目的 分析2004-2013年中国大陆地区肾综合征出血热(HFRS)发病情况的时空分布特征。方法 收集2004-2013年中国大陆31个省(自治区、直辖市)人口信息和HFRS疫情监测数据,利用ArcGIS 9.3软件建立地理信息数据库,计算HFRS发病重心并利用Excel 2010软件绘制气泡图呈现重心轨迹。利用SaTScan 9.1.1软件基于Poisson模型时空扫描统计探索HFRS高发病热点地区和高发时段。结果 2004-2013年HFRS发病人数呈先下降后上升趋势,人口重心位于东北部;2004-2013年全国发病重心向西南移动,方向角θ为241.69°。与2004年比较,2013年重心迁移307.87 km,其中在经度上移动距离为119.52 km,在纬度上移动距离为282.61 km。一级聚类区域为2004-2008年的黑龙江、吉林和辽宁省,相对危险度为9.22;二级聚类区域包括4个,分别为2008-2012年的陕西省,2004-2005年的山东省、天津市和河北省,2004-2007年的浙江省和2011-2013年的江西省,相对危险度为1.32~6.33。结论 HFRS发病具有明显的时空分布特征,发病重心由东北地区向华北地区转移,但疫情已呈减弱趋势。

Objective To explore the spatial-temporal characteristics of hemorrhagic fever with renal syndrome (HFRS) in mainland China. Methods Demographic information and the annual number of incident HFRS cases in mainland China from 2004 to 2013 were collected. Retrospective time-space analysis (based on discrete poisson model) was conducted to detect the spatial and spatio-temporal clusters of HFRS cases in SaTScan (Version 9.1.1) after geographical information system database constructed via ArcGIS software (Version 9.3). Gravity centers of HFRS cases were calculated and depicted with bubble charts in Excel 2010. Results The number of HFRS cases decreased from 2004 to 2009 and increased with a gravity center northeast to that of population. The gravity center of HFRS cases in 2013 moved to southwest for 307.87 km compared to that of 2004 with the directional angle as 241.69 degree. The distance in longitude was 119.52 km and 282.61 km in latitude. The most likely cluster was in Heilongjiang, Jilin and Liaoning during 2004 to 2008 with the relative risk 9.22. The secondary cluster included four geographical areas, Shaanxi area (2008-2012), Shandong, Tianjin and Hebei area (2004-2005), Zhejiang province (2004-2007) and Jiangxi (2011-2013), the relative risks varied from 1.32 to 6.33. Conclusion There are significant spatio-temporal cluster pattern for the distribution of HFRS cases in mainland China, the epidemic status showed a weakening trend and the gravity center moved from northeastern part to northern China.