山东省2007－2016年丙型病毒性肝炎流行趋势与影响因素研究

目的 分析2007－2016年山东省丙型病毒性肝炎（丙肝）疫情的流行病学特征，探索丙肝发病的影响因素，为制定防治策略提供依据。方法 收集2007年1月1日至2016年12月31日山东省丙肝发病监测数据，在县级单位上探索空间聚集性；在地市级水平上应用面板poisson回归分析丙肝发病时空差异的主要影响因素。结果 山东省丙肝报告发病率自2007年1.49/10万上升到2016年4.72/10万。丙肝高发地区集中在济南市、淄博市、威海市的主城区，并逐渐向周围地区扩散。丙肝病例以青壮年为主，53.16%为农民（14 711/27 671）。多因素面板poisson回归分析结果显示：人口密度（aIRR=1.07，95% CI：1.05～1.10）、十万人拥有医院数（aIRR=1.16，95% CI：1.08～1.24）、农村人均年医疗费支出（aIRR=1.21，95% CI：1.08～1.37）、第三产业比重（aIRR=1.08，95% CI：1.07～1.09）与地区丙肝发病率呈正相关。结论 2007－2016年来山东省丙肝新发病例快速增长，丙肝防控工作应重点关注高危人群，要做好经济相对落后和农村地区的丙肝筛查，多发现隐匿感染者，做到丙肝的早发现、早治疗。

Epidemiological features of hepatitis C and its related influencing factors in Shandong province, 2007-2016

Objective To analyze the epidemiological characteristics, dynamic trend of development and related influencing factors of hepatitis C in Shandong, China, 2007-2016, also to provide epidemiological evidence for prevention and control of HCV. Methods National surveillance data of hepatitis C from 2007 to 2016 in Shandong was used, with distribution and clustering map of hepatitis C drawn at the county level. Panel Poisson regression was used to explore the influencing factors of hepatitis C at the city level. Results The incidence of hepatitis C in Shandong increased from 1.49/100 000 in 2007 to 4.72/100 000 in 2016, with the high incidence mainly clustered in the urban regions in Jinan, Zibo, Weihai et al. and surrounding vicinities. Majority of the cases were young adults, with 53.16% (14 711/27 671) of them being farmers. Results from the Multiple panel Poisson regression analysis indicated that factors as:population density (aIRR=1.07, 95% CI:1.05-1.10), number of hospital per hundred thousand people shared (aIRR=1.16, 95% CI:1.08-1.24), expenditure of medical fee in rural (aIRR=1.21, 95% CI:1.08-1.37) and the proportion of the tertiary industry (aIRR=1.08, 95% CI:1.07-1.09) were all correlated to the incidence of hepatitis C. Conclusions The incidence of hepatitis C had been increasing rapidly in recent years, in Shandong. Prevention and control of HCV should focus on high risk population. In addition, rural, especially in areas with lower economics provision should be under more attentions, so as to find more concealed cases for early treatment.