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Article(id=1325503522552283177, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325502070660407522, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025134, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1729612800000, receivedDateStr=2024-10-23, revisedDate=1734278400000, revisedDateStr=2024-12-16, acceptedDate=null, acceptedDateStr=null, onlineDate=1793954266440, onlineDateStr=2026-11-06, pubDate=1748102400000, pubDateStr=2025-05-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793954266440, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793954266440, creator=13701087609, updateTime=1793954266440, updator=13701087609, issue=Issue{id=1325502070660407522, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='5', pageStart='609', pageEnd='760', issueExtLink='null', onlineDate='null', pubDate='1748102400000', pubDateStr='2025-05-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793953920283, creator='13701087609', updateTime=1793953920283, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=737, endPage=740, ext={EN=ArticleExt(id=1325503525156945962, articleId=1325503522552283177, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Epidemiological trends analysis of syphilis among students in Yunnan Province from 2005 to 2023, columnId=1325500884406379444, journalTitle=Chinese Journal of School Health, columnName=Disease Control, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze epidemiological trends and changing characteristics of syphilis among students in Yunnan Province from 2005 to 2023, so as to provide evidence for the comprehensive prevention and control of syphilis in schools.

Methods

The case data of syphilis among students in Yunnan Province from 2005 to 2023 were obtained from the China Information System for Disease Control and Prevention. The Joinpoint regression model was used to conduct a time trend analysis of the reported incidence rate of syphilis.

Results

From 2005 to 2023, a cumulative total of 3 191 cases of syphilis were reported in schools in Yunnan Province(1 248 male cases and 1 943 female cases). The reported incidence rate rose continuously from 0.17/100 000 in 2005 to 8.26/100 000 in 2023, with an average annual percent change (AAPC) of 24.89%(Z=13.18, P < 0.01). The reported incidence rate was higher in female students than in male students (χ2=229.48, P < 0.05). The incidence rates in the primary school, junior high school, senior high school and higher education were 0.21/100 000, 2.42/100 000, 4.45/100 000 and 6.29/100 000 respectively, and the difference was statistically significant(χ2=3 432.84, P < 0.05). The average annual growth rate was the highest in the junior high school stage(AAPC=30.68%, Z=7.57, P < 0.05), followed by the senior high school stage (AAPC=24.28%, Z=5.70, P < 0.05).The reported incidence rate of primary and secondary syphilis increased from 0.12/100 000 in 2005 to 2.06/100 000 in 2023, with an AAPC of 16.86% (Z=4.57, P < 0.05).

Conclusions

The overall reported incidence rate of syphilis among students in schools in Yunnan Province shows a sustained upward trend, with the most rapid annual increase observed in junior high schools. Schools should prioritize syphilis education and expand awareness campaigns to curb transmission.

, authors=Min TAN1, Litao CHANG1, Wanyue ZHANG2, Dafeng HUANG1, Chunyan LIU1, Lifang ZHANG*, 1, Yanling YANG*, 3, authorsList=Min TAN, Litao CHANG, Wanyue ZHANG, Dafeng HUANG, Chunyan LIU, Lifang ZHANG, Yanling YANG, authorCompany=null, correspAuthors=Lifang ZHANG, Yanling YANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2025 Chinese Journal of School Health. All rights reserved., 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=1325503526817890347, articleId=1325503522552283177, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=云南省学生2005—2023年梅毒流行趋势分析, columnId=1325500884628677558, journalTitle=中国学校卫生, columnName=疾病控制, runingTitle=null, highlight=null, articleAbstract=
目的

分析2005—2023年云南省学校学生梅毒流行趋势与变化特征，为学校梅毒综合防控工作提供依据。

方法

从中国疾病预防控制信息系统中获得2005—2023年云南省学生梅毒病例资料，采用Joinpoint回归模型对梅毒报告发病率进行时间趋势分析。

结果

2005—2023年云南省累计报告学生梅毒病例3 191例(男生1 248例，女生1 943例)，报告发病率由2005年的0.17/10万上升至2023年的8.26/10万，AAPC为24.89%(Z=13.18, P < 0.01)。女生报告发病率高于男生(χ2=229.48)；小学、初中、高中、高等教育阶段发病率分别为0.21/10万、2.42/10万、4.45/10万、6.29/10万，差异有统计学意义(χ2=3 432.84)，初中阶段发病率平均每年增长幅度最大(AAPC=30.68%，Z=7.57)，高中阶段次之(AAPC=24.28%，Z=5.70)；一、二期梅毒报告发病率由2005年的0.12/10万上升到2023年的2.06/10万，AAPC为16.86%(Z=4.57)(P值均 < 0.05)。

