Article(id=1324050699016872767, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050669933572771, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202512528, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1766851200000, receivedDateStr=2025-12-28, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793607886318, onlineDateStr=2026-11-02, pubDate=1778342400000, pubDateStr=2026-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793607886318, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793607886318, creator=13701087609, updateTime=1793607886318, updator=13701087609, issue=Issue{id=1324050669933572771, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='9', pageStart='1537', pageEnd='1728', issueExtLink='null', onlineDate='null', pubDate='1778342400000', pubDateStr='2026-05-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793607879384, creator='13701087609', updateTime=1793670100562, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324311644528050975, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050669933572771, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324311644528050976, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050669933572771, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1537, endPage=1542, ext={EN=ArticleExt(id=1324050699222393664, articleId=1324050699016872767, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Epidemiological characteristics of intestinal infectious diseases among the elderly in eastern China, 2008—2022, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To comprehensively analyze the epidemiological characteristics and trends of intestinal infectious diseases among the elderly population in eastern China, providing data support for formulating regional strategies for the prevention and control of intestinal infectious diseases.

Methods

Data on intestinal infectious disease cases among people aged 60 and above in eastern China from 2008 to 2022 were collected and organized from the China National Notifiable Infectious Disease Reporting System. Descriptive methods were used to analyze the distribution characteristics of intestinal infectious diseases among the elderly, and Joinpoint regression was applied to study the dynamic trends in standardized reported incidence rates.

Results

The annual standardized reported incidence rate of intestinal infectious diseases among the elderly in eastern China was 88.75 per 100 000, with males (95.18 per 100 000) having higher rates than females (83.85 per 100 000). The annual reported incidence rate increased with age, with the lowest in the 60-64 age group (79.82 per 100 000) and the highest in the ≥85 age group (118.05 per 100 000). From 2008 to 2022, the standardized reported incidence rate of intestinal infectious diseases among the elderly in eastern China showed a declining trend, with an average annual percentage change of -2.93% (-4.31%~-1.53%, P<0.001). For males and females, the changes were -4.03% (-5.48%~-2.56%, P<0.001) and-2.47% (-3.85%~-1.07%, P=0.001), respectively. Disease-specific trend analysis showed declining trends in the standardized reported incidence rates for bacterial and amebic dysentery, typhoid/paratyphoid, hepatitis E, and unspecified hepatitis, with average annual percentage changes of -14.39% (-16.46%~-12.26%, P<0.001), -7.87% (-10.24%~-5.43%, P<0.001),-3.33% (-5.22%~-1.41%, P=0.003), and -15.63% (-17.14%~-14.09%, P<0.001), respectively.

Conclusion

From 2008 to 2022, intestinal infectious diseases among the elderly in eastern China showed an overall year-by-year declining trend. Older adults and males should be prioritized in prevention and control efforts, and surveillance, prevention, and control measures for these key populations should be further strengthened.

, authors=Wen-shan SUN1, Wen-jing ZHENG2, Yi-ran XIAO3, Juan HUANG2, Xiang REN4, Jian-jun LIU5, Xi CHEN6, Qi-qi WANG3, Hong-yan YAO1, authorsList=Wen-shan SUN, Wen-jing ZHENG, Yi-ran XIAO, Juan HUANG, Xiang REN, Jian-jun LIU, Xi CHEN, Qi-qi WANG, Hong-yan YAO, authorCompany=null, correspAuthors=Qi-qi WANG, Hong-yan YAO, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324050700254192453, articleId=1324050699016872767, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=2008—2022年中国东部地区老年人群肠道传染病流行特征分析, columnId=1228016567632462653, journalTitle=现代预防医学, columnName=流行病与统计方法, runingTitle=null, highlight=null, articleAbstract=
目的

深入分析中国东部地区老年人群肠道传染病流行特征及其变化趋势,为制定肠道传染病防控区域策略提供数据支撑。

方法

从中国国家法定传染病报告系统收集整理2008—2022年中国东部地区60岁及以上老年人群肠道传染病发病数据,采用描述性方法分析老年人群肠道传染病的分布特征,采用joinpoint回归分析标化报告发病率动态变化趋势。

