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Article(id=1241322674115375375, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241322661654098823, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202307463, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1690300800000, receivedDateStr=2023-07-26, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773883988169, onlineDateStr=2026-03-19, pubDate=1706112000000, pubDateStr=2024-01-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773883988169, onlineIssueDateStr=2026-03-19, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773883988169, creator=13701087609, updateTime=1773883988169, updator=13701087609, issue=Issue{id=1241322661654098823, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='2', pageStart='193', pageEnd='384', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773883985198, creator=13701087609, updateTime=1773890256678, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241348966214849502, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241322661654098823, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241348966214849503, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241322661654098823, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=221, endPage=225, ext={EN=ArticleExt(id=1241322674652246321, articleId=1241322674115375375, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Ecological study of the incidence of Hepatitis B, in Chengdu City, 2010—2021, columnId=1228016567443718970, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods Advances, runingTitle=null, highlight=null, articleAbstract=
Objective

To determine the trend of the incidence of Hepatitis B in Chengdu City during 2010 to 2021, and its ecological determinants.

Methods

Linear correlations between Hepatitis B incidence and ecological factors was analyzed using the data collected in Chengdu from 2010 to 2021. Principal component analysis was used to eliminate the independent variables’ multicollinearity, and establishing a multivariate linear regression model to determine the ecological predictors of Hepatitis B incidence.

Results

The incidence of Hepatitis B in Chengdu decreased over the period of 2010-2021, from 50.03 per 100 000 to 24.81 per 100 000. multivariate linear regression showed the Results: The incidence of Hepatitis B decreased with the increases of Per capita disposable income(x1/x2) and expenditure on health care for urban/rural residents(x3/x4), per capita expenditure of rural residents on education, culture and entertainment(x5), urbanization rate(x8), per capita residential gross leasable area(x9), birth rate(x10), number of health institutions per 10 000 people(x11), number of health technicians per 10 000 people(x12), number of hospital beds per 10 000 people(x13), average annual relative humidity(x14). While it increased with the increase of urban/rural household Engel’s coefficient(x6/x7)(y=76.514-0.050x1-0.184x2-4.358x3-6.161x4-3.652x5+0.821x6+0.281x7- 0.081x8-0.404x9-1.036x10-0.360x11-0.005x12-0.075x13-0.607x14).

Conclusion

There is a linear relationship between hepatitis B incidence and social economic development, population, health resources and natural environmental factors, which could provide a basis for the prediction of hepatitis B incidence.

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目的

分析成都市2010—2021年乙肝发病趋势，探讨发病与生态学影响因素的关系。

方法

收集成都市2010—2021年乙肝发病资料进行描述性分析，应用双变量关联分析探讨发病的相关生态学因素；以关联有统计学意义的生态学因素为自变量，用主成分分析进行降维消除自变量间共线性，构建影响乙肝发病的多元线性回归模型。

结果

成都市2010—2021年乙肝发病率呈下降趋势，从2010年50.03 /10万降至2021年24.81/10万；多元线性回归结果显示：乙肝发病率（y）随城镇/农村居民的人均可支配收入（x1/x2）和人均医疗保健支出（x3/x4）、农村居民人均教育文化娱乐支出（x5）、城镇化率（x8）、人均住宅建筑面积（x9）、出生率（x10）、每万人医疗卫生机构数（x11）、每万人卫生技术人员数（x12）、每万人医疗机构床位数（x13）、年平均相对湿度（x14）增加而下降，随城镇/农村居民家庭恩格尔系数（x6/x7）增加而上升（y＝76.514－0.050x1－0.184x2－4.358x3－6.161x4－3.652x5＋0.821x6＋0.281x7－0.081x8－0.404x9－1.036x10－0.360x11－0.005x12－0.075x13－0.607x14）。

结论

多元线性回归模型显示乙肝发病率与社会经济、人口、卫生资源、自然环境等多个因素存在线性关系，可为乙肝发病的预测提供依据。

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张璇，E-mail：
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=1hNzsdQNqxT5L8twd9yPiQ==, magXml=vYERutPhVFebfElTj4hPnA==, pdfUrl=null, pdf=S1u3Y5G4Mr1d7Y7RMAS12A==, pdfFileSize=554276, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=7Nm9sGG6pNMprD2uyml45w==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=aCX5XezH5PvWLArNxCkAPA==, mapNumber=null, authorCompany=null, fund=null, authors=

