甘肃省大骨节病流行的长期趋势分析

Long-term trend of the prevalence of Kashin-Beck disease in Gansu Province

目的分析甘肃省大骨节病监测数据,了解大骨节病发病长期变化趋势。方法自甘肃省疾病预防控制中心收集1990-2021年甘肃省儿童大骨节病X线检查数据,利用Joinpoint回归模型分析儿童大骨节病X线检出率的变化趋势,以年度变化百分比(annual percent change,APC)和平均年度变化百分比(average annual percent change,AAPC)对观察指标进行趋势分析;同时构建多项式回归模型拟合儿童大骨节病X线检出率随时间的变化。结果1990-2021年,甘肃省儿童大骨节病X线累计检查儿童126726人次,阳性检出为3011人次,2019-2021年儿童大骨节病X线检出率为0。Joinpoint回归模型分析结果显示,1990-2018年甘肃省儿童大骨节病X线检出率总体呈下降趋势(AAPC=-14.40%,P=0.001)。1990-1998、2002-2008和2008-2012年APC分别为-17.75%、-21.89%和-49.89%,均呈下降趋势(均P<0.05);2012-2018年,APC=6.15%,变化趋势无统计学意义(P=0.475)。甘肃省儿童大骨节病X线检出率随时间变化曲线拟合的四次多项式模型方程为y=0.0003145 x^(4)-0.02137 x^(3)+0.4871 x^(2)-4.635 x+22.08。结论甘肃省儿童大骨节病病情得到有效控制,2012年以后,X线检出率维持在较低水平,2019年后达到消除状态。

Objective To analyze the monitoring data of Kashin-Beck disease(KBD)in Gansu Province and learn about the long-term trend of KBD incidence.Methods The X-ray detection rate of children with KBD in Gansu Province from 1990 to 2021 was collected through Gansu Provincial Center for Disease Control and Prevention.Joinpoint regression model was used to analyze the trend of X-ray detection rate of KBD in children.The annual percent change(APC)and average annual percent change(AAPC)were used to analyze the trend of the observed indicators.In addition,a polynomial regression model was constructed to fit the change of X-ray detection rate of children with KBD over time.Results From 1990 to 2021,a total of 126726 children were examined for KBD by X-ray in Gansu Province,with 3011 positive cases,X-ray detection rate of KBD in children was 0 in 2019-2021.Joinpoint regression model analysis showed that the X-ray detection rate of children with KBD in Gansu Province from 1990 to 2018 showed a decreasing trend(AAPC=-14.40%,P=0.001).The APC of 1990-1998,2002-2008 and 2008-2012 was-17.75%,-21.89%and-49.89%,respectively,showing a decreasing trend(P<0.05).The APC of 2012-2018 was 6.15%,but the trend change was not statistically significant(P=0.475).The curve fitting of X-ray detection rate of KBD in children in Gansu Province over time was carried out,and the quadric polynomial equation was y=0.0003145 x^(4)-0.02137 x^(3)+0.4871 x^(2)-4.635 x+22.08.Conclusions The condition of KBD in children of Gansu Province has been effectively controlled.The X-ray detection rate has remained at a relatively low level since 2012,and it has reached a state of elimination since 2019.