结果

中国东部地区老年人群肠道传染病年均标化报告发病率为 88.75/10万,男性为95.18/10万,高于女性的83.85/10万;年均报告发病率随年龄增长而上升,60 ~64岁组最低,为79.82/10万,≥85岁年龄组最高,为118.05/10万。2008—2022年,中国东部地区老年人群肠道传染病标化报告发病率呈下降趋势,年均变化百分比为-2.93%(95%CI:-4.31%~-1.53%,P<0.001),男性和女性分别为-4.03%(95%CI:-5.48%~-2.56%,P<0.001)和-2.47%(95%CI:-3.85%~-1.07%,P=0.001)。分病种趋势分析显示,标化报告发病率呈下降趋势的病种包括细菌性和阿米巴性痢疾、伤寒/副伤寒、戊型肝炎、肝炎(未分型),年均变化百分比分别为-14.39%(95%CI:-16.46%~-12.26%,P<0.001)、-7.87%(95%CI:-10.24%~-5.43%,P<0.001)、-3.33%(95%CI:-5.22%~-1.41%,P=0.003)、-15.63%(95%CI:-17.14%~-14.09%,P<0.001)。

结论

2008—2022年中国东部地区老年人群肠道传染病总体呈逐年下降趋势,高龄老人和男性是老年人群肠道传染病防控的重点关注对象,要继续重点强化对重点人群的肠道传染病疫情监测与防治。

, authors=孙雯珊1, 郑文静2, 肖依然3, 黄娟2, 任翔4, 刘剑君5, 陈曦6, 王琦琦3, 么鸿雁1, authorsList=孙雯珊, 郑文静, 肖依然, 黄娟, 任翔, 刘剑君, 陈曦, 王琦琦, 么鸿雁, authorCompany=null, correspAuthors=王琦琦, 么鸿雁, authorNote=

孙雯珊(2001—),女,硕士在读,研究方向:老年人群肠道传染病

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王琦琦,E-mail:;
么鸿雁,E-mail:;
王琦琦与么鸿雁为共同通信作者
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孙雯珊(2001—),女,硕士在读,研究方向:老年人群肠道传染病

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Journal of Epidemiology / Japan Epidemiological Association, 2013, 23(6): 418-423., articleTitle=High temperature as a risk factor for infectious diarrhea in Shanghai, China, refAbstract=null), Reference(id=1324050719325692869, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050699016872767, doi=null, pmid=null, pmcid=null, year=2009, volume=19, issue=4, pageStart=189, pageEnd=195, url=null, language=null, rfNumber=[38], rfOrder=52, authorNames=Cui FQ, Hadler SC, Zheng H, journalName=Journal of Epidemiology / Japan Epidemiological Association, refType=null, unstructuredReference=Cui FQ, Hadler SC, Zheng H, et al. Hepatitis a surveillance and vaccine use in China from 1990 through 2007 [J]. 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60 years and above in eastern China, 2008—2022, figureFileSmall=jitkrAfZmUxOq4FsSdKFjw==, figureFileBig=KOHGGiapq65yiE3tDmwgAA==, tableContent=null), ArticleFig(id=1324050712744829833, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050699016872767, language=CN, label=图1, caption=2008—2022年中国东部地区60岁及以上老年人群肠道传染病标化报告发病率变化趋势, figureFileSmall=jitkrAfZmUxOq4FsSdKFjw==, figureFileBig=KOHGGiapq65yiE3tDmwgAA==, tableContent=null), ArticleFig(id=1324050712941962122, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050699016872767, language=EN, label=Figure 2, caption=Time trends of standardized incidence rates of various intestinal infectious diseases among the elderly aged 60 years and above in eastern China, 2008—2022, figureFileSmall=lRXy5zzvVEqVGGx54+rZfA==, figureFileBig=YLYP3lE/UjaEHtIipYSezA==, tableContent=null), ArticleFig(id=1324050713030042507, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050699016872767, language=CN, label=图2, caption=2008—2022年中国东部地区60岁及以上老年人群各类肠道传染病标化报告发病率时间趋势, figureFileSmall=lRXy5zzvVEqVGGx54+rZfA==, figureFileBig=YLYP3lE/UjaEHtIipYSezA==, tableContent=null), ArticleFig(id=1324050713105539980, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050699016872767, language=EN, label=Table 1, caption=

Epidemiological characteristics of intestinal infectious diseases among the elderly aged 60 years and above in eastern China, 2008—2022