结论

云南省学生梅毒报告发病率总体呈持续上升趋势，初中阶段报告发病率平均每年增长幅度最大。学校需重视梅毒宣教，扩大宣教覆盖面，遏制校园梅毒的发生与传播。

, authors=谭敏1, 常利涛1, 张琬悦2, 黄达峰1, 刘春艳1, 张丽芳*, 1, 杨彦玲*, 3, authorsList=谭敏, 常利涛, 张琬悦, 黄达峰, 刘春艳, 张丽芳, 杨彦玲, authorCompany=null, correspAuthors=张丽芳, 杨彦玲, authorNote=

谭敏(1981-)，女，云南姚安人，大学本科，副主任医师，主要从事学校卫生相关工作

, correspAuthorsNote=
张丽芳，E-mail:
杨彦玲，E-mail:
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The syphilis cases reported and incidence among school students in Yunnan Province from 2005 to 2023

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年份病例数性别学段
男生女生小学初中高中高等教育
200513(0.17)7(0.18)6(0.17)004(0.51)9(2.25)
200621(0.27)10(0.24)11(0.30)2(0.04)4(0.21)5(0.57)10(2.16)
200712(0.15)9(0.21)3(0.08)3(0.07)1(0.05)3(0.30)5(1.03)
200823(0.28)7(0.16)16(0.41)2(0.04)4(0.20)5(0.46)12(2.26)
200920(0.24)9(0.21)11(0.28)6(0.14)5(0.24)5(0.46)4(0.68)
201026(0.32)16(0.38)10(0.25)12(0.27)3(0.15)2(0.18)9(1.52)
201124(0.29)12(0.28)12(0.31)9(0.21)4(0.19)3(0.22)8(1.58)
201238(0.47)24(0.56)14(0.36)6(0.15)3(0.15)11(0.80)18(2.48)
201341(0.52)23(0.55)18(0.48)5(0.13)6(0.32)9(0.68)21(2.71)
201460(0.76)36(0.87)24(0.64)5(0.13)10(0.53)13(0.96)32(3.94)
201567(0.84)40(0.96)27(0.72)15(0.40)15(0.79)11(0.80)26(3.03)
201683(1.04)47(1.12)36(0.95)7(0.19)11(0.59)25(1.76)40(4.46)
2017110(1.35)58(1.36)52(1.34)20(0.52)19(1.01)32(2.18)39(4.13)
2018148(1.80)65(1.50)83(2.12)7(0.18)40(2.15)50(3.30)51(4.92)
2019268(3.16)112(2.52)156(3.88)15(0.39)77(4.17)105(6.67)71(6.14)
2020379(4.32)149(3.23)230(5.52)8(0.21)107(5.87)147(8.49)117(9.11)
2021525(5.95)193(4.16)332(7.92)8(0.21)146(7.96)192(11.05)179(13.20)
2022611(7.02)214(4.68)397(9.62)15(0.40)200(10.73)245(15.93)151(10.39)
2023722(8.26)217(4.72)505(12.16)18(0.47)226(11.98)251(17.25)227(15.19)
合计3 191(2.05)1 248(1.53)1 943(2.63)163(0.21)881(2.42)1 118(4.45)1 029(6.29)
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云南省2005—2023年学生梅毒报告病例数及发病率

