of the feverish patients was 73.53%,with the highest rate seen in whose under 10 years old (100%). Assumed that the sensitivity of paratyphoid fever blood culture was 70%, and the case reporting rate was 90%, we estimated that the annual incidence of paratyphoid fever A in Hongta was 220.33 (95% CI: 170.1-521.4) per 100 thousand, with 965 (95%CI: 745-2284) as new cases. Among all the age groups, the incidence in the age group from 15 to 44 years old was estimated to be at the highest (318.27 per 100 thousand).Conclusion Hongta seemed to be an endemic region for paratyphoid fever A, with the highest incidence occurred in the age group of between 15 and 44 years old. These findings highlighted the urgent need to carry out further investigation on the risk factors and to implement targeted effective prevention and control measures.     

2004-2006年北京夏季最低气温对心脑血管疾病急诊数的影响

目的 探讨北京市夏季最低气温对心脑血管疾病(ICD10:100～199)急诊的影响.方法 收集2004-2006年北京大学某医院急诊科心脑血管疾病急诊资料、北京市环境监测中心大气污染物数据和中国气象科学数据共享服务网的气象资料,应用时间分层的病例交叉设计研究方法进行数据分析.结果 在控制大气污染物SO_2、NO_2、可吸入颗粒物(PM10)影响的情况下,无滞后夏季最低气温对心脑血管疾病总急诊、冠心病急诊、心律失常急诊、心衰急诊和脑血管疾病急诊的影响最大,气温每升高1℃,OR值分别为1.039(95%CI:1.008～1.071),1.077(95%CI:0.987～1.174),1.037(95%CI:0.963～1.116).1.103(95%CI:0.909～1.339)和 1.030(95%CI:0.985～1.077),其中最低气温与总心脑血管疾病急诊的关联有统计学意义(P<0.05).在多因素模型中,考虑到相对湿度因素时,气温每升高1℃对冠心病急诊和脑血管病急诊的OR值分别为1.095(95%CI:1.001～1.075)和1.050(95%CI:1.002～1.100),关联具有统计学意义(P<0.05).结论 夏季最低气温升高可以导致心脑血管疾病总急诊增加,同时相对湿度可能与气温有协同作用,可导致冠心病急诊,脑血管病急诊增加.

Abstract：

Objective To explore the association between the minimum temperature in different seasons and the hospital emergency room visits for cardiocerebrovascular diseases(International Classification of Diseases,tenth vision ICD-10：100-199)in Beijing.China.Methods The data of the daily hospital emergency room visits for cardiocerebrevascular diseases(ICD-10：100-199)from one of Peking university hospitals,the data of relevant ambient air pollution from the Beijing Municipal Environmental Monitoring Center and the data of meteorological index from China meteorological data sharing service system between 2004—2006 were collected The time-stratified case-crossover design was used to analyze the data.Results After adjusting SO_2,NO_2,and PM10.The results showed that each 1℃ increase in the daily minimum temperature in summer was associated with the intraday hospital emergency room visits(OR=1.039,P<0.05)for the total cardiocerebrovascular diseases.In multi-factor model,considering relative humidity,1℃ increase in the daily minimum temperature was associated with the coronary heart disease(OR=1.095,95％CI:1.001—1.075)and the cerebrovascular diseases(OR=1.050,95％CI：1.002—1.100)(P<0.05).Conclusion These outcomes suggest that elevated level of minimum temperature in summer will increase the hospital emergency room visits for the total circulatory diseases,and the relative humidity may enhance the effects of minimum temperature on the hospital emergency room visits of coronary heart disease and cerebrovaseular diseases.     