王旻（1989—），女，硕士，公卫主管医师，研究方向：传染病预防控制

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王旻（1989—），女，硕士，公卫主管医师，研究方向：传染病预防控制

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unstructuredReference=世界卫生组织．乙型肝炎[EB/OL]．[2023-12-12]．https://www.who.int/zh/news-room/fact-sheets/detail/hepatitis-b., articleTitle=乙型肝炎, refAbstract=null), Reference(id=1241341053261894295, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322674115375375, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[1], rfOrder=1, authorNames=World Health Organization, journalName=null, refType=null, unstructuredReference=World Health Organization. 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China Cancer, 2022, 31(12): 952-958., articleTitle=Results of hepatitis B vaccination: 40-year follow-up of a cohort in Qidong, Jiangsu, refAbstract=null), Reference(id=1241341057447809756, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322674115375375, doi=null, pmid=null, pmcid=null, year=2020, volume=52, issue=2, pageStart=308, pageEnd=316, url=null, language=null, rfNumber=[18], rfOrder=33, authorNames=包海荣, 刘晓菊, 谭恩丽, journalName=北京大学学报:医学版, refType=null, unstructuredReference=包海荣，刘晓菊，谭恩丽，等．兰州市气温和相对湿度对慢性阻塞性肺疾病患者门诊就诊人次的影响及其交互效应[J]．北京大学学报:医学版，2020，52（2）：308-316., articleTitle=兰州市气温和相对湿度对慢性阻塞性肺疾病患者门诊就诊人次的影响及其交互效应, refAbstract=null), Reference(id=1241341057531695838, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322674115375375, doi=null, pmid=null, pmcid=null, year=2020, volume=52, issue=2, pageStart=308, pageEnd=316, url=null, language=null, rfNumber=[18], rfOrder=34, authorNames=Bao HR, Liu XJ, Tan EL, journalName=Journal ofPeking University. 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Health Sciences, 2020, 52(2): 308-316., articleTitle=Effects of temperature and relative humidity on the number of outpatients with chronic obstructive pulmonary disease and their interaction effect in Lanzhou, China, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1241341048660742685, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322674115375375, xref=1., ext=[AuthorCompanyExt(id=1241341048677519902, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322674115375375, companyId=1241341048660742685, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Infectious Disease Prevention and Control, Xindu Center for Disease Control and Prevention, Chengdu, Sichuan 610500, China), AuthorCompanyExt(id=1241341048694297119, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322674115375375, companyId=1241341048660742685, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.成都市新都区疾病预防控制中心传染病预防与控制科，四川 成都 610500)]), AuthorCompany(id=1241341048769794593, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322674115375375, xref=2., ext=[AuthorCompanyExt(id=1241341048778183202, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322674115375375, companyId=1241341048769794593, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.四川大学华西医院呼吸与危重症医学科/呼吸疾病临床医学研究中心)])], figs=[ArticleFig(id=1241341052070711925, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322674115375375, language=EN, label=Fig.1, caption=The incidence trend of Hepatitis B in Chengdu City during 2010 to 2021, figureFileSmall=kJPxbhtC7epf9IB6QlBeRw==, figureFileBig=qjsbrtuAGXs2MYlvu9pC1g==, tableContent=null), ArticleFig(id=1241341052133626487, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322674115375375, language=CN, label=图1, caption=成都市2010—2021年乙肝发病率变化趋势, figureFileSmall=kJPxbhtC7epf9IB6QlBeRw==, figureFileBig=qjsbrtuAGXs2MYlvu9pC1g==, tableContent=null), ArticleFig(id=1241341052251067004, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322674115375375, language=EN, label=Table1, caption=

