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期刊信息/Journal information
中华流行病学杂志
中华流行病学杂志

李立明

月刊

0254-6450

lxbonly@public3.bta.net.cn

010-58900730

102206

北京市昌平区昌百路155号传染病所B115

中华流行病学杂志/Journal Chinese Journal of EpidemiologyCSCD北大核心CSTPCD
查看更多>>中华医学会主办。本刊是流行病学及其相关学科的高级专业学术期刊, 是国内预防医学和基础医学核心期刊、国家科技部中国科技论文统计源期刊，2004-2009年被中国科学技术信息研究所和中国科技论文与引文数据库(CSTPCD)定为“百种中国杰出学术期刊”，并被美国国立图书馆医学文献联机数据库（Medline）和美国化学文摘（CA）收录。读者对象为医学（预防医学、临床医学、基础医学及流行病学科研与教学）和健康相关学科的科研、疾病控制、临床、管理和教学工作者。本刊设有述评、论著（原著）包括现场调查、监测、实验室研究、临床研究、基础理论与方法，疾病控制、国家课题总结、国外杂志华人研究导读、文献综述、问题与探讨等重点栏目。
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    体力活动与成年人缺血性脑卒中发病关联的前瞻性研究

    王浩谢开婿陈玲琍曹元...
    325-330页
    查看更多>>摘要：目的 探讨体力活动和成年人缺血性脑卒中发病的关联。 方法 使用中国慢性病前瞻性研究浙江省桐乡市数据，剔除基线时自报患有恶性肿瘤、心脏病、脑卒中和糖尿病患者后，纳入分析30~79岁53 916名研究对象。体力活动分组采用五分位数。采用Cox比例风险回归模型计算缺血性脑卒中发病风险比（HR）值。 结果 调查对象体力活动水平为（30.63±15.25）代谢当量（MET）-h/d，男性体力活动水平［（31.04±15.48）MET-h/d］高于女性［（30.33±15.07）MET-h/d］（P<0.001）。调查对象累计随访595 526人年（平均随访11.4年）。随访期间，1 138名男性和1 082名女性被新诊断为缺血性脑卒中。在调整了社会人口学因素、行为生活方式、BMI、腰围和SBP等多种危险因素后，缺血性脑卒中发病风险随体力活动的增加而降低，趋势检验结果均有统计学意义（P<0.001）。与体力活动最低组（<16.17 MET-h/d）人群相比，中低组（16.17~24.94 MET-h/d）、中等组（24.95~35.63 MET-h/d）、中高组（35.64~43.86 MET-h/d）和最高组（≥43.87 MET-h/d）人群缺血性脑卒中发病HR值分别为0.93（95%CI：0.83~1.04）、0.87（95%CI：0.76~0.98）、0.82（95%CI：0.71~0.95）和0.76（95%CI：0.64~0.89）。 结论 增加体力活动可以降低缺血性脑卒中的发病风险。 Objective To explore the prospective associations between physical activity and incident ischemic stroke in adults. Methods Data of China Kadoorie Biobank study in Tongxiang of Zhejiang were used. After excluding participants with cancers, strokes, heart diseases and diabetes at baseline study, a total of 53 916 participants aged 30-79 years were included in the final analysis. The participants were divided into 5 groups according to the quintiles of their physical activity level. Cox proportional hazard regression models was used to calculate the hazard ratios (HR) for the analysis on the association between baseline physical activity level and risk for ischemic stroke. Results The total physical activity level in the participants was (30.63±15.25) metabolic equivalent (MET)-h/d, and it was higher in men [(31.04±15.48) MET-h/d] than that in women [(30.33±15.07) MET-h/d] (P<0.001). In 595 526 person-years of the follow-up (average 11.4 years), a total of 1 138 men and 1 082 women were newly diagnosed with ischemic stroke. Compared to participants with the lowest physical activity level (<16.17 MET-h/d), after adjusting for socio-demographic factors, lifestyle, BMI, waist circumference, and SBP, theHRs for the risk for ischemic stroke in those with moderate low physical activity level (16.17-24.94 MET-h/d), moderate physical activity level (24.95-35.63 MET-h/d), moderate high physical activity level (35.64-43.86 MET-h/d) and the highest physical activity level (≥43.87 MET-h/d) were 0.93 (95%CI: 0.83-1.04), 0.87 (95%CI: 0.76-0.98), 0.82 (95%CI: 0.71-0.95) and 0.76 (95%CI: 0.64-0.89), respectively. Conclusion Improving physical activity level has an effect on reducing the risk for ischemic stroke.

