2020-2021年山东省脑梗死发病流行特征及空间聚集性分析

Epidemiological characteristics and spatial clustering of cerebral infarction in Shandong, 2020−2021

  • 摘要:
    目的  了解 2020—2021年山东省脑梗死发病现状,为脑梗死防治提供参考依据。
    方法  数据来自于山东省慢性病监测信息管理系统,选取2020—2021年脑梗死发病事件进行分析。 用Excel 2013和SAS 9.4软件进行数据整理并计算发病率、标化率。 使用ArcGIS 10.8软件进行全局与局部空间自相关分析。 采用Excel 2013软件进行圆形分布分析,描述2020—2021年脑梗死发病季节分布。
    结果  2020—2021年山东省居民年均粗发病率为483.24/10万,标化发病率为323.84/10万,脑梗死发病率男性高于女性(557.45/10万 vs. 413.77/10万),农村高于城市(561.54/10万vs. 391.37/10万)。 2020年、2021年发病中位年龄分别为68.98岁、69.10岁,40岁以下人群脑梗死发病率较低,50岁以后发病率快速上升。 以月为观察时间单位做圆形分布,脑梗死发病时间有一定聚集性(P<0.001,r=0.07)。 2020、2021年山东省各区(县)脑梗死粗发病率的MP25P75)为458.70/10万(363.30/10万,585.80/10万)、505.41/10万(383.79/10万,655.87/10万), 标化发病率的MP25P75)为310.73/10万(226.79/10万,396.09/10万)、341.64/10万(241.98/10万,453.12/10万),呈现西高东低分布。 全局空间自相关分析显示,脑梗死粗发病率(Moran's I=0.47、0.56)、标化发病率(Moran's I=0.55、0.61)整体分布均呈现空间正相关(P<0.001),具有一定空间聚集性。 局部空间自相关分析显示,脑梗死发病“高–高”聚集区主要分布在山东省西北部的滨州、德州、聊城市,以及中南部的济南、泰安、济宁市。
    结论  山东省脑梗死发病形势严峻,具有一定空间聚集性,老年人与男性为发病高危人群,春季高发,西部地区为脑梗死高发地区,应积极采取相应防治措施,降低脑梗死疾病负担。

     

    Abstract:
    Objective To understand the incidence of cerebral infarction in Shandong province during 2020-2021, and provide reference for the prevention and treatment of cerebral infarction.
    Methods The incidence data of cerebral infarction in Shandong during 2020−2021 were obtained from the Chronic Disease Surveillance Information Management System of Shandong province for a descriptive analysis. Excel 2013 and SAS 9.4 were used for data process and calculation of incidence rate and standardized incidence rate of cerebral infarction. ArcGIS10.8 software was used to analyze the global and local spatial autocorrelation. Circular distribution analysis was performed using Excel 2013 to describe the seasonal distribution of cerebral infarction incidence during 2020−2021.
    Results The average annual crude incidence rate and the standardized incidence rate of cerebral infarction were 483.24/100 000 and 323.84/100 000, respectively, in Shandong during 2020−2021, and the incidence rate of cerebral infarction was higher in men (557.45/100 000) than in women (413.77/100 000) and higher in rural area (561.54/100 000) than in urban area (391.37/100 000). The median age of onset in 2020 and 2021 were 68.98 years and 69.10 years, respectively. The incidence of cerebral infarction in people aged <40 years was low, and the incidence increased rapidly after 50 years old. The onset time showed some clustering indicated by circular distribution based on monthly observation (P<0.001, r=0.07). The M (P25, P75) of the crude incidence rates of cerebral infarction in 2020 and in 2021 were 458.70/100 000 (363.30/100 000, 585.80/100 000), 505.41/100 000 (383.79/100 000, 655.87/100 000), the M (P25, P75) of the standardized incidence rate was 310.73/100 000 (226.79/100 000, 396.09/100 000), 341.64/100 000 (241.98/100 000, 453.12/100 000), showing a west-high east-low distribution. Global spatial autocorrelation analysis showed that the overall distributions of the crude incidence rates of cerebral infarction (Moran's I=0.47, 0.56) and the standardized incidence rates (Moran's I=0.55, 0.61) showed spatial positive correlation (P<0.001), with certain spatial clustering. Local spatial autocorrelation analysis showed that the high - high cluster of cerebral infarction incidence was mainly distributed in Binzhou, Dezhou and Liaocheng in northwestern Shandong, and Ji'nan, Tai'an and Jining in central and southern Shandong.
    Conclusion The incidence of cerebral infarction in Shandong is serious, with certain spatial clustering, and the elderly and men are the high-risk groups. The incidence is high in spring and in western Shandong. So it is necessary to take appropriate preventive and treatment measures to mitigate the burden of cerebral infarction.

     

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