上消化道三种恶性肿瘤的危险因素分析

目的 探讨我国食管癌、胃癌高发区目前上消化道3种恶性肿瘤发病的危险因素.方法 选择食管癌高发区河北省磁县、涉县,河南省林县和山东省肥城,胃癌高发区辽宁省庄河,每个地区分别从肿瘤登记数据库中选择发病日期为2009年1月1日以后的新诊断病例,利用随机数字表法选取食管下段癌、贲门癌、其他部位胃癌病例,共收集751例;按照病例与对照1∶3配对选取对照人群2253名.采用课题设计的调查表收集研究对象相关资料,并对相关变量进行单因素及多因素logistic回归分析,估计各危险因素的OR值(95%CI).结果 饮食不规律、经常食用油炸食品、有消化道病史及胃食管反流性疾病史者病例组分别有66、83、369、282例,而对照组分别为90、214、119、432名.单因素分析显示,以上因素可增加上消化道肿瘤发病风险[OR值(95%CI)分别为3.177(2.127～4.745)、3.190(2.061～4.927)、14.660(11.342～18.948)、3.137(2.546～3.864)];而常吃新鲜蔬菜者病例组中有387例,对照组有1278名,此因素可降低上消化道肿瘤发病风险(OR=0.609;95%CI:0.473～0.785).多因素分析显示,消化道病史(OR=21.420;95%CI:15.484～29.632)、饮食不规律(OR=3.097;95%CI:1.740～5.514)、经常食用腌晒食品(OR=3.005;95%CI:1.873～4.819)、胃食管反流性疾病史(OR=2.261;95%CI:1.673～3.057)等是上消化道肿瘤的危险因素;每天食用新鲜蔬菜(OR=0.562;95%CI:0.396～0.800)是上消化道肿瘤的保护因素.结论 不良生活方式和不健康饮食习惯是我国食管癌、胃癌高发区居民上消化道恶性肿瘤的危险因素.

Abstract：

Objective To explore the major risk factors for upper gastrointestinal cancer in high occurrence areas of esophageal and gastric cancer in China. Methods Four high occurrence areas of esophageal cancer, namely Cixian and Shexian from Hebei province, Linxian from Henan province, Feicheng from Shandong province, and Zhuanghe from Liaoning province, which is a high occurrence area of gastric cancer,were selected for the study. The newly-diagnosed cases whose date of onset were after January 1st,2009 were selected from the Cancer Registration Database in each district, and 751 cases diagnosed as cancers in lower segment of esophagus, cardiac and other subsite of stomach were randomly recruited. 2253 matched controls were selected to pair the cases at the ratio of 3: 1. The relative information of the study objects were collected from the face-to-face interviews with trained staff by designed questionnaires, and the data was input by EpiData software. Statistic software SPSS 13.0 was applied to conduct both univariate and multivariate logistic regression analysis to evaluate odd ratios (OR) and 95% confident interval (CI).Results As univariate analysis shown,66 objects in case group had irregular diet habit; while 90 in control group had ( OR= 3. 177;95% CI: 2. 127 - 4.745). A higher percentage in case group (83 objects)preferred fried food in comparison with only 214 in control group did (OR= 3. 190; 95% CI: 2.061 -4. 927). 369 objects in case group, but only 119 in control group had history of gastrointestinal diseases ( OR = 14. 660; 95% CI: 11. 342 - 18. 948 ). 282 objects in case group had history of gastroesophageal reflux disease (GERD) ,which was much higher than the percentage in control group (432 objects),with OR =3. 137 (95% CI: 2. 546 -3. 864). All the above factors could increase the risk for upper gastrointestinal cancer. 387 objects in case group and 1278 in control group reported they preferred fresh vegetables in daily diet,which was found to be a protective factor ( OR = 0. 609; 95% CI: 0. 473 - 0. 785 ). As multivariate analysis shown, history of gastrointestinal tract diseases ( OR = 21. 420; 95% CI: 15.484 - 29. 632 ),irregular food diet (OR=3.097; 95%CI: 1.740-5.514),pickled food (OR=3.005; 95%CI: 1.873 -4. 819) ,and GERD ( OR = 2. 261; 95% CI: 1. 673 - 3.057 ) were found to be risk factors for upper gastrointestinal cancer; while frequent fresh-vegetable diet was a protective factor (OR = 0. 562; 95% CI:0. 396 -0. 800). Conclusion Irregular lifestyle and unhealthy diet habit could be the major risk factors for upper gastrointestinal cancers among the residents from high occurrence areas of esophageal cancer and gastric cancer in China.     