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年份病例数性别学段
男生女生小学初中高中高等教育
200513(0.17)7(0.18)6(0.17)004(0.51)9(2.25)
200621(0.27)10(0.24)11(0.30)2(0.04)4(0.21)5(0.57)10(2.16)
200712(0.15)9(0.21)3(0.08)3(0.07)1(0.05)3(0.30)5(1.03)
200823(0.28)7(0.16)16(0.41)2(0.04)4(0.20)5(0.46)12(2.26)
200920(0.24)9(0.21)11(0.28)6(0.14)5(0.24)5(0.46)4(0.68)
201026(0.32)16(0.38)10(0.25)12(0.27)3(0.15)2(0.18)9(1.52)
201124(0.29)12(0.28)12(0.31)9(0.21)4(0.19)3(0.22)8(1.58)
201238(0.47)24(0.56)14(0.36)6(0.15)3(0.15)11(0.80)18(2.48)
201341(0.52)23(0.55)18(0.48)5(0.13)6(0.32)9(0.68)21(2.71)
201460(0.76)36(0.87)24(0.64)5(0.13)10(0.53)13(0.96)32(3.94)
201567(0.84)40(0.96)27(0.72)15(0.40)15(0.79)11(0.80)26(3.03)
201683(1.04)47(1.12)36(0.95)7(0.19)11(0.59)25(1.76)40(4.46)
2017110(1.35)58(1.36)52(1.34)20(0.52)19(1.01)32(2.18)39(4.13)
2018148(1.80)65(1.50)83(2.12)7(0.18)40(2.15)50(3.30)51(4.92)
2019268(3.16)112(2.52)156(3.88)15(0.39)77(4.17)105(6.67)71(6.14)
2020379(4.32)149(3.23)230(5.52)8(0.21)107(5.87)147(8.49)117(9.11)
2021525(5.95)193(4.16)332(7.92)8(0.21)146(7.96)192(11.05)179(13.20)
2022611(7.02)214(4.68)397(9.62)15(0.40)200(10.73)245(15.93)151(10.39)
2023722(8.26)217(4.72)505(12.16)18(0.47)226(11.98)251(17.25)227(15.19)
合计3 191(2.05)1 248(1.53)1 943(2.63)163(0.21)881(2.42)1 118(4.45)1 029(6.29)
), ArticleFig(id=1325503554928115813, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325503522552283177, language=EN, label=Tab.2, caption=

Distribution of syphilis infection routes among students of different genders and school stages in Yunnan Province

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性别与学段人数性传播母婴传播血液传播其他方式不详信息缺失
异性同性
性别男1 248736(58.97)121(9.70)9(0.72)1(0.08)13(1.04)200(16.03)168(13.46)
女1 9431 368(70.41)015(0.77)1(0.05)15(0.77)316(16.26)228(11.74)
学段小学16327(16.56)017(10.43)1(0.62)7(4.29)73(44.79)38(23.31)
初中881613(69.58)1(0.11)5(0.57)1(0.11)14(1.59)135(15.33)112(12.71)
高中1 118802(71.74)25(2.24)2(0.18)04(0.36)152(13.59)133(11.89)
高等教育1 029662(64.33)95(9.24)003(0.29)156(15.16)113(10.98)
), ArticleFig(id=1325503555301408870, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325503522552283177, language=CN, label=表2, caption=

云南省不同性别不同学段学生梅毒感染途径分布

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性别与学段人数性传播母婴传播血液传播其他方式不详信息缺失
异性同性
性别男1 248736(58.97)121(9.70)9(0.72)1(0.08)13(1.04)200(16.03)168(13.46)
女1 9431 368(70.41)015(0.77)1(0.05)15(0.77)316(16.26)228(11.74)
学段小学16327(16.56)017(10.43)1(0.62)7(4.29)73(44.79)38(23.31)
初中881613(69.58)1(0.11)5(0.57)1(0.11)14(1.59)135(15.33)112(12.71)
高中1 118802(71.74)25(2.24)2(0.18)04(0.36)152(13.59)133(11.89)
高等教育1 029662(64.33)95(9.24)003(0.29)156(15.16)113(10.98)
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云南省学生2005—2023年梅毒流行趋势分析
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谭敏 1 , 常利涛 1 , 张琬悦 2 , 黄达峰 1 , 刘春艳 1 , 张丽芳 *, 1 , 杨彦玲 *, 3
中国学校卫生 | 疾病控制 2025,46(5): 737-740
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中国学校卫生 |疾病控制 2025 , 46 (5) : 737 -740
云南省学生2005—2023年梅毒流行趋势分析
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谭敏1, 常利涛1, 张琬悦2, 黄达峰1, 刘春艳1, 张丽芳*, 1 , 杨彦玲*, 3
作者信息
  • 1云南省疾病预防控制中心学校卫生所，昆明 650500
  • 2云南省疾病预防控制中心质量管理部
  • 3云南省疾病预防控制中心营养与食品卫生所
通讯作者:
张丽芳，E-mail:
杨彦玲，E-mail:
作者简介:

谭敏(1981-)，女，云南姚安人，大学本科，副主任医师，主要从事学校卫生相关工作

Epidemiological trends analysis of syphilis among students in Yunnan Province from 2005 to 2023
Min TAN1, Litao CHANG1, Wanyue ZHANG2, Dafeng HUANG1, Chunyan LIU1, Lifang ZHANG*, 1 , Yanling YANG*, 3
Affiliations
  • 1School Health Section, Yunnan Provincial Center for Disease Control and Prevention, Kunming (650500), Yunnan Province, China
出版时间: 2025-05-25 doi: 10.16835/j.cnki.1000-9817.2025134
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摘要
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目的

分析2005—2023年云南省学校学生梅毒流行趋势与变化特征，为学校梅毒综合防控工作提供依据。

方法

从中国疾病预防控制信息系统中获得2005—2023年云南省学生梅毒病例资料，采用Joinpoint回归模型对梅毒报告发病率进行时间趋势分析。

结果

2005—2023年云南省累计报告学生梅毒病例3 191例(男生1 248例，女生1 943例)，报告发病率由2005年的0.17/10万上升至2023年的8.26/10万，AAPC为24.89%(Z=13.18, P < 0.01)。女生报告发病率高于男生(χ2=229.48)；小学、初中、高中、高等教育阶段发病率分别为0.21/10万、2.42/10万、4.45/10万、6.29/10万，差异有统计学意义(χ2=3 432.84)，初中阶段发病率平均每年增长幅度最大(AAPC=30.68%，Z=7.57)，高中阶段次之(AAPC=24.28%，Z=5.70)；一、二期梅毒报告发病率由2005年的0.12/10万上升到2023年的2.06/10万，AAPC为16.86%(Z=4.57)(P值均 < 0.05)。

结论

云南省学生梅毒报告发病率总体呈持续上升趋势，初中阶段报告发病率平均每年增长幅度最大。学校需重视梅毒宣教，扩大宣教覆盖面，遏制校园梅毒的发生与传播。

梅毒  /  流行病学研究  /  回归分析  /  学生
Objective

To analyze epidemiological trends and changing characteristics of syphilis among students in Yunnan Province from 2005 to 2023, so as to provide evidence for the comprehensive prevention and control of syphilis in schools.

Methods

The case data of syphilis among students in Yunnan Province from 2005 to 2023 were obtained from the China Information System for Disease Control and Prevention. The Joinpoint regression model was used to conduct a time trend analysis of the reported incidence rate of syphilis.

Results

From 2005 to 2023, a cumulative total of 3 191 cases of syphilis were reported in schools in Yunnan Province(1 248 male cases and 1 943 female cases). The reported incidence rate rose continuously from 0.17/100 000 in 2005 to 8.26/100 000 in 2023, with an average annual percent change (AAPC) of 24.89%(Z=13.18, P < 0.01). The reported incidence rate was higher in female students than in male students (χ2=229.48, P < 0.05). The incidence rates in the primary school, junior high school, senior high school and higher education were 0.21/100 000, 2.42/100 000, 4.45/100 000 and 6.29/100 000 respectively, and the difference was statistically significant(χ2=3 432.84, P < 0.05). The average annual growth rate was the highest in the junior high school stage(AAPC=30.68%, Z=7.57, P < 0.05), followed by the senior high school stage (AAPC=24.28%, Z=5.70, P < 0.05).The reported incidence rate of primary and secondary syphilis increased from 0.12/100 000 in 2005 to 2.06/100 000 in 2023, with an AAPC of 16.86% (Z=4.57, P < 0.05).