, figureFileSmall=null, figureFileBig=null, tableContent=
分组总病例数年均病例数年均人口数年均报告发病率(/10万)年均标化报告发病率(/10万)
合计1 132 83375 52286 905 07886.9088.75
性别
男性575 21838 34841 954 49591.4095.18
女性557 61537 17444 950 58982.7083.85
年龄组(岁)
60~64332 05622 13727 735 30279.82—
65~69263 42617 56220 867 87084.16—
70~74202 53213 50215 470 01887.28—
75~79155 33710 35611 538 81789.75—
80~84108 6017 2407 290 20999.31—
≥8570 8814 7254 002 864118.05—
), ArticleFig(id=1324050713176843149, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050699016872767, language=CN, label=表1, caption=

2008—2022年中国东部地区60岁及以上老年人群肠道传染病的流行特征

, figureFileSmall=null, figureFileBig=null, tableContent=
分组总病例数年均病例数年均人口数年均报告发病率(/10万)年均标化报告发病率(/10万)
合计1 132 83375 52286 905 07886.9088.75
性别
男性575 21838 34841 954 49591.4095.18
女性557 61537 17444 950 58982.7083.85
年龄组(岁)
60~64332 05622 13727 735 30279.82—
65~69263 42617 56220 867 87084.16—
70~74202 53213 50215 470 01887.28—
75~79155 33710 35611 538 81789.75—
80~84108 6017 2407 290 20999.31—
≥8570 8814 7254 002 864118.05—
), ArticleFig(id=1324050713252340622, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050699016872767, language=EN, label=Table 2, caption=

Joinpoint regression results of standardized incidence rates of infectious diseases among the elderly in eastern China, 2008—2022

, figureFileSmall=null, figureFileBig=null, tableContent=
分组转折点数时段(年)APC%(95%CI)AAPC%(95%CI)t值P值趋势
肠道传染病合计12008—2019-0.47(-1.41~0.47)-2.93*(-4.31~-1.53)-4.067<0.001下降
2019—2022-11.42*(-17.20~-5.23)
性别
男性22008—2015-3.61*(-4.95~-2.25)-4.03*(-5.48~-2.56)-5.311<0.001下降
2015—20192.00(-2.66~6.88)
2019—2022-12.41*(-16.56~-8.06)
女性12008—20190.54(-0.41~1.50)-2.47*(-3.85~-1.07)-3.4390.001下降
2019—2022-12.77*(-18.44~-6.71)
疾病类型
细菌性和阿米巴性痢疾22008—2014-12.72*(-14.53~-10.86)-14.39*(-16.46~-12.26)-12.436<0.001下降
2014—2018-7.15(-13.93~0.16)
2018—2022-23.31*(-27.98~-18.34)
伤寒/副伤寒22008—2011-12.38*(-20.40~-3.55)-7.87*(-10.24~-5.43)-6.154<0.001下降
2011—20181.71(-1.38~4.90)
2018—2022-19.55*(-24.51~-14.26)
其他感染性腹泻病12008—20192.38*(1.32~3.45)-0.77(-2.21~0.69)-1.0350.301无意义
2019—2022-11.51*(-17.30~-5.31)
甲型肝炎22008—2012-14.51*(-20.59~-7.96)-4.69(-9.22~0.07)-1.9310.053无意义
2012—20159.11(-14.71~39.59)
2015—2022-4.29*(-7.14~-1.36)
戊型肝炎02008—2022-3.33*(-5.22~-1.41)-3.33*(-5.22~-1.41)-3.7130.003下降
肝炎(未分型)12008—2015-8.52*(-10.42~-6.59)-15.63*(-17.14~-14.09)-18.427<0.001下降
2015—2022-22.18*(-24.89~-19.38)
急性出血性结膜炎22008—2010274.65*(101.67~596.00)10.07(-0.90~22.27)1.7910.073无意义
2010—2013-45.33*(-63.83~-17.37)
2013—20225.87*(2.63~9.22)
), ArticleFig(id=1324050713336226703, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050699016872767, language=CN, label=表2, caption=