中国成年人高血压患病区域聚集性及危险因素的多水平模型分析

Objective To analyze the region cluster and risk factors of hypertension in the Chinese adult population and to explore the application of multilevel regression model in the risk factors of hypertension. Methods Multi-stage random sampling technique was used to choose 15 540 individuals aged 35-74 years from 10 regions in China. Two-level logistic regression models were fitted under MLwiN 2.02 software. Results The region cluster of hypertension existed and variance portion coefficient was 3.1%. After adjusting for the age and gender, overall obese people (BMI≥28 kg/m2) were 4.50(95%CI: 4.00-5.06) times, overweight people (BMI=24-27.9 kg/m2) were 2.26 (95%CI: 2.07-2.46) times more likely to be hypertensive as compared with those of normal BMI (18.5-23.9 kg/m2), and those centrally obesive people (Waist circumference≥85 cm in male or 80 cm in female) were 2.62 (95%CI: 2.42-2.83) times more likely to be hypertensive as compared with those of normal WC. The age-and gender-adjusted odds ratios (Ors) of triglyceride (TG), serum total cholesterol (TC), glucose, low-density lipoprotein cholesterol (LDL-C) , high-density lipoprotein cholesterol (HDL-C) and drinking alcohol were 2.10 (95% CI: 1.89-2.33) , 2.08 (95% CI: 1.84-2.35) , 1.85 (95% CI: 1.60-2.14) , 1.58 (95% CI: 1.38-1.81), 1.49(95%CI: 1.32-1.69) and 1.15(95%CI: 1.05-1.27), respectively. Conclusion The prevalence of hypertension was not only affected by individual risk factors, such as obesity, drinking alcohol, abnormal glucose and serum lipids profile, but also affected by the geographic environment where people resided in. Population-and risk factors targeted strategies, proved a promising way to reduce individual risk of hypertension in the primary prevention of hypertension.     

中国成年人高血压患病区域聚集性及危险因素的多水平模型分析

Objective To analyze the region cluster and risk factors of hypertension in the Chinese adult population and to explore the application of multilevel regression model in the risk factors of hypertension. Methods Multi-stage random sampling technique was used to choose 15 540 individuals aged 35-74 years from 10 regions in China. Two-level logistic regression models were fitted under MLwiN 2.02 software. Results The region cluster of hypertension existed and variance portion coefficient was 3.1%. After adjusting for the age and gender, overall obese people (BMI≥28 kg/m2) were 4.50(95%CI: 4.00-5.06) times, overweight people (BMI=24-27.9 kg/m2) were 2.26 (95%CI: 2.07-2.46) times more likely to be hypertensive as compared with those of normal BMI (18.5-23.9 kg/m2), and those centrally obesive people (Waist circumference≥85 cm in male or 80 cm in female) were 2.62 (95%CI: 2.42-2.83) times more likely to be hypertensive as compared with those of normal WC. The age-and gender-adjusted odds ratios (Ors) of triglyceride (TG), serum total cholesterol (TC), glucose, low-density lipoprotein cholesterol (LDL-C) , high-density lipoprotein cholesterol (HDL-C) and drinking alcohol were 2.10 (95% CI: 1.89-2.33) , 2.08 (95% CI: 1.84-2.35) , 1.85 (95% CI: 1.60-2.14) , 1.58 (95% CI: 1.38-1.81), 1.49(95%CI: 1.32-1.69) and 1.15(95%CI: 1.05-1.27), respectively. Conclusion The prevalence of hypertension was not only affected by individual risk factors, such as obesity, drinking alcohol, abnormal glucose and serum lipids profile, but also affected by the geographic environment where people resided in. Population-and risk factors targeted strategies, proved a promising way to reduce individual risk of hypertension in the primary prevention of hypertension.     