Conclusions

The overall reported incidence rate of syphilis among students in schools in Yunnan Province shows a sustained upward trend, with the most rapid annual increase observed in junior high schools. Schools should prioritize syphilis education and expand awareness campaigns to curb transmission.

Syphilis  /  Epidemiologic studies  /  Regression analysis  /  Students
谭敏, 常利涛, 张琬悦, 黄达峰, 刘春艳, 张丽芳, 杨彦玲. 云南省学生2005—2023年梅毒流行趋势分析. 中国学校卫生, 2025 , 46 (5) : 737 -740 . DOI: 10.16835/j.cnki.1000-9817.2025134
Min TAN, Litao CHANG, Wanyue ZHANG, Dafeng HUANG, Chunyan LIU, Lifang ZHANG, Yanling YANG. Epidemiological trends analysis of syphilis among students in Yunnan Province from 2005 to 2023[J]. Chinese Journal of School Health, 2025 , 46 (5) : 737 -740 . DOI: 10.16835/j.cnki.1000-9817.2025134
正文
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梅毒是由梅毒螺旋体引起的一种系统性、慢性性传播疾病，可通过性、血液和母婴途径传播，引起神经、心血管等多系统损害，甚至威胁生命[1-2]。经对中国疾病预防控制信息系统中报告的学生乙类传染病发病情况分析发现，2020—2023年云南省学生梅毒发病数跃居学生乙类传染病发病数前5位。本文对云南省2005—2023年学校学生梅毒患病情况进行分析，以期为学校梅毒综合防控工作提供参考依据。
1　资料来源与方法
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1.1　资料来源
学生梅毒报告病例数来源于中国疾病预防控制信息系统，学生人数来源于云南省教育厅全省教育事业发展统计公报。系统中的病例信息为医疗机构医生日常接诊时按照《中华人民共和国传染病防治法》[3]要求录入上报，本文仅分析群体发病情况。本研究经云南省疾病预防控制中心伦理审查通过(伦审批号：2024-61号)。
1.2　方法
通过中国疾病预防控制信息系统，按照发病日期、现住址，下载2005年1月1日至2023年12月31日期间，由医疗机构首诊医生录入报告的职业为学生的梅毒病例信息。2018年8月1日前梅毒病例由各级医疗机构首诊医生依据《梅毒诊断》(WS 273—2007)[4]进行诊断和上报，2018年8月1日后参照《梅毒诊断》(WS 273—2018)[5]进行诊断及疫情上报。
1.3　统计学分析
采用Excel 2017软件进行数据整理、SPSS 20.0和Joinpoint 4.8.0.1软件进行统计分析。计量资料以(x±s)描述；计数资料采用率(%)描述，组间比较采用χ2检验；应用Joinpoint 4.8.0.1回归模型对梅毒报告发病率进行时间趋势分析，计算年度变化百分比(APC)和平均年度变化百分比(AAPC)，并对APC和AAPC进行趋势检验, 以P < 0.05为有统计学意义。
2　结果
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2.1　学生梅毒总发病率的时间变化趋势
2005—2023年云南省共报告学生梅毒病例3 191例，报告发病率由2005年的0.17/10万持续上升至2023年的8.26/10万，AAPC为24.89%(Z=13.18, P < 0.01)；分3个时段分析显示，2005—2016，2016—2021，2021—2023年APC分别为18.39%，44.51%，16.35%，变化趋势均有统计学意义(Z值分别为8.66，10.39，2.50，P值均 < 0.05)，其中2016—2021年增幅最大，APC为44.51%。见表1。
2.2　不同性别学生梅毒发病率时间变化趋势