    缺血性脑卒中体力活动前瞻性研究

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    苏州市成年人睡眠时长与慢性阻塞性肺疾病发病风险关联的前瞻性研究

    杨梦诗范习康苏健宛星霖...
    331-338页
    查看更多>>摘要：目的 探讨苏州市成年人睡眠时长与慢性阻塞性肺疾病（COPD）发病的前瞻性关联。 方法 利用中国慢性病前瞻性研究苏州市吴中区项目点53 269名30~79岁调查对象的基线和随访信息，基线调查开展于2004-2008年，本研究使用的数据随访截至2017年12月31日。剔除基线气流阻塞者、基线调查时自报患有慢性支气管炎/肺气肿/肺心病、数据异常或缺失的研究对象后，最终纳入分析45 336名。利用Cox比例风险回归模型分析睡眠时长与COPD发病风险的关联，并计算发病风险比（HR）值及其95%CI。按照年龄、性别、生活方式等因素进行分层分析，根据吸烟状况和每日睡眠时长交叉分组进行联合分析。 结果 研究对象中位随访时间为11.12年，随访期间共诊断COPD 515名。调整潜在混杂因素后，多因素Cox比例风险回归分析显示，每日睡眠时长≥10 h增加COPD发病风险（HR=1.42，95%CI：1.03~1.97）。联合分析结果显示，睡眠时长过长（≥10 h）可显著增加吸烟者COPD发病风险（HR=2.49，95%CI：1.35~4.59，交互作用P<0.001）。 结论 每日睡眠时长过长（≥10 h）可以增加苏州市成年人中COPD发病风险，在吸烟者中更加明显。 Objective To investigate the prospective association of sleep duration with the development of chronic obstructive pulmonary disease (COPD) in adults in Suzhou. Methods The study used the data of 53 269 participants aged 30-79 years recruited in the baseline survey from 2004 to 2008 and the follow-up until December 31, 2017 of China Kadoorie Biobank (CKB) conducted in Wuzhong District, Suzhou. After excluding participants with airflow limitation, self-reported chronic bronchitis/emphysema/coronary heart disease history at the baseline survey and abnormal or incomplete data, a total of 45 336 participants were included in the final analysis. The association between daily sleep duration and the risk for developing COPD was analyzed by using a Cox proportional hazard regression model, and the hazard ratio (HR) values and their 95%CI were calculated. The analysis was stratified by age, gender and lifestyle factors, and cross-analysis was conducted according to smoking status and daily sleep duration. Results The median follow-up time was 11.12 years, with a total of 515 COPD diagnoses in the follow-up. After adjusting for potential confounders, multifactorial Cox proportional hazard regression analysis showed that daily sleep duration ≥10 hours was associated with higher risk for developing COPD (HR=1.42, 95%CI: 1.03-1.97). The cross analysis showed that excessive daily sleep duration increased the risk for COPD in smokers (HR=2.49, 95%CI: 1.35-4.59, interaction P<0.001). Conclusion Longer daily sleep duration (≥10 hours) might increase the risk for COPD in adults in Suzhou, especially in smokers.

    慢性阻塞性肺疾病睡眠时长前瞻性研究

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    上海市2014-2021年肠道门诊15岁及以上感染性腹泻病例中致泻性大肠埃希菌流行特征分析