中国成年人高血压患病区域聚集性及危险因素的多水平模型分析

Objective To analyze the region cluster and risk factors of hypertension in the Chinese adult population and to explore the application of multilevel regression model in the risk factors of hypertension. Methods Multi-stage random sampling technique was used to choose 15 540 individuals aged 35-74 years from 10 regions in China. Two-level logistic regression models were fitted under MLwiN 2.02 software. Results The region cluster of hypertension existed and variance portion coefficient was 3.1%. After adjusting for the age and gender, overall obese people (BMI≥28 kg/m2) were 4.50(95%CI: 4.00-5.06) times, overweight people (BMI=24-27.9 kg/m2) were 2.26 (95%CI: 2.07-2.46) times more likely to be hypertensive as compared with those of normal BMI (18.5-23.9 kg/m2), and those centrally obesive people (Waist circumference≥85 cm in male or 80 cm in female) were 2.62 (95%CI: 2.42-2.83) times more likely to be hypertensive as compared with those of normal WC. The age-and gender-adjusted odds ratios (Ors) of triglyceride (TG), serum total cholesterol (TC), glucose, low-density lipoprotein cholesterol (LDL-C) , high-density lipoprotein cholesterol (HDL-C) and drinking alcohol were 2.10 (95% CI: 1.89-2.33) , 2.08 (95% CI: 1.84-2.35) , 1.85 (95% CI: 1.60-2.14) , 1.58 (95% CI: 1.38-1.81), 1.49(95%CI: 1.32-1.69) and 1.15(95%CI: 1.05-1.27), respectively. Conclusion The prevalence of hypertension was not only affected by individual risk factors, such as obesity, drinking alcohol, abnormal glucose and serum lipids profile, but also affected by the geographic environment where people resided in. Population-and risk factors targeted strategies, proved a promising way to reduce individual risk of hypertension in the primary prevention of hypertension.     

中国成年人高血压患病区域聚集性及危险因素的多水平模型分析

Objective To analyze the region cluster and risk factors of hypertension in the Chinese adult population and to explore the application of multilevel regression model in the risk factors of hypertension. Methods Multi-stage random sampling technique was used to choose 15 540 individuals aged 35-74 years from 10 regions in China. Two-level logistic regression models were fitted under MLwiN 2.02 software. Results The region cluster of hypertension existed and variance portion coefficient was 3.1%. After adjusting for the age and gender, overall obese people (BMI≥28 kg/m2) were 4.50(95%CI: 4.00-5.06) times, overweight people (BMI=24-27.9 kg/m2) were 2.26 (95%CI: 2.07-2.46) times more likely to be hypertensive as compared with those of normal BMI (18.5-23.9 kg/m2), and those centrally obesive people (Waist circumference≥85 cm in male or 80 cm in female) were 2.62 (95%CI: 2.42-2.83) times more likely to be hypertensive as compared with those of normal WC. The age-and gender-adjusted odds ratios (Ors) of triglyceride (TG), serum total cholesterol (TC), glucose, low-density lipoprotein cholesterol (LDL-C) , high-density lipoprotein cholesterol (HDL-C) and drinking alcohol were 2.10 (95% CI: 1.89-2.33) , 2.08 (95% CI: 1.84-2.35) , 1.85 (95% CI: 1.60-2.14) , 1.58 (95% CI: 1.38-1.81), 1.49(95%CI: 1.32-1.69) and 1.15(95%CI: 1.05-1.27), respectively. Conclusion The prevalence of hypertension was not only affected by individual risk factors, such as obesity, drinking alcohol, abnormal glucose and serum lipids profile, but also affected by the geographic environment where people resided in. Population-and risk factors targeted strategies, proved a promising way to reduce individual risk of hypertension in the primary prevention of hypertension.     