Correlations betweenecologic factors and Hepatitis B incidence

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指标生态学因素rP
社会经济指标城镇居民人均可支配收入（万元／年）-0.6140.034
农村居民人均可支配收入（万元／年）-0.6070.036
城镇居民人均医疗保健支出（万元／年）-0.6150.033
农村居民人均医疗保健支出（万元／年）-0.6120.034
城镇居民人均教育文化娱乐支出（万元／年）-0.5550.061
农村居民人均教育文化娱乐支出（万元／年）-0.6060.037
城镇居民家庭恩格尔系数（％）0.8300.001
农村居民家庭恩格尔系数（％）0.6880.013
城镇化率（％）-0.6750.016
初中学生升学率（％）-0.4170.178
人均住宅建筑面积（m2）-0.8330.001
人口学指标出生率（‰）-0.5950.041
死亡率（‰）-0.3450.272
卫生资源指标每万人医疗卫生机构数（家）-0.6860.014
每万人卫生技术人员数（人）-0.6130.034
每万人医疗机构床位数（张）-0.7970.002
自然环境指标年平均气温（℃）-0.4800.114
年日照时数（h）-0.2420.448
年降水量（ml）-0.2260.480
年平均相对湿度（％）-0.6190.032
), ArticleFig(id=1241341052334953087, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322674115375375, language=CN, label=表1, caption=

乙肝发病率与生态学影响因素的Pearson相关性分析结果

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指标生态学因素rP
社会经济指标城镇居民人均可支配收入（万元／年）-0.6140.034
农村居民人均可支配收入（万元／年）-0.6070.036
城镇居民人均医疗保健支出（万元／年）-0.6150.033
农村居民人均医疗保健支出（万元／年）-0.6120.034
城镇居民人均教育文化娱乐支出（万元／年）-0.5550.061
农村居民人均教育文化娱乐支出（万元／年）-0.6060.037
城镇居民家庭恩格尔系数（％）0.8300.001
农村居民家庭恩格尔系数（％）0.6880.013
城镇化率（％）-0.6750.016
初中学生升学率（％）-0.4170.178
人均住宅建筑面积（m2）-0.8330.001
人口学指标出生率（‰）-0.5950.041
死亡率（‰）-0.3450.272
卫生资源指标每万人医疗卫生机构数（家）-0.6860.014
每万人卫生技术人员数（人）-0.6130.034
每万人医疗机构床位数（张）-0.7970.002
自然环境指标年平均气温（℃）-0.4800.114
年日照时数（h）-0.2420.448
年降水量（ml）-0.2260.480
年平均相对湿度（％）-0.6190.032
), ArticleFig(id=1241341052418839170, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322674115375375, language=EN, label=Table 2, caption=

Ecologic factors correlation matrix

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生态学因素x1x2x3x4x5x6x7x8x9x10x11x12x13x14
x11.0000.9940.9910.9920.990-0.844-0.9590.9860.4630.3240.8580.9980.9500.530
x20.9941.0000.9780.9960.997-0.845-0.9720.9910.4860.3580.8420.9940.9480.542
x30.9910.9781.0000.9830.976-0.865-0.9540.9750.4720.3560.8650.9890.9460.548
x40.9920.9960.9831.0000.991-0.856-0.9780.9930.5200.4100.8550.9930.9580.558
x50.9900.9970.9760.9911.000-0.861-0.9760.9900.4790.3650.8240.9890.9440.574
x6-0.844-0.845-0.865-0.856-0.8611.0000.928-0.896-0.724-0.677-0.809-0.839-0.939-0.758
x7-0.959-0.972-0.954-0.978-0.9760.9281.000-0.989-0.627-0.544-0.825-0.958-0.972-0.678
x80.9860.9910.9750.9930.990-0.896-0.9891.0000.5670.4480.8570.9840.9750.612
x90.4630.4860.4720.5200.479-0.724-0.6270.5671.0000.8250.5120.4640.6880.614
x100.3240.3580.3560.4100.365-0.677-0.5440.4480.8251.0000.4510.3280.5510.633
x110.8580.8420.8650.8550.824-0.809-0.8250.8570.5120.4511.0000.8640.8960.360
x120.9980.9940.9890.9930.989-0.839-0.9580.9840.4640.3280.8641.0000.9510.525
x130.9500.9480.9460.9580.944-0.939-0.9720.9750.6880.5510.8960.9511.0000.640
x140.5300.5420.5480.5580.574-0.758-0.6780.6120.6140.6330.3600.5250.6401.000
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生态学因素相关性矩阵