2005—2023年云南省男生梅毒报告病例1 248例，女生1 943例，男、女性别比为0.64∶1，女生报告发病率高于男生，差异有统计学意义(χ2=229.48，P < 0.01)。女生报告发病率由2005年的0.17/10万上升到2023年12.16/10万，AAPC为25.86%(Z=9.86, P < 0.01)；分3个时段分析显示，2005—2015，2015—2021，2021—2023年APC分别为12.85%，52.65%，21.77%，变化趋势均有统计学意义(Z值分别为3.66，11.66，2.80，P值均 < 0.05)。男生报告发病率由2005年的0.18/10万上升到2023年的4.72/10万，AAPC为21.81%(Z=8.98, P < 0.01)；分3个时段分析显示，2005—2018(APC=21.13%，Z=13.29，P < 0.01)、2018—2021年(APC=37.91%，Z=3.11，P < 0.01)报告发病率均呈上升趋势，2021—2023年报告发病率相对平稳(APC=4.83%，Z=0.59，P>0.05)。
2.3　不同学段学生梅毒发病率的时间变化趋势
2005—2023年云南省小学、初中、高中、高等教育阶段学生梅毒报告发病率分别为0.21/10万，2.42/10万，4.45/10万，6.29/10万，不同学段之间发病率差异有统计学意义(χ2=3 432.84，P < 0.01)。小学阶段报告发病率由2005年的零报告上升到2023年的0.47/10万，报告发病率呈持续上升趋势(AAPC=8.03%，Z=3.36，P < 0.05)。初中阶段报告发病率由2005年的零报告持续上升到2023年的11.98/10万(AAPC=30.68%, Z=7.57，P < 0.05)；分3个时段分析显示，2005—2016，2016—2020，2020—2023年APC分别为19.05%，75.15%，24.46%，变化趋势均有统计学意义(Z值分别为4.24，5.28，4.64，P值均 < 0.01)，其中2016—2020年增幅最大，APC为75.15%。高中阶段报告发病率由2005年的0.51/10万上升到2023年的17.25/10万，AAPC为24.28%(Z=5.70, P < 0.01)；分3个时段分析显示，2005—2015年报告发病率相对平稳(APC=8.59%，Z=1.84，P>0.05)，2015—2019，2019—2023年APC分别为67.05%，29.56%，变化趋势均有统计学意义(Z值分别为4.09，7.70，P值均 < 0.01)。高等教育阶段报告发病率由2005年的2.25/10万上升到2023年的15.19/10万，呈持续上升趋势(AAPC=16.47%，Z=11.32，P < 0.01)。报告发病率平均每年增长幅度初中阶段最大(AAPC=30.68%)，高中阶段次之(AAPC=24.28%)。
2.4　学生梅毒分期报告发病率的时间变化趋势
2005—2023年云南省学生梅毒报告病例中，一、二期818例(占25.63%)，三期2例(占0.06%)，胎传13例(占0.41%)，隐性2 358例(占73.90%)。一、二期梅毒报告发病率由2005年的0.12/10万上升到2023年的2.06/10万，AAPC为16.86%(Z=4.57，P < 0.01)。分3个时段分析显示，2005—2017(APC=5.47%，Z=2.16)、2021—2023年(APC=16.39%，Z=1.26)2个时段的变化趋势无统计学意义(P值均>0.05)；2017—2021年报告发病率呈快速上升趋势，变化趋势有统计学意义(APC=59.30%，Z=3.87，P < 0.05)。隐性梅毒报告发病率由2005年的0.05/10万上升到2023年的6.20/10万，AAPC为31.79%(Z=14.38，P < 0.01)；分3个时段分析显示，2005—2017，2017—2020，2020—2023年APC分别为30.26%，51.84%，19.89%，变化趋势均有统计学意义(Z值分别为15.38，4.70，7.06，P值均 < 0.01)。
2.5　学生梅毒病例感染途径
2005—2023年云南省报告的学生梅毒病例中，2 225例最有可能的感染途径为性传播(2 104例为异性性传播、121例为男性同性性传播)。男、女生最有可能的感染途径均为性传播，差异有统计学意义(χ2=206.55，P < 0.01)。除小学阶段外，其余3个学段学生最有可能的感染途径为性传播，差异有统计学意义(χ2=408.171，P < 0.01)。见表2。
3　讨论