中国成年人高血压患病区域聚集性及危险因素的多水平模型分析

Objective To analyze the region cluster and risk factors of hypertension in the Chinese adult population and to explore the application of multilevel regression model in the risk factors of hypertension. Methods Multi-stage random sampling technique was used to choose 15 540 individuals aged 35-74 years from 10 regions in China. Two-level logistic regression models were fitted under MLwiN 2.02 software. Results The region cluster of hypertension existed and variance portion coefficient was 3.1%. After adjusting for the age and gender, overall obese people (BMI≥28 kg/m2) were 4.50(95%CI: 4.00-5.06) times, overweight people (BMI=24-27.9 kg/m2) were 2.26 (95%CI: 2.07-2.46) times more likely to be hypertensive as compared with those of normal BMI (18.5-23.9 kg/m2), and those centrally obesive people (Waist circumference≥85 cm in male or 80 cm in female) were 2.62 (95%CI: 2.42-2.83) times more likely to be hypertensive as compared with those of normal WC. The age-and gender-adjusted odds ratios (Ors) of triglyceride (TG), serum total cholesterol (TC), glucose, low-density lipoprotein cholesterol (LDL-C) , high-density lipoprotein cholesterol (HDL-C) and drinking alcohol were 2.10 (95% CI: 1.89-2.33) , 2.08 (95% CI: 1.84-2.35) , 1.85 (95% CI: 1.60-2.14) , 1.58 (95% CI: 1.38-1.81), 1.49(95%CI: 1.32-1.69) and 1.15(95%CI: 1.05-1.27), respectively. Conclusion The prevalence of hypertension was not only affected by individual risk factors, such as obesity, drinking alcohol, abnormal glucose and serum lipids profile, but also affected by the geographic environment where people resided in. Population-and risk factors targeted strategies, proved a promising way to reduce individual risk of hypertension in the primary prevention of hypertension.     

猩红热的发病率与气象因素的负二项回归分析

目的通过负二项回归模型探讨气象因素与猩红热发病的关系。方法对1985—2005年安徽省某市猩红热月平均发病率和月平均降水量、月平均气压、月平均气温、月平均相对湿度、月平均最低气温5项气象资料的数据进行描述性分析,然后拟合负二项回归模型,并且对2006年每个月份的发病率做一个预测。结果模型的超离散度K=0．41（95％CI：0．32-0．53）,进行似然比）x2检验x2=306．42,P〈0．001,认为发现负二项回归是适合的模型。猩红热的发生与月平均气压、月平均相对湿度和月平均最低气温有统计学意义（均有P〈0．05）。对2006年各个月份的月发病率预测的结果表明（Wilcoxon符号秩和检验,Z=0．24,P=0．814）,预测值与实际值之间差异无统计学意义,提示预测效果比较理想。结论通过拟合负二项回归模型发现,对猩红热的发生和预测,月平均气压、月平均相对湿度和月平均最低气温是不可忽略的气象因素。     

基于Bayes时空分析探讨气象因素对手足口病的影响

目的 探讨气象因素对我国手足口病患病的影响。方法 采用层次Bayes模型[Besag, York, and Mollie''(BYM) model]对数据进行拟合, 比较空间异质模型(UH)、空间相关模型(CH)和时空交互效应模型对数据的拟合效果, 选取最优模型结合生态学分析手足口病的气象影响因素。结果 加入协变量的时空交互CH+UH拟合效果较优(DIC=35 507.2), 降水量(RR=1.051 7, 95%CI:1.050 4～1.052 5)、平均气压(RR=1.076 4, 95%CI:1.074 8～1.077 9)、平均温度(RR=1.089 6, 95%CI:1.078 1～1.106 9)、平均相对湿度(RR=1.089 0, 95%CI:1.082 1～1.091 2)和日照时数(RR=1.085 1, 95%CI:1.079 8 ～1.087 5)是手足口病的危险因素。结论 手足口病的发生具有时空聚集的特点, 气象因素与手足口病的发生关系密切。     