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生态学因素x1x2x3x4x5x6x7x8x9x10x11x12x13x14
x11.0000.9940.9910.9920.990-0.844-0.9590.9860.4630.3240.8580.9980.9500.530
x20.9941.0000.9780.9960.997-0.845-0.9720.9910.4860.3580.8420.9940.9480.542
x30.9910.9781.0000.9830.976-0.865-0.9540.9750.4720.3560.8650.9890.9460.548
x40.9920.9960.9831.0000.991-0.856-0.9780.9930.5200.4100.8550.9930.9580.558
x50.9900.9970.9760.9911.000-0.861-0.9760.9900.4790.3650.8240.9890.9440.574
x6-0.844-0.845-0.865-0.856-0.8611.0000.928-0.896-0.724-0.677-0.809-0.839-0.939-0.758
x7-0.959-0.972-0.954-0.978-0.9760.9281.000-0.989-0.627-0.544-0.825-0.958-0.972-0.678
x80.9860.9910.9750.9930.990-0.896-0.9891.0000.5670.4480.8570.9840.9750.612
x90.4630.4860.4720.5200.479-0.724-0.6270.5671.0000.8250.5120.4640.6880.614
x100.3240.3580.3560.4100.365-0.677-0.5440.4480.8251.0000.4510.3280.5510.633
x110.8580.8420.8650.8550.824-0.809-0.8250.8570.5120.4511.0000.8640.8960.360
x120.9980.9940.9890.9930.989-0.839-0.9580.9840.4640.3280.8641.0000.9510.525
x130.9500.9480.9460.9580.944-0.939-0.9720.9750.6880.5510.8960.9511.0000.640
x140.5300.5420.5480.5580.574-0.758-0.6780.6120.6140.6330.3600.5250.6401.000
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Component score coefficient matrix

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主成分X1X2X3X4X5X6X7X8X9X10X11X12X13X14
Z10.1430.1350.1340.1230.130-0.007-0.0750.106-0.133-0.1740.1000.1430.067-0.084
Z2-0.094-0.077-0.075-0.052-0.068-0.168-0.045-0.0170.3850.444-0.026-0.0930.0600.293
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成分得分系数矩阵

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主成分X1X2X3X4X5X6X7X8X9X10X11X12X13X14
Z10.1430.1350.1340.1230.130-0.007-0.0750.106-0.133-0.1740.1000.1430.067-0.084
Z2-0.094-0.077-0.075-0.052-0.068-0.168-0.045-0.0170.3850.444-0.026-0.0930.0600.293
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Multivariate linear regression model

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变量参数值tP
常量27.82715.825<0.001
Z1-4.686-3.5950.006
Z2-6.603-2.5510.031
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多元线性回归方程

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变量参数值tP
常量27.82715.825<0.001
Z1-4.686-3.5950.006
Z2-6.603-2.5510.031
), ArticleFig(id=1241341052968293007, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322674115375375, language=EN, label=Table 5, caption=

Multivariate linear regression model of original independent variables

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变量常量x1x2x3x4x5x6x7
参数值76.514-0.05-0.184-4.358-6.161-3.6520.8210.281
变量x8x9x10x11x12x13x14
参数值-0.081-0.404-1.036-0.36-0.005-0.075-0.607
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原始自变量的多元线性回归方程

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变量常量x1x2x3x4x5x6x7
参数值76.514-0.05-0.184-4.358-6.161-3.6520.8210.281
变量x8x9x10x11x12x13x14
参数值-0.081-0.404-1.036-0.36-0.005-0.075-0.607
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成都市2010—2021年乙肝发病生态学研究
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王旻 1 , 刘华 1 , 刘祥欢 1 , 张璇 2
现代预防医学 | 流行病与统计方法 2024,51(2): 221-225
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现代预防医学 | 流行病与统计方法 2024, 51(2): 221-225
成都市2010—2021年乙肝发病生态学研究
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王旻1, 刘华1, 刘祥欢1, 张璇2
作者信息
  • 1.成都市新都区疾病预防控制中心传染病预防与控制科，四川 成都 610500
  • 2.四川大学华西医院呼吸与危重症医学科/呼吸疾病临床医学研究中心

    • 王旻（1989—），女，硕士，公卫主管医师，研究方向：传染病预防控制

通讯作者:

张璇，E-mail：
Ecological study of the incidence of Hepatitis B, in Chengdu City, 2010—2021
Min WANG1, Hua LIU1, Xiang-huan Liu1, Xuan ZHANG2
Affiliations
  • Department of Infectious Disease Prevention and Control, Xindu Center for Disease Control and Prevention, Chengdu, Sichuan 610500, China
出版时间: 2024-01-25 doi: 10.20043/j.cnki.MPM.202307463
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摘要
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目的