    林声郑雅旭宫霄欢肖文佳...
    339-346页
    查看更多>>摘要：目的 了解上海市肠道门诊≥15岁感染性腹泻病例中致泻性大肠埃希菌（DEC）流行特征，为DEC感染性腹泻防控策略的制定提供科学依据。 方法 采用多阶段系统抽样方法，在上海市22家监测点医疗机构的肠道门诊开展腹泻症状监测，收集病例的人口学、临床和流行病学资料，同时采集病例粪便标本，送至医疗机构所在区CDC开展DEC检测及鉴定分型，分析比较2014-2021年不同人群和季节的DEC阳性率。统计学分析采用χ2检验。 结果 在15 185例感染性腹泻病例中，DEC的总阳性率为8.05%（1 222/15 185）。其中男性阳性率（8.74%，684/7 824）高于女性（7.31%，538/7 361），15~29岁组人群阳性率最高（9.14%，335/3 665），2021年阳性率最高（10.21%，83/813），以上差异有统计学意义（均P<0.05）。DEC阳性PCR菌型鉴定分离出菌株1 264株中，肠产毒性大肠埃希菌为主（50.24%，635/1 264），其次是肠黏附性大肠埃希菌（27.93%，353/1 264）和肠致病性大肠埃希菌（21.36%，270/1 264）。DEC存在明显季节性流行特征，夏季阳性率最高（13.92%，774/5 562）（χ2=495.73，P<0.001）。 结论 DEC是2014-2021年上海市感染性腹泻患者重要病原体之一，引起的感染性腹泻全年均可发生，夏秋季高发，流行型别为肠产毒性大肠埃希菌、肠黏附性大肠埃希菌和肠致病性大肠埃希菌。应针对不同年龄、不同季节和不同型别的DEC感染性腹泻采取特异性的防控措施。 Objective . To understand the epidemiological characteristics of diarrheagenic Escherichia (E. ) coli infection in infectious diarrhea outpatients aged 15 years and older in Shanghai and provide evidence for the development of disease control strategies Methods Based on multistage systematic sampling, diarrhea surveillance was conducted in 22 sentinel hospitals in Shanghai, the information about cases' demographic, clinical, and epidemiological characteristics were collected. Stool samples were collected for the detection and typing of diarrheagenic E. coli by local centers for disease control and prevention. The positive rate of diarrheagenic E. coli in different populations and seasons from 2014 to 2021 were analyzed. Statistical analysis was conducted by using χ2 test. Results In 15 185 diarrhea cases, 8.05% (1 222/15 185) were positive for diarrheagenic E. coli. The positive rate was higher in men (8.74%, 684/7 824) than in women (7.31%, 538/7 361). The positive rate was highest in age group 15-29 years (9.14%, 335/3 665) and the annual positive rate was highest in 2021 (10.21%, 83/813), the differences were all significant (P<0.05). In the 1 264 strains of diarrheagenicE. coli analyzed through PCR, enterotoxingenic E. coli was the most frequently identified pathogen (50.24%, 635/1 264), followed by enteroadhesiveE. coli (27.93%, 353/1 264), and enteropathogenicE. coli (21.36%, 270/1 264). The positive rate of diarrheagenic E. coli showed obvious seasonality with peak in summer (13.92%, 774/5 562) (χ2=495.73, P<0.001). Conclusions Diarrheagenic E. coli has become a prominent pathogen in infectious diarrhea cases in Shanghai, the disease can occur all the year round with incidence peak during summer and autumn. Predominant subtypes included enterotoxingenic E. coli, enteroadhesiveE. coli and enteropathogenicE. coli. Targeted prevention and control strategies are needed for diarrheagenic E. coli-induced infectious diarrhea in different age groups, seasons and for different types of infections.

    哨点监测肠道门诊感染性腹泻致泻性大肠埃希菌流行特征

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    河北省卢龙县2010-2020年哨点监测5岁以下儿童病毒性腹泻病原学特征分析

    赵文娜苏通刘莹莹于秋丽...
    347-352页
    查看更多>>摘要：目的 分析河北省哨点监测<5岁儿童病毒性腹泻病原学特征，为儿童病毒性腹泻科学防控提供参考依据。 方法 收集2010-2020年河北省卢龙县哨点监测医院<5岁腹泻住院病例粪便标本。采用ELISA法检测轮状病毒抗原，轮状病毒分型采用半巢式两轮RT-PCR方法。杯状病毒检测及分型、星状病毒和肠道腺病毒检测均采用实时荧光定量PCR方法。采用SPSS 20.0软件对数据进行统计学分析。 结果 共检测2 925例粪便标本，病原总体阳性率为65.61%（1 919/2 925）。轮状病毒、杯状病毒、肠道腺病毒和星状病毒阳性率分别为42.80%（1 252/2 925）、22.12%（647/2 925）、6.19%（181/2 925）、3.56%（104/2 925）。2010-2017年病毒性腹泻主要以轮状病毒感染为主（59.30%，1 017/1 715），2018-2020年以杯状病毒感染为主（53.43%，109/204）。轮状病毒阳性率峰值出现在冬季，以12~17月龄婴幼儿最高（52.96%，483/912）。轮状病毒阳性标本，G/P分型以G9P［8］型为主（58.31%，730/1 252），其次为G3P［8］型（8.15%，102/1 252）。杯状病毒以诺如病毒Ⅱ组为主，2011-2016年和2018年优势基因型分别为GⅡ.4［P31］型和GⅡ.3［P12］型。 结论 轮状病毒和杯状病毒是2010-2020年河北省卢龙县<5岁儿童病毒性腹泻的优势病原体，冬季为主要流行季节。 Objective To analyze pathogenic characteristics of viral diarrhea in children aged <5 years in Hebei Province and provide reference for the prevention and control of viral diarrhea in children. Methods Stool samples were collected from in-patients with diarrhea under five years old from sentinel hospitals in Lulong County of Hebei between 2010 and 2020. ELISA detected rotavirus antigen, and then positive samples were genotyped by semi nested reverse transcription PCR of two rounds. Calicivirus, genotyping astrovirus, and adenovirus were detected by real-time fluorescence quantification PCR. The data were analyzed by using software SPSS 20.0. Results In 2 925 detected stool samples, 1 919 (65.61%) were positive. The positive rates of rotavirus, calicivirus, adenovirus, and astrovirus were 42.80% (1 252/2 925), 22.12% (647/2 925), 6.19% (181/2 925), 3.56% (104/2 925). Viral diarrhea was mainly caused by rotavirus infection, accounting for 59.30% (1 017/1 715) between 2010 and 2017, and by calicivirus infection accounting for 53.43% (109/204) between 2018 and 2020. The peak positive rate of rotavirus occurred in winter, with the highest rate in infants aged 12 to 17 months (52.96%,483/912). In the rotavirus positive samples, G9P[8] was mainly detected strains (58.31%,730/1 252), followed by G3P[8] (8.15%,102/1 252). The calicivirus-positive samples were mainly infected with norovirus GⅡ. Sequence analysis indicated that the main type was GⅡ.4 [P31] between 2011 and 2016 and GⅡ.3 [P12] in 2018. Conclusions Rotavirus and calicivirus were the main pathogens causing infant diarrhea in children under five years old in Hebei from 2010 to 2020. Winter was the main epidemic season.

