2004—2018年中国主要呼吸道传染病的流行趋势及特征

郑泽扬; 王众楷; 王连珂; 刘丹丹; 张白玉; 周乾宇; 贾善群; 沈俊如; 刘慧敏; 刘习羽; 孙长青

doi:10.16462/j.cnki.zhjbkz.2022.06.002

2004—2018年中国主要呼吸道传染病的流行趋势及特征

doi: 10.16462/j.cnki.zhjbkz.2022.06.002

1.
450001 郑州，郑州大学公共卫生学院社会医学与卫生事业管理教研室
2.
454000 焦作，焦作市中医院
3.
450001 郑州，郑州大学护理与健康学院社区护理教研室

基金项目:

国家社会科学基金项目 20BRK041

详细信息

通讯作者:
孙长青, E-mail: suncq@zzu.edu.cn

中图分类号: R183.3
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出版历程
- 收稿日期: 2021-12-15
- 修回日期: 2022-03-10
- 网络出版日期: 2022-06-16
- 刊出日期: 2022-06-10

Epidemiological trends and characteristics of major respiratory infectious diseases in China from 2004 to 2018

1.
Department of Social Medicine and Health Management, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
2.
Jiaozuo Hospital of Traditional Chinese Medicine, Jiaozuo 454000, China
3.
Department of Community Nursing, College of Nursing and Health, Zhengzhou University, Zhengzhou 450001, China

Funds:

National Social Science Foundation of China 20BRK041

More Information

Corresponding author: SUN Chang-qing, E-mail: suncq@zzu.edu.cn

摘要

摘要: 目的分析2004-2018年我国麻疹、肺结核、百日咳、流行性感冒(简称流感)、流行性腮腺炎、风疹以及猩红热的流行趋势及特征, 为明确我国呼吸道传染病防控重点提供科学依据。方法整理归纳2004-2018年我国7种呼吸道传染病的发病数据, 采用Joinpoint软件分析发病率的变化趋势。结果我国2004-2018年7种呼吸道传染病总报告23 903 628例, 年均发病率117.96/10万, 男性发病率高于女性, 主要发病人群为青少年和儿童, 高发于春冬季。我国主要呼吸道传染病发病率在2004-2016年呈下降趋势[年度变化百分比(annual percent change, APC)=-2.00%, P < 0.001], 但是在2016到2018年又有所回升(APC=15.00%, P=0.30)。肺结核和麻疹发病率呈下降趋势, 但流行性感冒、百日咳、猩红热的发病率呈上升趋势。结论中国呼吸道传染病自2016年以来发病率有所回升, 如何应对季节性流感的流行及新型流感的暴发、肺结核的高疾病负担及百日咳和猩红热的复燃, 是未来我国防控呼吸道传染病的重点。
- 中国 /
- 呼吸道传染病 /
- 流行趋势 /
- 监测
Abstract: Objective To analyze the epidemic trends and characteristics of measles, tuberculosis, pertussis, influenza, mumps, rubella and scarlet fever in China from 2004 to 2018, so as to provide evidence for defining the prevention and control priorities of respiratory infectious diseases in China. Methods The incidence data of 7 respiratory infectious diseases in China from 2004 to 2018 were summarized, and the trend of incidence rate was analyzed by the Joinpoint regression model. Results A total of 23 903 628 cases of 7 respiratory infectious diseases were reported in China from 2004 to 2018, with an average annual incidence of 117.96/100 000. The incidence was higher in males than in females, mainly in teenagers and children, with a higher incidence in spring and winter.In 2004-2016, the overall incidence of major respiratory infectious diseases in China declined significantly. (APC=-2.00%, P < 0.001). However, it increased from 2016 to 2018(APC=15.00%, P=0.30). The incidence of tuberculosis and measles decreased, but the incidence of influenza, whooping cough and scarlet fever increased. Conclusions The incidence of respiratory infectious diseases in China has been rising since 2016. How to deal with the epidemic of seasonal influenza and the outbreak of new influenza, the high disease burden of tuberculosis, and the resurgence of whooping cough and scarlet fever will be the focus of prevention and control of respiratory infectious diseases in China in the future.
- China /
- Respiratory infectious diseases /
- Prevalence trend /
- Surveillance

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图 1 2004—2018年全国主要呼吸道传染病发病趋势

Figure 1. Incidence trend of major respiratory infectious diseases in China from 2004 to 2018

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图 2 2004—2018年全国主要呼吸道传染病不同地区的发病情况

注：(a)呼吸道传染病、(b)肺结核、(c)流感、(d)麻疹、(e)百日咳、(f)猩红热、(g)流行性腮腺炎、(h)风疹。

Figure 2. Incidence of major respiratory infectious diseases in different regions of China from 2004 to 2018

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图 3 2004—2018年全国主要呼吸道传染病不同季节的发病情况

Figure 3. Incidence of major respiratory infectious diseases in China in different seasons from 2004 to 2018

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表 1 2004—2018年全国主要呼吸道传染病发病概况

Table 1. Incidence of major respiratory infectious diseases in China from 2004 to 2018

病种	发病人数(例)	年均发病率(1/10万)	构成比(%)
肺结核	14 816 329	73.31	61.96
流腮	4 269 946	21.10	17.85
流感	2 751 722	13.30	11.51
麻疹	797 833	4.00	3.34
猩红热	655 396	3.20	2.74
风疹	547 838	2.74	2.29
百日咳	74 249	0.31	0.31
总计	23 913 313	117.96	100.00
注：“流腮”为流行性腮腺炎。

