山东省肾综合征出血热发病水平及其疫源地时空动态特征研究

Study on the incidence and spatiotemporal dynamic variation of hemorrhagic fever with renal syndrome in Shandong province

目的 探讨山东省肾综合征出血热（HFRS）发病水平及其疫源地时空动态变化及其影响因素。方法 依据1974-2004年山东省HFRS疫情资料和监测点宿主动物监测资料,采用疾病空间分布的“等值线-面积”多重分形模型分析HFRS发病水平及其疫源地时空动态特征。结果 山东省1974-2004年HFRS疫源地空间结构的动态变化可以分为5个阶段：第一阶段（1974-1981年） HFRS处于完全自然疫源状态,疫源地性质为典型的姬鼠型;第二阶段（1982-1986年）为姬鼠型疫源地和家鼠型疫源地扩张融合的过程;第三阶段（1987-1990年）初步形成了鲁中南山区丘陵地带为中心的以姬鼠型为主的混合型疫源地,及鲁西、北黄河流域为中心的以家鼠型为主的混合型疫源地;第四阶段（1991-1993年）初步形成了以家鼠型为主的混合型疫区的空间格局;第五阶段（1994-2004年）以家鼠型为主的混合型疫区空间格局的相对稳定阶段。结论 山东省HFRS疫源地性质的时空动态演化过程：由单纯姬鼠型和单纯家鼠型疫源地独立存在,转变为以姬鼠型和以家鼠型为主的混合型疫源地相互叠加共存,再达到以家鼠型为主的混合型疫源地长期稳定期。

Objective To study the incidence and spatiotemporal dynamic variation of hemorrhagic fever with renal syndrome （HFRS） in Shandong province. Methods According to surveillance data on HFRS epidemics and host animals, a ＇contour area multifractal model＇ was estimated on the HFRS＇ incidence and multi-analysis model was applied to study spatiotemporal dynamic variation. Results The process could be classified into 5 periods： 1^st.period （ 1974 - 1981 ） when HFRS was in completely natural focal state in Shandong, and the nature of focus was typical Apodemus type. 2^nd period （ 1982 - 1986 ） indicated the process of expanding and merging of the Apodemus type focus in the southeastern part of Linyi district and the Rattus type focus was in the southern part of Jining city. 3^rd period （1987- 1990） indicated that through the expanding and merging of the two epidemic focuses, one mixed focus dominated by the Apodemus type had been formed in the hilly area of the southern and middle part of Shandong while another one dominated by the Rattus type in the Yellow River valley of the northwestern part of Shandong. 4^th period （1991- 1993 ） showed that the process of the spatial pattern of the mixed focus dominated by the Rattus type in Shandong. 5^th period （1994 -2004） referred to the spatial pattern of the mixed focus dominated by the Rattus became stabilized. Conclusion Evolution of the characteristics of HFRS focus in Shandong province experienced the following three processes ： the simple Apodemus type and the simple Rattus type were seen separately to the mixed foci with the Apodemus type dominant and the Rattus dominant type coexisted and merged to the stable state of the mixed focus with Rattus as the dominant one.