    病毒性腹泻轮状病毒杯状病毒星状病毒肠道腺病毒

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    天津市2019-2022年新报告HIV感染者抗病毒治疗前病毒载量基线特征分析

    赵璇候金余朱静瑾郑敏娜...
    353-357页
    查看更多>>摘要：目的 了解天津市新报告HIV感染者抗病毒治疗前病毒载量（VL）基线特征及相关因素。 方法 资料来源于中国疾病预防控制信息系统，研究对象为天津市2019-2022年新报告且首次抗病毒治疗前HIV感染者，收集其社会人口学特征、CD4+T淋巴细胞（CD4）计数及VL值等基线信息，基线高VL值定义标准为≥100 000拷贝数/ml，分析影响VL水平的相关因素。采用SPSS 24.0软件进行统计学分析。 结果 研究对象新报告HIV感染者共1 296例，其中，基线高VL值的HIV感染者占15.89%（206/1 296）。多因素logistic回归分析结果显示，有STD史者（aOR=1.45，95%CI：1.00~2.08），基线高VL值的可能性较大；相比于基线CD4计数<200个/µl者，基线CD4计数分别为200~350个/μl（aOR=0.40，95%CI：0.27~0.57）、351~500个/μl（aOR=0.32，95%CI：0.20~0.49）和>500个/µl者（aOR=0.30，95%CI：0.18~0.49）的基线高VL值的可能性较小。 结论 2019-2022年天津市HIV感染者抗病毒治疗前基线VL值高的比例较低，HIV感染者基线VL值高的相关因素为有STD史和基线CD4计数<200个/µl，艾滋病防控工作应给予重点关注。 Objective To understand the baseline viral load (VL) of newly reported HIV- infected patients before antiretroviral therapy and related factors in Tianjin. Methods Data were obtained from the China Disease Control and Prevention Information System, and the study subjects were HIV-infected patients before the first antiretroviral therapy in Tianjin from 2019 to 2022, and the information about their socio-demographic characteristics, baseline CD4+T lymphocyte (CD4) counts before antiretroviral therapy and baseline VL test results were collected, the baseline high VL was defined as ≥100 000 copies/ml. The effect of different factors on viral load were analyzed. Software SPSS 24.0 was used for statistical analysis. Results A total of 1 296 newly reported HIV-infected patients were included in the study, in whom 15.89% (206/1 296) had high baseline VL, and multifactorial logistic regression analysis showed that those with history of STD (aOR=1.45, 95%CI:1.00-2.08) were more likely to have high baseline VL. Compared with those with baseline CD4 counts <200 cells/μl, those with baseline CD4 counts 200-350 cells/μl (a OR=0.40, 95%CI: 0.27-0.57), 351-500 cells/μl (aOR=0.32, 95%CI: 0.20-0.49), and >500 cells/μl (a OR=0.30, 95%CI: 0.18-0.49) were less likely to have high baseline VL. Conclusions The proportion of HIV-infected patients with high baseline VL before antiretroviral therapy was low in Tianjin during 2019-2022. History of STD and baseline CD4 counts <200 cells/μl were associated with high baseline VL in HIV-infected patients, to which close attention needs to be paid in AIDS prevention and control.