2008—2022年中国东部地区老年人群肠道传染病标化报告发病率的joinpoint回归结果

, figureFileSmall=null, figureFileBig=null, tableContent=
分组转折点数时段(年)APC%(95%CI)AAPC%(95%CI)t值P值趋势
肠道传染病合计12008—2019-0.47(-1.41~0.47)-2.93*(-4.31~-1.53)-4.067<0.001下降
2019—2022-11.42*(-17.20~-5.23)
性别
男性22008—2015-3.61*(-4.95~-2.25)-4.03*(-5.48~-2.56)-5.311<0.001下降
2015—20192.00(-2.66~6.88)
2019—2022-12.41*(-16.56~-8.06)
女性12008—20190.54(-0.41~1.50)-2.47*(-3.85~-1.07)-3.4390.001下降
2019—2022-12.77*(-18.44~-6.71)
疾病类型
细菌性和阿米巴性痢疾22008—2014-12.72*(-14.53~-10.86)-14.39*(-16.46~-12.26)-12.436<0.001下降
2014—2018-7.15(-13.93~0.16)
2018—2022-23.31*(-27.98~-18.34)
伤寒/副伤寒22008—2011-12.38*(-20.40~-3.55)-7.87*(-10.24~-5.43)-6.154<0.001下降
2011—20181.71(-1.38~4.90)
2018—2022-19.55*(-24.51~-14.26)
其他感染性腹泻病12008—20192.38*(1.32~3.45)-0.77(-2.21~0.69)-1.0350.301无意义
2019—2022-11.51*(-17.30~-5.31)
甲型肝炎22008—2012-14.51*(-20.59~-7.96)-4.69(-9.22~0.07)-1.9310.053无意义
2012—20159.11(-14.71~39.59)
2015—2022-4.29*(-7.14~-1.36)
戊型肝炎02008—2022-3.33*(-5.22~-1.41)-3.33*(-5.22~-1.41)-3.7130.003下降
肝炎(未分型)12008—2015-8.52*(-10.42~-6.59)-15.63*(-17.14~-14.09)-18.427<0.001下降
2015—2022-22.18*(-24.89~-19.38)
急性出血性结膜炎22008—2010274.65*(101.67~596.00)10.07(-0.90~22.27)1.7910.073无意义
2010—2013-45.33*(-63.83~-17.37)
2013—20225.87*(2.63~9.22)
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2008—2022年中国东部地区老年人群肠道传染病流行特征分析
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孙雯珊 1 , 郑文静 2 , 肖依然 3 , 黄娟 2 , 任翔 4 , 刘剑君 5 , 陈曦 6 , 王琦琦 3 , 么鸿雁 1
现代预防医学 | 流行病与统计方法 2026,53(9): 1537-1542
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现代预防医学 |流行病与统计方法 2026 , 53 (9) : 1537 -1542
2008—2022年中国东部地区老年人群肠道传染病流行特征分析
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孙雯珊1, 郑文静2, 肖依然3, 黄娟2, 任翔4, 刘剑君5, 陈曦6, 王琦琦3 , 么鸿雁1
作者信息
  • 1.中国疾病预防控制中心(中国预防医学科学院)教育培训处(研究生院),北京 102206
  • 2.中国中医科学院广安门医院统计信息科
  • 3.中国疾病预防控制中心(中国预防医学科学院)流行病学办公室(爱国卫生工作技术指导处),北京 102206
  • 4.中国疾病预防控制中心(中国预防医学科学院)传染病管理处
  • 5.中国防痨协会
  • 6.传染病溯源预警与智能决策全国重点实验室/中国疾病预防控制中心(中国预防医学科学院)环境与健康相关产品安全所
通讯作者:
王琦琦,E-mail:;
么鸿雁,E-mail:;
王琦琦与么鸿雁为共同通信作者
作者简介:

孙雯珊(2001—),女,硕士在读,研究方向:老年人群肠道传染病

Epidemiological characteristics of intestinal infectious diseases among the elderly in eastern China, 2008—2022
Wen-shan SUN1, Wen-jing ZHENG2, Yi-ran XIAO3, Juan HUANG2, Xiang REN4, Jian-jun LIU5, Xi CHEN6, Qi-qi WANG3 , Hong-yan YAO1
Affiliations
  • Office of Education and Training (Graduate School), Chinese Center for Disease Control and Prevention (Chinese Academy of Preventive Medicine), Beijing 102206, China
出版时间: 2026-05-10 doi: 10.20043/j.cnki.MPM.202512528
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目的