分析成都市2010—2021年乙肝发病趋势，探讨发病与生态学影响因素的关系。

方法

收集成都市2010—2021年乙肝发病资料进行描述性分析，应用双变量关联分析探讨发病的相关生态学因素；以关联有统计学意义的生态学因素为自变量，用主成分分析进行降维消除自变量间共线性，构建影响乙肝发病的多元线性回归模型。

结果

成都市2010—2021年乙肝发病率呈下降趋势，从2010年50.03 /10万降至2021年24.81/10万；多元线性回归结果显示：乙肝发病率（y）随城镇/农村居民的人均可支配收入（x1/x2）和人均医疗保健支出（x3/x4）、农村居民人均教育文化娱乐支出（x5）、城镇化率（x8）、人均住宅建筑面积（x9）、出生率（x10）、每万人医疗卫生机构数（x11）、每万人卫生技术人员数（x12）、每万人医疗机构床位数（x13）、年平均相对湿度（x14）增加而下降，随城镇/农村居民家庭恩格尔系数（x6/x7）增加而上升（y＝76.514－0.050x1－0.184x2－4.358x3－6.161x4－3.652x5＋0.821x6＋0.281x7－0.081x8－0.404x9－1.036x10－0.360x11－0.005x12－0.075x13－0.607x14）。

结论

多元线性回归模型显示乙肝发病率与社会经济、人口、卫生资源、自然环境等多个因素存在线性关系，可为乙肝发病的预测提供依据。

乙肝  /  流行特征  /  影响因素  /  生态学研究
Objective

To determine the trend of the incidence of Hepatitis B in Chengdu City during 2010 to 2021, and its ecological determinants.

Methods

Linear correlations between Hepatitis B incidence and ecological factors was analyzed using the data collected in Chengdu from 2010 to 2021. Principal component analysis was used to eliminate the independent variables’ multicollinearity, and establishing a multivariate linear regression model to determine the ecological predictors of Hepatitis B incidence.

Results

The incidence of Hepatitis B in Chengdu decreased over the period of 2010-2021, from 50.03 per 100 000 to 24.81 per 100 000. multivariate linear regression showed the Results: The incidence of Hepatitis B decreased with the increases of Per capita disposable income(x1/x2) and expenditure on health care for urban/rural residents(x3/x4), per capita expenditure of rural residents on education, culture and entertainment(x5), urbanization rate(x8), per capita residential gross leasable area(x9), birth rate(x10), number of health institutions per 10 000 people(x11), number of health technicians per 10 000 people(x12), number of hospital beds per 10 000 people(x13), average annual relative humidity(x14). While it increased with the increase of urban/rural household Engel’s coefficient(x6/x7)(y=76.514-0.050x1-0.184x2-4.358x3-6.161x4-3.652x5+0.821x6+0.281x7- 0.081x8-0.404x9-1.036x10-0.360x11-0.005x12-0.075x13-0.607x14).

Conclusion

There is a linear relationship between hepatitis B incidence and social economic development, population, health resources and natural environmental factors, which could provide a basis for the prediction of hepatitis B incidence.