    艾滋病病毒病毒载量抗病毒治疗基线

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    德宏傣族景颇族自治州HIV感染者抗病毒治疗后新发糖尿病及影响因素分析

    叶润华张韵秋曹东冬时允...
    358-364页
    查看更多>>摘要：目的 分析德宏傣族景颇族自治州（德宏州）HIV感染者启动抗病毒治疗（ART）后新发糖尿病及影响因素、随访血糖变化趋势及死亡风险。 方法 资料来源于中国疾病预防控制信息系统，采用回顾性队列研究方法，纳入2004-2020年启动ART的HIV感染者为研究对象。采用Cox比例风险回归模型分析研究对象的糖尿病新发率及影响因素，采用混合线性效应模型分析其FPG变化趋势，预测基线不同糖代谢状态者随访FPG值。采用SAS 9.4软件进行统计学分析。 结果 在8 763例研究对象中，基线糖尿病患者331例，未患糖尿病者占96.2%（8 432/8 763），新发糖尿病的发病密度为2.31/1 000人年。Cox比例风险回归模型多因素分析结果显示，HIV感染者启动ART后新发糖尿病的危险因素包括30~59岁、基线BMI≥24.0 kg/m2、基线ART方案含依非韦伦（EFV）和基线空腹血糖受损（IFG）。混合效应模型分析结果显示，ART后HIV感染者FPG值与ART时长、年龄、基线FPG呈正相关。基线和随访均患糖尿病的HIV感染者死亡风险显著增高。 结论 2004-2020年德宏州HIV感染者启动ART后，在高龄、超重、基线ART方案使用EFV和IFG的HIV感染者中，糖尿病发病风险较高，应重点监测HIV感染者FPG情况，加强随访和糖尿病的科学防治。 Objective To understand the incidence of diabetes and influencing factors, the trend of FPG change and risk for mortality in HIV-infected individuals after antiretroviral therapy (ART) in Dehong Dai and Jingpo Autonomous Prefecture (Dehong). Methods The HIV/AIDS treatment database was collected from China Information System for Disease Control and Prevention. This retrospective cohort study was conducted in HIV-infected individuals with access to ART in Dehong during 2004-2020.The Cox proportional hazard regression model was used to analyze the incidence density of diabetes, the influencing factors and risk for mortality in HIV-infected individuals with access to ART, mixed linear effects model was used to analyze the trend of FPG change and predict FPG in those with different glucose metabolic status at baseline survey. Statistical analysis was performed using software SAS 9.4. Results A total of 8 763 HIV-infected individuals were included, in whom 8 432 (96.2%) had no diabetes, 331 had diabetes. The incidence density of diabetes was 2.31/1 000 person years. Multivariate Cox proportional hazard regression analysis revealed that 30- 59 years old, BMI ≥24.0 kg/m2, Efavirenz (EFV) based initial treatment regimen and impaired fasting glucose (IFG) at baseline survey were significantly and positively associated with incidence of diabetes. Mixed effect model revealed that FPG was positively correlated with the duration of ART, age and baseline FPG. Suffering from diabetes was a risk factor for mortality in HIV-infected individuals both at baseline survey and during follow-up. Conclusions The risk for diabetes increased in HIV-infected individuals who were 30-59 years old, baseline BMI ≥24.0 kg/m2, received EFV based initial treatment, and IFG in HIV-infected individuals after antiretroviral therapy in Dehong, 2004-2020. It is important to pay close attention to their blood glucose, and patients with high blood glucose should receive treatment as early as possible.