深入分析中国东部地区老年人群肠道传染病流行特征及其变化趋势,为制定肠道传染病防控区域策略提供数据支撑。

方法

从中国国家法定传染病报告系统收集整理2008—2022年中国东部地区60岁及以上老年人群肠道传染病发病数据,采用描述性方法分析老年人群肠道传染病的分布特征,采用joinpoint回归分析标化报告发病率动态变化趋势。

结果

中国东部地区老年人群肠道传染病年均标化报告发病率为 88.75/10万,男性为95.18/10万,高于女性的83.85/10万;年均报告发病率随年龄增长而上升,60 ~64岁组最低,为79.82/10万,≥85岁年龄组最高,为118.05/10万。2008—2022年,中国东部地区老年人群肠道传染病标化报告发病率呈下降趋势,年均变化百分比为-2.93%(95%CI:-4.31%~-1.53%,P<0.001),男性和女性分别为-4.03%(95%CI:-5.48%~-2.56%,P<0.001)和-2.47%(95%CI:-3.85%~-1.07%,P=0.001)。分病种趋势分析显示,标化报告发病率呈下降趋势的病种包括细菌性和阿米巴性痢疾、伤寒/副伤寒、戊型肝炎、肝炎(未分型),年均变化百分比分别为-14.39%(95%CI:-16.46%~-12.26%,P<0.001)、-7.87%(95%CI:-10.24%~-5.43%,P<0.001)、-3.33%(95%CI:-5.22%~-1.41%,P=0.003)、-15.63%(95%CI:-17.14%~-14.09%,P<0.001)。

结论

2008—2022年中国东部地区老年人群肠道传染病总体呈逐年下降趋势,高龄老人和男性是老年人群肠道传染病防控的重点关注对象,要继续重点强化对重点人群的肠道传染病疫情监测与防治。

肠道传染病  /  老年人群  /  流行特征  /  趋势分析
Objective

To comprehensively analyze the epidemiological characteristics and trends of intestinal infectious diseases among the elderly population in eastern China, providing data support for formulating regional strategies for the prevention and control of intestinal infectious diseases.

Methods

Data on intestinal infectious disease cases among people aged 60 and above in eastern China from 2008 to 2022 were collected and organized from the China National Notifiable Infectious Disease Reporting System. Descriptive methods were used to analyze the distribution characteristics of intestinal infectious diseases among the elderly, and Joinpoint regression was applied to study the dynamic trends in standardized reported incidence rates.

Results

The annual standardized reported incidence rate of intestinal infectious diseases among the elderly in eastern China was 88.75 per 100 000, with males (95.18 per 100 000) having higher rates than females (83.85 per 100 000). The annual reported incidence rate increased with age, with the lowest in the 60-64 age group (79.82 per 100 000) and the highest in the ≥85 age group (118.05 per 100 000). From 2008 to 2022, the standardized reported incidence rate of intestinal infectious diseases among the elderly in eastern China showed a declining trend, with an average annual percentage change of -2.93% (-4.31%~-1.53%, P<0.001). For males and females, the changes were -4.03% (-5.48%~-2.56%, P<0.001) and-2.47% (-3.85%~-1.07%, P=0.001), respectively. Disease-specific trend analysis showed declining trends in the standardized reported incidence rates for bacterial and amebic dysentery, typhoid/paratyphoid, hepatitis E, and unspecified hepatitis, with average annual percentage changes of -14.39% (-16.46%~-12.26%, P<0.001), -7.87% (-10.24%~-5.43%, P<0.001),-3.33% (-5.22%~-1.41%, P=0.003), and -15.63% (-17.14%~-14.09%, P<0.001), respectively.

Conclusion

From 2008 to 2022, intestinal infectious diseases among the elderly in eastern China showed an overall year-by-year declining trend. Older adults and males should be prioritized in prevention and control efforts, and surveillance, prevention, and control measures for these key populations should be further strengthened.