Hepatitis B  /  Epidemiological characteristics  /  Influence factor  /  Ecological study
王旻, 刘华, 刘祥欢, 张璇. 成都市2010—2021年乙肝发病生态学研究. 现代预防医学, 2024 , 51 (2) : 221 -225 . DOI: 10.20043/j.cnki.MPM.202307463
Min WANG, Hua LIU, Xiang-huan Liu, Xuan ZHANG. Ecological study of the incidence of Hepatitis B, in Chengdu City, 2010—2021[J]. Modern Preventive Medicine, 2024 , 51 (2) : 221 -225 . DOI: 10.20043/j.cnki.MPM.202307463
正文
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乙型病毒性肝炎（以下简称乙肝）是一种病毒感染传染病，它通过损害肝脏引起急性或慢性疾病。据世界卫生组织（WHO）2022年报道，全球有2.96亿人患慢性乙肝，每年有150万新发感染者，2019年约82万人死于乙肝，肝硬化和肝细胞癌是主要死因[1]。2021年《四川卫生健康统计年鉴》数据表明乙肝发病率居乙类法定报告传染病排名第1位[2]，主要通过性接触、母婴和血液等传播，社会经济、卫生资源等因素容易影响其传播，既往关于乙肝发病因素的研究主要集中在个体的人口学特征、疫苗接种情况、可疑暴露史等[3-7]，尚未对群体的社会经济、人口、卫生资源和自然环境等生态学因素进行研究，本研究收集成都市2010—2021年乙肝发病数据，采用生态学研究方法探讨乙肝发病的因素，不仅可为病因学研究提供线索，还可通过建立预测模型为乙肝发病的预测提供依据，对于其公共卫生应对具有重要意义。
1　材料与方法
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1.1　资料来源
1.1.1　乙肝发病数据
来源于成都市法定传染病与突发公共卫生事件监测信息统计年报、《中国疾病预防控制信息系统》传染病监测数据。
1.1.2　生态学因素资料
来源于2011—2022年四川统计年鉴、成都统计年鉴。包括（1）经济社会因素：城镇/农村居民的人均可支配收入（万元／年）、人均医疗保健支出（万元／年）、人均教育文化娱乐支出（万元／年）、家庭恩格尔系数（％），城镇化率（％）、初中学生升学率（％）、人均住宅建筑面积（m2）；（2）人口学因素：出生率（‰）、死亡率（‰）；（3）卫生资源因素：每万人医疗卫生机构数（家）、每万人卫生技术人员数（人）、每万人医疗机构床位数（张）；（4）自然环境因素：全年的平均气温（℃）、降水量（ml）、日照时数（h）、平均相对湿度（％）。
1.2　统计分析
采用WPS 2019软件建立论文数据库，采用IBM SPSS Statistics 23软件对论文数据进行统计性描述及分析，乙肝发病率的比较采用卡方检验；采用双变量关联分析法（Pearson相关）分别计算各个生态学影响因素与乙肝发病率的相关系数r和P 值；将乙肝发病率作为因变量，相关系数有统计学意义的生态学因素作为自变量，采用主成分分析[8]（将多个相关的自变量通过线性变化转成不相关又包含原变量信息的综合潜变量）消除自变量因素间的共线性，建立潜变量的多元线性回归方程，再将潜变量变换为原始自变量，建立原始自变量的多元线性回归模型。双侧检验，检验水准α=0.05。
2　结果
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2.1　成都市乙肝发病率变化趋势
成都市2010—2021年乙肝发病率总体呈现下降趋势，从2010年50.03 /10万降至2021年24.81/10万，2010年最高，之后下降至2015年最低，2016年略回升后呈波动变化至2021年，不同年度发病率差异有统计学意义（χ2=5 192.306, P<0.001）（图1）。
2.2　乙肝发病生态学影响因素相关分析
采用双变量关联分析法分别计算成都市2010—2021年乙肝发病率与各项生态学因素的相关系数r和P 值，结果表明，乙肝发病率与城镇/农村居民的人均可支配收入和人均医疗保健支出、农村居民人均教育文化娱乐支出、城镇化率、人均住宅建筑面积、出生率、每万人医疗卫生机构数、每万人卫生技术人员数、每万人医疗机构床位数、年平均相对湿度呈负相关，与城镇/农村居民家庭恩格尔系数呈正相关（表1）。
2.3　乙肝发病生态学影响因素多元线性回归模型
2.3.1　乙肝发病生态学影响因素的相关矩阵
由表1可见，与乙肝发病率相关的生态学因素具有相关性统计学意义的共有14项，各因素间相关性多大于0.7（表2），因此为避免回归模型中各生态学因素间“共线性”的影响，可对自变量（生态学因素）进行主成分分析。
2.3.2　主成分分析
以特征值大于1为标准，提取2个公因子，最大方差法得到成分1（Z1）特征值=11.385，成分2（Z2）特征值=1.640，Z1和Z2的方差贡献率=93.037%。成分1和成分2得分系数矩阵见表3。
2.3.3　多元线性回归