    艾滋病病毒新发糖尿病影响因素

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    广东省1990-2019年急性病毒性肝炎疾病负担分析

    邱嘉敏曾芳芳程琛温卉妍...
    365-372页
    查看更多>>摘要：目的 了解1990-2019年广东省急性病毒性肝炎的疾病负担情况及变化趋势，为广东省肝炎防治提供参考依据。 方法 资料来源于2019全球疾病负担研究数据库广东省1990-2019年的相关数据。急性病毒性肝炎包括甲型肝炎（甲肝）、乙型肝炎（乙肝）、丙型肝炎（丙肝）和戊型肝炎（戊肝）。对不同时期的分年龄、性别构成的发病、死亡以及伤残调整寿命年（DALY）数据进行描述与分析，以及年估计变化百分比（EAPC），以描述急性病毒性肝炎疾病负担的变化趋势。 结果 1999- 2019年广东省急性病毒性肝炎疾病负担均呈逐年下降趋势，其中死亡率与DALY年龄标化率下降趋势尤为明显。2019年在急性病毒性肝炎患者4 365 221例中，急性乙肝患者占51.43%（2 245 087例），而急性乙肝的死亡病例占急性病毒性肝炎死亡病例的77.18%（106/138）。在不同年龄组中，除急性乙肝高发于成年人外，急性甲肝、急性乙肝和急性戊肝等其他肝炎发病率总体随着年龄增长呈下降趋势。除<5岁年龄组的急性病毒性肝炎死亡率稍高外，其他年龄组的急性病毒性肝炎死亡率均随年龄增长呈上升趋势。男性的急性病毒性肝炎总体发病率和死亡率均高于女性。 结论 1999-2019年广东省急性病毒性肝炎疾病负担总体有所下降，但始终高于全国平均水平，须进一步加强对广东省不同人群尤其是儿童及老年人的肝炎预防与筛查工作。 Objective To examine the burden and trends of acute viral hepatitis in Guangdong Province from 1990 to 2019, and provide reference evidences for hepatitis prevention and control in the province. Methods Data on acute viral hepatitis (hepatitis A, B, C, and E) in Guangdong from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019 database. The incidence, prevalence, mortality, and disability-adjusted life years (DALY) data were analyzed by age and gender, and the estimated annual percentage change (EAPC) was calculated to describe the changing trends in disease burden. Results From 1999 to 2019, the standardized incidence, prevalence, mortality, and DALY of acute viral hepatitis in Guangdong were higher than the national averages. In 2019, 51.43% (2 245 087/4 365 221) of acute viral hepatitis cases in Guangdong Province were mainly attributed to hepatitis B, and 77.18% (106/138) of deaths were due to acute hepatitis B. In different age groups, except for acute hepatitis B, which was more common in adults, the incidence rates of other types of viral hepatitis such as hepatitis A, B, and E showed an overall decreasing trend with age. The mortality rates of different types of acute viral hepatitis, except for the <5 age group, increased with age. The overall incidence and mortality rates of acute viral hepatitis were higher in men than in women. Conclusions The overall burden of acute viral hepatitis in Guangdong declined in 2019, but remained higher than the national level. Further efforts are needed to strengthen hepatitis prevention and screening in different population in Guangdong Province, especially in children and the elderly.

    急性病毒性肝炎疾病负担趋势分析

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    天津市1999-2021年0~14岁儿童伤害死亡谱及城乡差异分析