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表 2 2004—2018年全国主要呼吸道传染病发病率时间趋势分析

Table 2. Time trend analysis of incidence of major respiratory infectious diseases in China from 2004 to 2018

病种	时间段(年)	APC(%)	(95% CI)值	t值	P值	AAPC(%)	(95% CI)值
风疹	2004—2008	57.40	20.5~105.7	3.80	< 0.001	-7.40	-17.6~4.1
	2008—2018	-25.10	-35.7~-12.7	-4.20	< 0.001
肺结核	2004—2018	-3.30	-4.3~-2.3	-7.20	< 0.001	-3.30	-4.3~-2.3
流感	2004—2015	7.30	-3.8~19.7	1.40	0.200	16.30	7.0~26.3
	2015—2018	55.80	30.8~85.6	5.60	< 0.001
流腮	2004—2012	8.70	3.4~14.2	3.90	< 0.001	0.80	-11.8~15.3
	2012—2015	-29.50	-63.2~35.3	-1.30	0.204
	2015—2018	18.20	-17.6~69.5	1.10	0.300
猩红热	2004—2018	8.30	4.9~11.8	5.40	< 0.001	8.30	4.9~11.8
麻疹	2004—2018	-9.10	-15.6~-2.1	-2.80	< 0.001	-9.10	-15.6~-2.1
百日咳	2004—2010	-17.40	-29.1~-3.8	-2.80	< 0.001	6.80	-0.0~14.1
	2010—2018	29.60	21.4~38.3	8.90	< 0.001
合计	2004—2016	-2.00	-3.8~-0.2	-2.40	< 0.001	0.30	-3.4~4.1
	2016—2018	15.00	-12.6~51.3	1.10	0.300
注：“流腮”为流行性腮腺炎。

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表 3 2004—2018年全国主要呼吸道传染病不同性别的发病情况

Table 3. Incidence of major respiratory infectious diseases in China by gender from 2004 to 2018

病种	男性		女性		性别比	χ²值	P值
病种	病例数(n)	发病率(1/10万)	病例数(n)	发病率(1/10万)	性别比	χ²值	P值
麻疹	469 216	4.72	328 617	3.32	1∶0.70	24 300.80	＜0.001
肺结核	9 466 913	95.28	4 532 884	45.77	1∶0.48	1 704 687.43	＜0.001
百日咳	39 578	0.40	34 671	0.35	1∶0.88	308.29	＜0.001
猩红热	402 333	4.05	253 063	2.56	1∶0.63	33 489.73	＜0.001
流感	1 535 048	15.45	1 216 673	12.29	1∶0.79	35 718.70	＜0.001
流腮	2 656 766	26.74	1 613 180	16.29	1∶0.61	250 814.49	＜0.001
风疹	310 850	3.13	236 988	2.39	1∶0.76	9 172.15	＜0.001
总计	14 880 704	149.77	8 216 076	82.97	1∶0.55	6 623.79	＜0.001
注：“流腮”为流行性腮腺炎。

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表 4 2004-2018年全国主要呼吸道传染病不同年龄的发病情况[n(%)]

Table 4. Incidence of major respiratory infectious diseases in China at different ages from 2004 to 2018 [n(%)]

年龄(岁)	麻疹(%)	肺结核(%)	百日咳(%)	猩红热(%)	流腮(%)	风疹(%)	流感(%)
0~<1	212 424(26.63)	11 053(0.07)	40 258(54.22)	4 040(0.06)	14 299(0.33)	25 106(4.58)	115 586(4.2)
1~<10	298 609(37.43)	74 399(0.50)	31 760(42.77)	586 334(89.46)	2 575 464(60.32)	174 464(31.85)	1 167 708(42.44)
10~<20	81 149(10.17)	975 014(6.58)	1 288(1.73)	561 33(8.56)	1 304 089(30.54)	242 408(44.25)	424 461(15.43)
20~<30	101 826(12.76)	2 654 403(17.92)	243(0.33)	5 706(0.87)	163 768(3.84)	75 107(13.71)	235 485(8.56)
30~<40	75 082(9.41)	2 058 278(13.89)	308(0.41)	1 954(0.30)	117 704(2.76)	22 091(4.03)	215 543(7.83)
40~<50	23 932(3.00)	2 259 586(15.25)	121(0.16)	659(0.10)	47 978(1.12)	5 192(0.95)	181 758(6.61)
50~<60	4 042(0.51)	2 383 800(16.09)	148(0.20)	310(0.05)	25 989(0.61)	1 826(0.33)	170 210(6.19)
60~<70	519(0.07)	2 298 718(15.51)	77(0.10)	159(0.02)	13 701(0.32)	951(0.17)	142 286(5.17)
70~<80	176(0.02)	1 647 732(11.12)	35(0.05)	71(0.01)	5 240(0.12)	534(0.10)	69 100(2.51)
≥80	34(0.00)	452 229(3.05)	9(0.01)	19(0.00)	1 572(0.04)	147(0.02)	29 539(1.07)
不详	40(0.00)	1 117(0.00)	2(0.00)	11(0.00)	142(0.00)	12(0.00)	46(0.00)
注：“流腮”为流行性腮腺炎。

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