Intestinal infectious diseases  /  Elderly population  /  Epidemiological characteristics  /  Trend analysis
孙雯珊, 郑文静, 肖依然, 黄娟, 任翔, 刘剑君, 陈曦, 王琦琦, 么鸿雁. 2008—2022年中国东部地区老年人群肠道传染病流行特征分析. 现代预防医学, 2026 , 53 (9) : 1537 -1542 . DOI: 10.20043/j.cnki.MPM.202512528
Wen-shan SUN, Wen-jing ZHENG, Yi-ran XIAO, Juan HUANG, Xiang REN, Jian-jun LIU, Xi CHEN, Qi-qi WANG, Hong-yan YAO. Epidemiological characteristics of intestinal infectious diseases among the elderly in eastern China, 2008—2022[J]. Modern Preventive Medicine, 2026 , 53 (9) : 1537 -1542 . DOI: 10.20043/j.cnki.MPM.202512528
肠道传染病是病原体经口侵入肠道并引起腹泻和/或其他脏器及全身性感染的一类疾病[1]。随着社会经济的快速发展,水、环境卫生和个人卫生基础设施的改善,以及各项卫生防控措施(如改水改厕、安全饮用水项目等)的落实,中国人群肠道传染病疾病负担出现大幅下降[2],但其发病在中国法定报告传染病中仍居首位[3],流行形势仍较严峻,是重要的公共卫生问题之一。
老年人群由于免疫功能低下、基础疾病多、营养不良相对高发等因素,是肠道传染病的高危人群[4-6]。已有研究发现,60岁及以上老年人群肠道传染病发病率随年龄增长呈上升趋势,85~89岁老年人群肠道传染病发病率是60~64岁老年人群的近10倍[7]。且由于免疫系统功能下降和基础疾病的存在,老年人群在感染肠道传染病后更容易发展为重症,甚至死亡[8]。了解老年人群肠道传染病发病流行特征,对制定精准防控策略、优化医疗资源配置、提升老年人群健康具有重要意义。
不同肠道传染病地区分布特征存在差异,其流行受社会经济发展水平、气候和地理条件、生产方式、生活饮食习惯等多种因素影响[9-11]。已有研究表明,东部沿海省份肠道传染病年均报告发病率高于内陆省份[12-13]。目前关于中国老年人群的肠道传染病流行病学特征探索不足[14-15],缺乏对不同区域变化趋势的系统评估[16-18]。因此,本研究旨在对2008—2022年中国东部地区老年人群肠道传染病流行病学特征及其变化趋势进行分析,为老年人群肠道传染病防控区域策略的制定和调整提供数据支撑。
肠道传染病发病数据来源于中国疾病预防控制中心管理的中国国家法定传染病报告系统[19],选取2008—2022年60岁及以上老年人群的肠道传染病报告发病数据。参考全国疾病监测系统[20],本研究将北京市、天津市、河北省、辽宁省、上海市、江苏省、浙江省、福建省、山东省、广东省、海南省共11个省及直辖市纳入东部地区研究范围。常住人口数据来源于中国疾病预防控制中心的疾病预防控制综合管理信息系统[21],标准人口数据参考由国务院人口普查办公室与国家统计局人口和就业统计司联合编纂的《中国2010年人口普查资料》[22]。
本研究聚焦于《中华人民共和国传染病防治法》法定报告管理的肠道传染病,并排除了年均报告发病例数少于100的疾病,最终纳入研究的疾病包括细菌性和阿米巴性痢疾、伤寒/副伤寒、其他感染性腹泻病(指除霍乱、细菌性和阿米巴性痢疾、伤寒/副伤寒以外的感染性腹泻病)、甲型肝炎、戊型肝炎、肝炎(未分型)和急性出血性结膜炎共七种肠道传染病。
对2008—2022年中国东部地区老年人群肠道传染病的流行特征进行描述,年均报告发病率(/10万)=年均发病数/年均人口数×100 000,标化报告发病率以2010年第六次人口普查中60岁及以上的人口数据为标准人口进行计算。研究人群按性别(男性和女性)、年龄(按五岁为一组的年龄组:60~64岁,65~69岁,70~74岁,75~79岁,80~84岁,≥85岁)进行分层。
采用joinpoint回归模型中的网格搜索法对发病率变化进行建模处理,选择对数线性模型计算年变化百分比(annual percentage change,APC)和年均变化百分比(average annual percentage change,AAPC),若APC>0表示发病率呈逐年上升趋势,APC<0表示发病率呈逐年下降趋势;转折点个数依据模型默认的最优数量进行分析,若无趋势变化连接点,则APC=AAPC,表示发病率呈单调递增或递减趋势。检验水准α=0.05。