    张爽张辉郑文龙王德征...
    373-378页
    查看更多>>摘要：目的 分析天津市0~14岁儿童伤害死亡谱的特征、变化情况及城乡差异。 方法 1999-2021年天津市儿童伤害死亡数据来源于天津市全人口全死因监测数据库，计算不同亚组人群和主要伤害原因的构成比、粗死亡率和标化死亡率并比较城乡差异。采用Cochran-Armitage趋势检验分析死亡原因构成比的时间变化趋势。采用Joinpoint回归分析变化趋势，计算平均年变化百分比（AAPC）。伤害死亡风险的季节差异用死亡率比值及其95%CI表示。 结果 1999-2021年，伤害是天津市0~14岁儿童的第3位死因。农村儿童死于医疗卫生机构的比例为31.08%，低于城市的37.82%。儿童伤害的总体标化死亡率呈下降趋势（AAPC=-5.54%，P<0.001）。溺水和道路交通伤害的标化死亡率在城市和农村地区呈下降趋势（P<0.001）。意外中毒的标化死亡率仅在农村地区呈下降趋势（AAPC=-8.09%，P<0.001），在城市地区无明显变化趋势（P>0.05）。自杀标化死亡率在城市地区无明显变化趋势（P>0.05），在10~14岁农村儿童中呈上升趋势（AAPC=4.58%）。跌倒/坠落标化死亡率在城市和农村地区均无明显变化趋势（P>0.05）。伤害死亡的总体风险和溺水死亡风险在城乡均为夏季最高；道路交通伤害在城市为秋季最高，在农村为夏季最高；意外中毒死亡风险在城乡均为冬季最高。 结论 近年来天津市儿童伤害死亡情况得到明显改善。城市和农村地区的儿童伤害死亡水平仍存在较大差异，在未来政策制定中，应充分考虑缩小城乡差距。 Objective To analyze the characteristics, change of injury death spectrum in children aged 0-14 years and its urban-rural difference in Tianjin. Methods The incidence data of injury death in children aged 0-14 years in Tianjin from 1999 to 2021 were collected from the "Population Based Mortality Surveillance System in Tianjin". We calculated constituent ratio, crude and standardized mortality rates in different subgroups of the population and major injury subtypes, and compared the rural-urban differences. The Cochran-Armitage trend test was used to analyze temporal trends in cause-of-death component ratios. Joinpoint regression model was used to calculate average annual percent change (AAPC). Seasonal difference in injury mortality risk were expressed as mortality ratio and 95% confidence interval. Results From 1999 to 2021, injury was the third cause of death in children aged 0-14 years in Tianjin. The percentage of children who died in health-care facilities in rural area was 31.08%, which was lower than 37.82% in urban area. There was a downward trend in the standardized mortality rate of injury in children (AAPC=-5.54%, P<0.001). The standardized mortality rates of drowning and road traffic injury declined in both urban area and rural area (P<0.001). The mortality rate of accidental poisoning decreased in rural area (AAPC=-8.09%,P<0.001), but showed no significant change trend in urban area (P>0.05). The standardized mortality rate of suicide showed no significant change trend in urban area, but there was an increasing trend in the standardized mortality rate of suicide in rural children aged 10-14 years (AAPC=4.58%). No significant change trend was observed in mortality rate of falls in urban and rural children (P>0.05). The injury mortality rate showed obvious seasonality in children in Tianjin. Overall injury death risk and risk for drowning-caused death were highest in summer in both urban area and rural area. The risk for road traffic injury-related death was highest in autumn in urban area and in summer in rural area. The risk for death caused by accidental poisoning was highest in winter in both urban area and rural area. Conclusions In recent decades, the injury mortality rate in children aged 0-14 years in Tianjin showed a decreasing trend. There is still a significant difference in the injury mortality level between urban area and rural area, to which close attention needs to be paid in the future policy development.

    伤害死亡率儿童城乡差异

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    我国布鲁氏菌病重点地区高风险职业人群个人防护用品使用及影响因素分析

    王哲林胜红刘新荣于爱枝...
    379-384页
    查看更多>>摘要：目的 了解我国布鲁氏菌病（布病）高风险职业人群个人防护行为现状，为评估我国布病防治计划实施效果提供科学依据。 方法 选择山西省和新疆维吾尔自治区的4个县，采用横断面调查方法，于2019年12月至2020年7月对布病高风险职业人群开展问卷调查。 结果 共调查高风险职业人群2 384人，个人防护用品规范使用率为20.13%（480/2 384），手套、口罩、胶鞋和工作服4种主要个人防护用品的使用率分别为38.26%（912/2 384）、31.80%（758/2 384）、32.01%（763/2 384）和30.87%（736/2 384）。不同年龄、职业、文化程度、地区的人群不同防护用品的使用率和规范使用率的差异有统计学意义（均P<0.001），≥60岁、女性、农民、文化程度较低的人群各种防护用品的使用率和规范使用率均较低。多因素分析结果显示，职业和地区是布病个人防护用品规范使用的影响因素，牧民和兽医的个人防护用品规范使用率更高；阳高县和霍城县的高风险职业人群的个人防护用品规范使用率明显高于左云县和浑源县。 结论 我国布病重点地区高风险职业人群4种主要个人防护用品使用率均不高，规范使用率低，不同地区差异很大，与防治计划目标差距较大，亟需向高风险职业人群发放防护用品，并开展易于接受的个人防护使用的宣教活动，加强各地经验交流和沟通。 Objective To understand the current status of personal protection in occupational population at high risk for brucellosis in China and provide evidence for the evaluation of implementation of National Brucellosis Prevention and Control Plan (2016-2020). Methods Four counties in Shanxi Province and Xinjiang Uygur Autonomous Region were selected to conduct a questionnaire survey in occupational population at high risk for brucellosis from December 2019 to July 2020 by using cross-sectional survey methods. Results A total of 2 384 persons at high risk for brucellosis were surveyed, and the standardized utilization rate of personal protective equipment (PPE) was 20.13% (480/2 384). The utilization rate of glove, mask, rubber shoe, and work cloth were 38.26% (912/2 384), 31.80% (758/2 384), 32.01% (763/2 384) and 30.87% (736/2 384),respectively. There were significant differences in the utilization rate and standardized utilization rate of the four types of PPE among populations in different age, occupation, educational level and area groups (all P<0.001). The utilization rate and standardized utilization rate of PPE were lower in people over 60 years old, women, farmers, and those with lower educational level. The results of multivariate analysis showed that occupation and area were the influencing factors for the standardized utilization of PPE, the standardized utilization rates of PPE were higher in herdsmen and veterinarians. The standardized utilization rate of PPE in Yanggao County and Huocheng County was significantly higher than that in Zuoyun County and Hunyuan County. Conclusions The utilization rate of the four types of PPE in occupational population at high risk for brucellosis was not high in China, and the standardized utilization rate was low, lower than the requirement in National Brucellosis Prevention and Control Plan, and there were significant differences among different areas. It is urgent to distribute PPE to occupational population at high risk for brucellosis and carry out health education about PPE utilization. Meanwhile, it is necessary to strengthen information exchange or sharing among different areas.