气候变化对长沙市肾综合征出血热发病的影响与预警模型

目的 了解气象因素变化对肾综合征出血热(HFRS)发病的影响,探索应用气象因素对HFRS发病进行预警。方法 收集长沙市2000-2009年HFRS病例（共2171例）,同时收集同期气象数据,构建基于气象因素的长沙市HFRS传播预测模型,使用Cochran-Armitage趋势检验分析HFRS年发病率的变化趋势,采用交叉相关分析法计算气象因素[包括月平均温度、相对湿度、降水量及厄尔尼诺南方涛动指数(MEI)]与每月HFRS发病人数之间的时滞周期,最后采用时间序列泊松回归模型分析不同气象因素对HFRS传播的影响。结果 2000-2009年长沙市HFRS年发病率分别为13.09/10万（755例）、9.92/10万（578例）、5.02/10万（294例）、2.55/10万（150例）、1.13/10万(67例)、1.16/10万（70例）、0.95/10万（58例）、1.40/10万（87例）、0.75/10万（47例）、1.02/10万（65例）,整体呈下降趋势（Z= -5.78,P＜0.01）。模型分析显示,月平均气温[18.00℃,r=0.26,P ＜0.01,1个月时滞周期;发病率比(IRR)=1.02,95％CI:1.00～1.03,P＜0.01]、相对湿度（75.50％,r=0.62,P＜0.01,3个月时滞周期;IRR= 1.03,95％CI:1.02～ 1.04,P＜ 0.01）、降水量（112.40mm,r=0.25,P＜0.01,6个月时滞周期;IRR= 1.01,95％CI:1.01～1.02,P=0.02）和MEI（r=0.31,P＜0.01,3个月时滞周期;IRR =0.77,95％ CI:0.67～0.88,P＜0.01）与HFRS月发病人数（18.10例）紧密相关。结论 气象因素对HFRS发病存在明显影响,在控制变量自相关、季节性及长期趋势的影响后,长沙市时间序列泊松回归模型预测精度较高,可以实现对长沙市HFRS的提前预警。     

邯郸市1972-2010年猩红热发病的气象流行病学特征分析

目的 查找研究猩红热发病率和气象因素之间关系的适用方法,探讨邯郸市猩红热的气象流行病学特征. 方法 收集1972-2010年邯郸市猩红热疫情资料、气象资料和人口资料,采用EpiData3.0进行“双重录入”,用SPSS17.0统计分析软件建立数据库,对数据进行统计分析. 结果 ①气象参数的共线性诊断结果显示,本组气象因子数据容差最小为0.014,方差膨胀因子最大达69.998.②Spearman相关分析结果显示,邯郸市1972-2010年猩红热月发病率与月平均风速、月日照时数、月小型蒸发量呈正相关,与月平均气温、月平均相对湿度、月总降雨量、月极端最低气温呈负相关（P＜0.05或P＜0.01）.③猩红热月发病率的曲线估计方程为（Y）=1.369-0.2301n（X）.④猩红热月发病率与月平均风速之间得到曲线拟合方程（Y）=-0.781＋ 1.242X-0.585X2＋0.097X3.⑤气象参数的KMO和Bartlett检验结果显示,本文中的气象参数非常适合做因子分析,通过做主成分多元线性回归分析得到方程（Y）=1.946＋ 0.378Z2（P＜0.01）. 结论 （D邯郸市10个气象参数之间存在严重的多重共线性.②邯郸市猩红热月发病率的模型曲线为对数模型曲线.③猩红热月发病率与月平均风速之间呈三次方程曲线关系,月平均风速是影响猩红热月发病率的主要气象因素.④气象因素对猩红热发病的影响在总的影响因素中所占比例较小.     