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云南省2005—2023年学生梅毒报告发病率总体呈上升趋势，女生报告发病率高于男生，高等教育学段学生报告发病率最高，与浙江省、海南省的情况一致[6-7]。受新型冠状病毒感染疫情的影响，2021—2023年学生梅毒感染的增长率有所下降，与全国研究结果一致[8]。有研究显示，美国15~24岁的青少年仅占性活跃人群的1/4，但在新增的性传播疾病病例中占到一半[9]，表明在发达国家中性传播疾病发病呈年轻化倾向。本研究显示，云南省在校学生中梅毒报告发病趋于年轻化，虽然主要集中在高等教育学段学生，但初中和高中学段的感染者均在增加，提示梅毒防控工作应向高中甚至初中学段的学生倾斜。青少年期是生长发育过程中变化比较大的阶段，身心仍处于发育期，性观念和性行为还未成熟，但是新媒体的普及、同伴影响等导致接触了大量的相关信息，且青少年为寻求圈内同伴的认同，对与圈内人发生不安全的临时性行为有很高的“接受度”，加之性病相关知识的缺乏，都是造成学生群体梅毒感染增加的原因[10]。此外，由于我国儿童青少年性教育与生殖健康教育仍以“禁欲性教育”为主[11]，而青少年往往在异性交往过程中对性有强烈的好奇心，发生不安全性行为的风险增加，增加了感染梅毒的风险。
本研究发现，2005—2023年不同学段的学生梅毒感染率均呈上升趋势，初中阶段每年增长幅度最大，提示学生梅毒发病率呈低龄化趋势，与在成都开展的研究结果相似[12]，和陆瑶等[13]报道中国青年学生不同年份梅毒总体合并感染率呈逐年上升趋势相似，也提示今后应加强低龄青少年、甚至是青春早期儿童青少年的性病预防健康教育。有研究发现，青少年发生性行为存在偶然性和低龄化, 而且初中阶段初次性行为使用安全套的比例低于50%[14-16]。本研究显示，初中学生梅毒报告发病率每年增长幅度最大，提示初中学生青春期性教育存在较大薄弱环节，加强初中生青春期性教育和性病预防教育及行为干预是今后教育和卫生部门及学校健康教育和疾病预防工作的重点。本研究发现，在校学生梅毒以隐性梅毒为主，但是一、二期和隐性梅毒报告发病率均呈持续上升趋势，与全国[17]和云南省[18]报告结果基本一致。一、二期梅毒报告发病率上升，提示传染源活动性较高。分析原因可能是交友软件盛行，无保护临时性行为普遍存在，导致梅毒感染的发生。提示国家相关部门应制定相关法规，加强对新媒体的监督管理和引导；此外，卫生健康部门可通过与此类新媒体合作，传播相关性病防治知识，提高学生的健康防护意识。学校可根据儿童青少年的年龄特点，以融合学科或载体课程推进青春期性教育、性与生殖健康知识、安全性行为指导的健康教育，通过举办校园健康周活动、社团活动等提高青少年的参与积极性，有条件的学校可以设置生殖健康咨询中心，结合心理健康教育课提供个性化、匿名咨询服务[19]，让更多青少年在初次性行为前有充足的性健康知识。
性传播为学生梅毒感染主要传播途径，与全国相关研究基本一致[20-22]。本次调查中发现学生病例中有先天梅毒病例，主要集中在2018年以前，2018年以后均未出现，其一定程度反映了云南省加强梅毒母婴阻断传播工作和病例报告规范工作的成效。
综上所述，云南省2005—2023年学校学生梅毒疫情逐年增长，有低龄化趋势。应通过学校的教育，全方位营造学校性健康教育的良好环境，遏制校园梅毒的发生与传播。

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2025年第46卷第5期
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doi: 10.16835/j.cnki.1000-9817.2025134
  • 接收时间：2024-10-23
  • 首发时间：2026-11-06
  • 出版时间：2025-05-25
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  • 收稿日期：2024-10-23
  • 修回日期：2024-12-16
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    1云南省疾病预防控制中心学校卫生所，昆明 650500
    2云南省疾病预防控制中心质量管理部
    3云南省疾病预防控制中心营养与食品卫生所

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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
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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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