    布鲁氏菌病高风险职业人群个人防护用品规范使用健康教育

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    老年人不健康生活方式与高血压、糖尿病和血脂异常的关联研究

    叶婷婷邵英余彬蔡长伟...
    385-392页
    查看更多>>摘要：目的 分析老年人不健康生活方式对高血压、糖尿病和血脂异常患病的影响及累积效应，并探索起关键作用的生活方式。 方法 基于2021年云南省行为与疾病监测队列的基线数据，选取年龄≥60岁的16 763名老年人作为研究对象。不健康生活方式包括吸烟、饮酒、不健康饮食、低体力活动、BMI异常和腰围异常，并使用每个研究对象暴露的累积数量来计算不健康生活方式得分。采用多因素logistic回归模型以及混合图模型，分析不健康生活方式与高血压、糖尿病和血脂异常之间的关系。 结果 老年人的高血压、糖尿病和血脂异常的患病率分别为57.0%、11.5%和37.0%。研究纳入的6种不健康生活方式大多数表现为高血压、糖尿病和血脂异常的危险因素，患病风险随不健康生活方式数量的累积而上升。与无不健康生活方式者相比，同时具有6种不健康生活方式者，患高血压、糖尿病和血脂异常的OR值分别为3.99（95%CI：1.81~8.80）、4.64（95%CI：1.64~13.15）和4.26（95%CI：2.08~8.73）。混合图模型构建的网络中腰围异常（桥强度=0.81）和高血压（桥强度=0.55）为连接不健康生活方式与高血压、糖尿病和血脂异常的关键“桥接节点”。 结论 老年人的不健康生活方式得分越高，高血压、糖尿病和血脂异常患病风险越大，腰围异常是不健康生活方式中的关键因素。 Objective To analyze the individual and cumulative effects of unhealthy lifestyle on the prevalence of hypertension, diabetes and dyslipidemia in old adults in China, and find out the critical lifestyle in the network. Methods Based on the baseline data of Yunnan Behavior and Disease Surveillance Cohort in 2021, a total of 16 763 older adults aged ≥60 years were included in our study. The unhealthy lifestyle factors including smoking, drinking, unhealthy eating habit, lower physical activity level, abnormal BMI and abnormal waist circumference. We calculated the unhealthy lifestyle score by using the cumulative exposures of each participant. Multiple logistic regression and mixed graphical models were used to describe the association between unhealthy lifestyle and the prevalence of hypertension, diabetes and dyslipidemia. Results The prevalence of hypertension, diabetes and dyslipidemia were 57.0%, 11.5% and 37.0%, respectively. Most of the unhealthy lifestyles included in the study were risk factors for hypertension, diabetes and dyslipidemia, and the risks of disease increased with the increase of the unhealthy lifestyle score. The participants with the highest score (score: 6) had significantly higher prevalence of hypertension (OR=3.99, 95%CI: 1.81-8.80), diabetes (OR=4.64, 95%CI: 1.64-13.15) and dyslipidemia (OR=4.26, 95%CI: 2.08-8.73) compared with those with lowest score (score: 0). In the network constructed by mixed graphical model, abnormal waist circumference (bridge strength=0.81) and hypertension (bridge strength=0.55) were vital bridge nodes connecting unhealthy lifestyle and hypertension, diabetes and dyslipidemia. Conclusions The unhealthy lifestyle score was associated with risks for hypertension, diabetes and dyslipidemia. Abnormal waist circumference was the key factor for chronic diseases in old adults.

    生活方式高血压糖尿病血脂异常网络分析

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