2008—2022年中国东部地区老年人群共报告1 132 833例肠道传染病病例,年均报告发病率为86.90/10万,年均标化报告发病率为88.75/10万,其中男性年均标化报告发病率为95.18/10万,高于女性的83.85/10万。年均报告发病率随年龄增长呈上升趋势,60~64岁组最低,为79.82/10万,在≥85岁年龄组达到峰值,为118.05/10万。见表1。在纳入研究的11个省份中,肠道传染病发病最高的三个省份依次为山东省、浙江省、河北省,年均标化报告发病率分别为8.58/10万、7.62/10万、5.87/10万;最低的三个省份依次为福建省、上海市、海南省,年均标化报告发病率分别为1.73/10万、0.65/10万、0.43/10万。
2008—2022年中国东部地区60岁及以上老年人群肠道传染病标化报告发病率整体随时间呈显著下降趋势,AAPC为-2.93%(95%CI:-4.31%~-1.53%,P<0.001),其中男性和女性的AAPC分别为-4.03%(95%CI:-5.48%~-2.56%,P<0.001)和-2.47%(95%CI:-3.85%~-1.07%,P=0.001),各年份男性标化报告发病率均高于女性。分段来看,肠道传染病的标化报告发病率存在1个转折点,2008—2019年标化报告发病率下降但无统计学意义,2019—2022年期间呈逐年下降趋势,AAPC为-11.42%(95%CI:-17.20%~-5.23%)。男性的标化报告发病率存在2个转折点,2008—2015年和2019—2022年呈逐年下降趋势,AAPC分别为-3.61%(95%CI:-4.95%~-2.25%)和-12.41%(95%CI:-16.56%~-8.06%);女性的标化报告发病率存在1个转折点,2019—2022年呈逐年下降趋势,AAPC为-12.77%(95%CI:-18.44%~-6.71%)。见图1,表2。
2008—2022年中国东部地区60岁及以上老年人群各类肠道传染病中,其他感染性腹泻病的标化报告发病率明显高于其他疾病。从时间趋势上来看;细菌性和阿米巴性痢疾、伤寒/副伤寒、戊型肝炎、肝炎(未分型)标化报告发病率呈显著下降趋势,AAPC分别为-14.39%(95%CI:-16.46%~-12.26%,P<0.001)、-7.87%(95%CI:-10.24%~-5.43%,P<0.001)、-3.33%(95%CI:-5.22%~-1.41%,P=0.003)、-15.63%(95%CI:-17.14%~-14.09%,P<0.001),其他感染性腹泻病、甲型肝炎和急性出血性结膜炎的标化报告发病率变化趋势无统计学意义。从分段来看,其他感染性腹泻病的标化报告发病率存在1个转折点,2008—2019年呈逐年上升趋势,2019—2022年呈逐年下降趋势,AAPC分别为2.38%(95%CI:1.32%~3.45%)和-11.51%(95%CI:-17.30%~-5.31%);甲型肝炎存在2个转折点,标化报告发病率在2008—2012年和2015—2022年呈逐年下降趋势,AAPC分别为-14.51%(-20.59%~-7.96%)和-4.29%(95%CI:-7.14%~-1.36%);急性出血性结膜炎存在2个转折点,标化报告发病率在2008—2010年和2013—2022年呈逐年上升趋势,在2010—2013年呈逐年下降趋势,AAPC分别为274.65%(95%CI:101.67%~596.00%)、5.87%(95%CI:2.63%~9.22%)和-45.33%(95%CI:-63.83%~-17.37%)。见图2,表2。
本研究对2008—2022年中国东部地区老年人群肠道传染病流行特征进行分析,研究结果显示,中国东部地区老年人群肠道传染病年均标化报告发病率为88.75/10万,且总体呈下降趋势,反映出该区域老年人群肠道传染病防控工作的效果显著。
老年男性标化报告发病率大于老年女性,与多地报道的老年肠道传染病发病性别特点一致[23-24],男性发病率高可能由于生物学和行为学因素的共同作用,雌激素可增强体液免疫,睾酮可能具有免疫抑制效应[25],而中国老年男性通常表现出更高的吸烟和饮酒率,这些习惯会破坏肠道上皮屏,且女性相比男性更注重自身卫生情况[26]。东部地区老年人群肠道传染病年均报告发病率随年龄上升,与已有研究结果一致[27-28],黄相刚等[29]调查显示年龄是影响人群传染病健康素养的重要因素,高年龄群体传染病健康素养水平偏低,导致传染病发病率较高。随着年龄增加,老年人免疫功能和肠道功能逐渐衰退,在同等条件下更容易感染致病菌[30]。