多元线性回归模型的因变量为乙肝发病率，自变量为Z1、Z2，拟合模型的方差分析检验结果显示F=9.718，P=0.006，R=0.683，采用多元回归模型拟合效果较好，因变量与自变量存有线性关系，满足正态性、独立性且方差齐性，回归系数参数值和假设检验结果见表4，y＝27.827－4.686Z1－6.603Z2。标准自变量X1～X14是对原始自变量x1～x14进行标准化：，表示第j个自变量的均值，sj 表示第j个自变量的标准差，将标准自变量X1～X14转换为原始自变量x1～x14后得出原始自变量的线性回归方程见表5。结果显示，乙肝发病率（y）随城镇/农村居民的人均可支配收入（x1/x2）和人均医疗保健支出（x3/x4）、农村居民人均教育文化娱乐支出（x5）、城镇化率（x8）、人均住宅建筑面积（x9）、出生率（x10）、每万人医疗卫生机构数（x11）、每万人卫生技术人员数（x12）、每万人医疗机构床位数（x13）、年平均相对湿度（x14）增加而下降，随城镇/农村居民家庭恩格尔系数（x6/x7）增加而上升。
3　讨论
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本研究结果显示，成都市乙肝发病率从2010年的50.03 /10万降至2021年的24.81/10万，与四川省乙肝发病率从2010年的68.82/10万降至2021年的62.52/10万比较[9]，成都市下降更加明显，可能是由于成都市是四川省省会，经济实力强，发展水平高，有条件在传染病防控中投入更多的财力、物力和人力，以保障人群健康。
本研究结果显示，乙肝发病率与城镇/农村居民的人均可支配收入呈负相关，与城镇/农村居民家庭恩格尔系数呈正相关，杨琨等[10]，刘都祥等[11]研究发现低收入是阻碍乙肝疫苗接种的重要因素，马倩[12]、张蕃等[13]研究发现低收入人群乙肝防控知识知晓率较低，故可能是由于随着社会经济的不断提高，财政经费逐步得到保障，政府更加重视乙肝防控，同时人们收入的提高使得其更有条件重视自身健康和获取防治知识，更愿意接种疫苗，从而控制乙肝发病。乙肝发病率与农村居民人均教育文化娱乐支出呈负相关，杨琨等[10]，马倩等[12]，范璐晨等[14]研究发现农民、文化水平低影响乙肝疫苗接种率及知识知晓率，提示农村居民教育文化水平的提高，更能显著降低乙肝发病。乙肝发病率与人均医疗保健支出呈负相关，可能是由于经济水平的发展，政府能够提供更好的医疗保健服务，有能力为人们提供更多的医疗资源，从而提升人民健康素质。乙肝发病率与人均住宅建筑面积、城镇化率呈负相关，可能是由于随着城镇化进程的推进，政府更加注重城市规划和治理，城市规划可以将人口分散到更广阔的空间，改善人居环境，增加空间面积，城市治理可以通过加强卫生管理、加强疫情监测、强化疫苗接种等措施来减少传染病的发生风险。
本研究结果显示，乙肝发病率与每万人医疗卫生机构数、每万人卫生技术人员数、每万人医疗机构床位数呈负相关，韦艳等[15]研究发现就医距离近等空间可及性高有利于居民利用卫生服务，张蕊等[16]研究发现医疗床位数充足使得居民医疗卫生服务满意度更高。故可能是由于地区医疗服务资源量不断提高，民众接受更多健康服务的可及性更高，加之医疗服务满意度的不断提高，使得人群更愿意寻求卫生服务支持，健康水平得到提升，从而降低发病。
本研究结果显示，乙肝发病率与出生率呈负相关，可能是由于乙肝疫苗2002年已纳入儿童计划免疫，新生儿均能免费接种疫苗，高效降低了2002年及以后出生人群的乙肝发病率[17]。
本研究结果显示，乙肝发病率与年平均相对湿度呈负相关，可能是由于人体适宜的相对湿度维持在40%～60%，相对湿度过高不利于人体健康[18]，抵抗力降低，从而更易发病。
本研究采用主成分分析法提取综合指标，消除自变量间的共线性，在没有删除变量的前提下最大程度地利用了原始数据信息。本研究基于“群体”层面对乙肝发病的生态学影响因素进行探讨，对乙肝病因学研究、发病预测和公共卫生应对具有重要意义，但生态学研究有其局限性，仍需进一步研究探讨其相关因素。
综上所述，乙肝发病与社会经济、人口、卫生资源、自然环境等多个因素存在线性关系，可为乙肝发病的预测提供依据，可为卫生健康政策的制定和实施提供参考。
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doi: 10.20043/j.cnki.MPM.202307463
  • 接收时间：2023-07-26
  • 首发时间：2026-03-19
  • 出版时间：2024-01-25
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    1.成都市新都区疾病预防控制中心传染病预防与控制科，四川 成都 610500
    2.四川大学华西医院呼吸与危重症医学科/呼吸疾病临床医学研究中心

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2种不同金属材料的力学参数
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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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