智能神经网络模型用于气象因素对疟疾发病影响的初步研究

目的 建立气象因素与疟疾的智能神经网络预测模型。方法 利用Matlab6．1软件中的神经网络工具箱，根据预实验结果，利用云南省红河地区1994～1999年月平均气压、月平均气温、月最高气温、月最低气温、月降水量、月降水日数、月平均相对湿度、月蒸发量、月日照时数等气象数据与疟疾发病率等级数据建立反向传播网络(BP网络)预测模型，并对模型进行验证。结果 神经网络经100次学习和训练，训练误差从3．23608下降至0．035862，通过建立的智能神经网络模型对未来疟疾发病率进行预测，其预测符合率为84．85％。结论 智能神经网络在气象因素与疟疾之间建模是可行的，其预测符合率达80％以上。智能神经网络具有综合能力强，对数据的要求不高，适时学习等突出优点，且操作简便，节省时间，易于掌握和应用。研究中数据的应用、纳入、排出等问题有待于进一步研究。智能神经网络模型可以作为疟疾预测的一种新方法。     

流行性乙型脑炎发病率的气象影响因子分析

目的探讨山西省运城地区流行性乙型脑炎(乙脑)发病率与气象因子之间的关系。方法收集2000-2009年7-9月运城地区乙脑发病率及同期气象资料,用SPSS17.0软件分析两者相关性,并用逐步回归分析建立乙脑发病率的气象因子拟合模型。结果运城地区乙脑病例多在6月开始出现,7月增多,8月达到高峰,9月减少,10月偶有发生。乙脑发病率与月平均温度、月平均气压等相关,与月温差、月日照、相对湿度、月降雨量无关。逐步回归分析得出乙脑发病率的气压回归方程,ap1(提前1个月的平均气压)有良好的拟合效果。结论气象因子对乙脑发病有重要影响,可以利用气压拟合模型预测乙脑发病率变化趋势。     

银川市空气污染物与心脑血管疾病院前急救的关联性分析

目的 探讨银川市空气污染物与心脑血管疾病院前急救之间的关联。方法 收集2018年1月1日—2020年12月31日银川市人群心脑血管疾病院前急救资料、大气污染物(PM_2.5、PM₁₀、CO、SO₂、NO_x、O₃)和气象数据(平均温度、相对湿度),并作相关性分析。采用广义相加模型(GAM),在控制了星期几效应、气象因素后,研究大气污染物对心脑血管疾病发病的效应。结果 单污染物滞后模型结果显示PM₁₀在升高一个浓度单位后,在其滞后第五天心脑血管疾病的院前急救量增加,ER为0.056 6(95%CI:0.159 0～0.973 0);而O₃浓度在升高一个单位后,在其滞后的第三天和第六天使心脑血管疾病的院前急救量有所减少,其ER值分别为-0.101 0(95%CI:-0.195 2～-0.006 7),-0.114 1(95%CI:-0.207 9～-0.020 2)。在单污染物累积滞后模型中,O₃的累积效应呈负趋势,而N...     