本研究发现,2008—2022年间细菌性和阿米巴性痢疾、伤寒/副伤寒、戊型肝炎以及肝炎(未分型)的标化报告发病率显著下降,与全国监测数据显示过去二十年间细菌性痢疾发病率已下降超90%的结论相吻合[31],可能与中国在公共卫生方面的各种投入有效减少了细菌性病原体的粪-口传播途径有关[31]。我国自20世纪90年代以来开展改水改厕等专项卫生活动,使得城乡环境卫生和饮用水状况明显改善,极大降低了细菌性肠道传染病的发病水平[32];持续开展的疾病监测与规范化临床诊治也有效控制了伤寒、细菌性和阿米巴性痢疾等重点肠道传染病的传播[33]。戊型肝炎和肝炎(未分型)发病率下降可能是因为生猪养殖与屠宰环节的卫生管理逐步规范,以及针对如慢性肝病患者等高危人群的戊肝疫苗接种意识提高,减少了食源性人畜共患传播风险[34]。其他感染性腹泻病的标化报告发病率在2008—2019年呈现的上升趋势与发达国家观察到的现象一致。已有研究报告,诺如病毒、轮状病毒等病毒性病原体已逐渐取代细菌性病原体成为其他感染性腹泻病的主要致病原因[14];气温、相对湿度等环境气象因素均会对其他感染性腹泻病的发病产生影响[35-36]。其他感染性腹泻病的标化报告发病率的上升可能与近年来我国气候变暖有关,Zhou等人[37]的研究也显示高温可能是其他感染性腹泻病的危险因素。2008年甲肝减毒活疫苗被纳入国家免疫规划并对适龄儿童进行普遍接种,本研究观察到老年人群甲型肝炎标化报告发病率在2008—2012年间也呈明显下降趋势,提示上述措施不仅直接保护了儿童接种者,也通过群体免疫效应大幅降低了全人群的病毒传播压力[38]。2020—2022年,各类肠道传染病的发病率均出现显著下降,提示新冠疫情期间实施的防控措施起到了重要作用,不仅有效遏制了新冠病毒传播,也切断了肠道病原体的粪-口传播和接触传播途径,从而降低了老年人群肠道传染病的传播。
本研究存在一定的局限性。肠道传染病发病数据来自中国国家法定传染病报告系统,为被动监测数据,而非研究人员开展主动调查获取;某些症状轻的病例可能不去医疗机构就诊,导致报告发病率被低估。
综上,2008—2022年中国东部地区老年人群肠道传染病总体呈逐年下降趋势,提示我国在老年人群肠道传染病防控工作中取得显著成效。高龄老人和男性是老年人群肠道传染病防控的重点关注对象,要继续重点强化对重点人群的肠道传染病疫情监测与防治,有效地预防和控制老年人群肠道传染病的流行。
  • 国家重点研发计划(2022YFC3603002; 2022YFC3603001; 2018YFC1315305)
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2026年第53卷第9期
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doi: 10.20043/j.cnki.MPM.202512528
  • 接收时间:2025-12-28
  • 首发时间:2026-11-02
  • 出版时间:2026-05-10
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  • 收稿日期:2025-12-28
基金
国家重点研发计划(2022YFC3603002; 2022YFC3603001; 2018YFC1315305)
作者信息
    1.中国疾病预防控制中心(中国预防医学科学院)教育培训处(研究生院),北京 102206
    2.中国中医科学院广安门医院统计信息科
    3.中国疾病预防控制中心(中国预防医学科学院)流行病学办公室(爱国卫生工作技术指导处),北京 102206
    4.中国疾病预防控制中心(中国预防医学科学院)传染病管理处
    5.中国防痨协会
    6.传染病溯源预警与智能决策全国重点实验室/中国疾病预防控制中心(中国预防医学科学院)环境与健康相关产品安全所

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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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