2009—2018年湖南省手足口病时空分布与气象因子关系研究

目的 回顾性分析2009—2018年湖南省14个市州手足口病时空分布与病原学特征,开展与气象因子相关性及预测模型研究。 方法 采用SQLSEVER 2008、Excel 2016处理数据,ARGGIS制作图表,SPSS 22.0统计软件进行相关性分析,多元线性逐步回归法进行预测,赋值评价法进行风险区划研究。 结果 2009—2018年湖南省共报告手足口病患者1 402 027例,年发病率5.05/万～31.94/万,年均发病率20.92/万;重症患者10 248例,年重症率在0.18%～1.64%,年均重症率为0.73%;死亡275例,年均死亡率0.02%;发病人群主要在6岁以下,占97.50%;男女比例1.58∶1;年发病人数与年降水量、年日照时数相关系数r_s=0.661、-0.661,P=0.038、0.038;月发病人数与月均气压、月均气温、月均相对湿度、月均降水量的相关系数r_s=-0.446、0.423、0.288、0.542,P=0.000、0.000、0.002、0.000。 结论 2009—2018年湖南省手足口病发病率整体呈上升趋势,偶数年高发,4—7月、9—11月为高峰期,6岁以下散居和幼托儿童为主,男性高于女性;月发病人数与月均降水量、月均气温、月均日照时数显著相关;高风险发病地区位于长沙、娄底、湘西州、湘潭、益阳、岳阳。     

气温变化与心脑血管疾病急诊关系的病例交叉研究

目的 探讨北京市日平均气温与心脑血管疾病急诊(ICD-10:I00～I99)的关系,研究气温变化对心脑血管疾病的影响.方法 收集北京大学第三医院急诊科心脑血管疾病急诊资料、北京市气象资料和北京市大气污染物数据,应用时间分层的病例交叉设计研究方法分析春季(3-5月)、夏季(6-8月)、秋季(9-11月)、冬季(12-2月)日平均气温与心脑血管疾病急诊的关系.结果 在控制二氧化硫(SO2)、二氧化氮(NO2)及大气可吸入颗粒物(PM10)影响的情况下,春季、夏季、秋季、冬季当日平均气温对心脑血管疾病急诊的影响最大,平均气温每升高1℃与心脑血管疾病急诊的OR值分别为1.282(95%CI:1.250 ～1.315)、1.027(95% CI:1.001～1.055)、0.661(95% CI:0.637～0.687)、0.960(95%CI:0.937～0.984),关联有统计学意义(P<0.05).当同时调整相对湿度、风速、大气压强的影响时,春季、夏季、秋季、冬季平均气温与心脑血管疾病急诊的OR值分别为1.423(95%CI:1.377～1.471)、1.082(95%CI:1.041～1.124)、0.633(95%CI:0.607～0.660)、0.971(95%CI:0.944～1.000).关联有统计学意义(P<0.05).结论 春季、夏季日平均气温升高可以导致心脑血管疾病急诊人次增加,说明春夏季气温升高对心脑血管疾病患者是危险因素,应注意防暑;秋季、冬季气温升高可以导致心脑血管疾病急诊减少,说明秋冬季气温升高对心脑血管疾病患者是保护性因素,应注意保暖.     

基于DLNM模型探讨江阴市手足口病发病与气象因素之间的关联

  目的  探讨气象因素对江阴市手足口病(hand foot and mouth disease,HFMD)发病情况的影响。  方法  采用分布滞后非线性模型(distributed lag non-linear model,DLNM)分析2012-2017年江阴市气象因素对HFMD发病的累计效应及滞后效应。  结果  2012-2017年江阴市共报告HFMD 21 791例,HFMD日发病数与日均气温(r_s=0.402,P < 0.001)、日均气压(r_s=-0.453,P < 0.001)、日均相对湿度(r_s=0.075,P < 0.001)均存在相关性。DLNM拟合结果显示,日均温度11℃时对HFMD发病的累计效应最高(RR=1.473,95% CI:1.099~1.974),并在当天即对HFMD发病产生最大影响(RR=1.090,95% CI:1.045~1.136);日均相对湿度85%时对HFMD发病的累计效应最高(RR=1.346,95% CI:1.154~1.571),对HFMD发病影响在第6 d达到高峰(RR=1.023,95% CI:1.015~1.031);日均气压1 010.0 hpa时对HFMD发病的累计效应最高(RR=1.221,95% CI:1.020~1.463),但在该气压水平并未观察到滞后效应。  结论  气象因素对江阴市HFMD发病存在影响,气温和湿度存在明显的滞后效应。