1990—2014年徐州地区布加综合征空间分布特征和空间自相关分析研究

doi:10.12114/j.issn.1007-9572.2019.00.401

摘要/Abstract

摘要： 背景　布加综合征（BCS）是因肝静脉或下腔静脉流出道阻塞而导致各种症状的总称，流出道阻塞的范围可以是肝静脉到下腔静脉连接处之间，以及肝静脉到右心房之间的任何一处血管，目前中国BCS患者病因仍不明确。地理信息系统（GIS）是一门结合地图和地理空间分析方法的综合学科，不仅在地理学上有所应用，还广泛应用于疾病的空间分布研究。本研究首次应用GIS来描述徐州地区BCS患者空间分布情况及特征。目的　通过分析1990—2014年徐州地区BCS的空间分布特征及空间自相关关系，为BCS的病因研究和疾病防治提供参考依据。方法　收集1990—2014年徐州地区徐州医科大学附属医院、丰县人民医院、沛县人民医院、邳州市人民医院、新沂市人民医院、睢宁县人民医院的住院病历信息系统中所有首次确诊的BCS患者病历资料。汇总病例的人口信息，包括姓名、性别、年龄、家庭住址、住院日期、诊断等。每5年为1个时间段统计1990—2014年徐州地区BCS发病率；基于ArcGIS 10.4软件，采用全局空间自相关Moran's I指数分析和局部空间自相关Getis-Ord指数分析进行空间自相关分析。结果　1990—2014年，徐州市共有568例新发BCS患者。1990—2014年徐州地区BCS发病率逐年上升（由1990—1994年间的0.08/10万上升到2010—2014年间的0.35/10万）。对1990—2014年徐州地区BCS发病率以镇为单位进行全局空间自相关Moran's I指数分析，结果显示P值均>0.05，表明1990—2014年的各时间段BCS发病率空间分布自相关性均不显著（P>0.05）。局部空间自相关Getis-Ord指数分析结果显示，1990—1994年徐州地区BCS发病热点区域有徐州丰县、徐州市区东南部与睢宁县交界地区；1995—1999年徐州地区BCS发病热点区域为徐州市区与丰县、沛县交界地区，冷点地区为邳州市与睢宁县交界地区。2000—2004年徐州地区BCS发病热点区域为沛县微山湖周边，冷点区域为睢宁县南部；2005—2009年徐州地区BCS发病热点区域为沛县微山湖周围地区，冷点区域为徐州市区与丰县、沛县交界处；2010—2014年徐州地区BCS发病热点区域为徐州睢宁县东南部、沛县靠近微山湖地区、徐州市区，冷点区域在邳州市东部、新沂市、丰县。结论　1990—2014年各时间段徐州市BCS热点区域多为徐州市区及丰县、沛县、睢宁县以及微山湖周围受水污染的城镇，冷点区域为邳州市、新沂市；BCS热点区域多出现在重工业区和环境污染区，这提示环境污染以及重体力劳动可能是BCS发病的影响因素。

关键词: Budd-Chiari综合征, 地理信息系统, 空间自相关, 空间分布特征, 徐州市

Abstract: Background　Budd-Chiari syndrome（BCS） is a general term for various symptoms caused by obstruction of the hepatic vein or inferior vena cava outflow tract.The range of the outflow tract obstruction can be any vessel between the hepatic vein and the inferior vena cava or any vessel between the hepatic vein and the right atrium.The etiology of BCS in China is still unclear.Geographic information systems（GIS） is a comprehensive discipline that combines maps and geo-spatial analysis methods.It is not only used in geography，but also widely used in the study of spatial distribution of diseases.In this study，GIS was used for the first time to describe the spatial distribution and characteristics of BCS patients in Xuzhou area.Objective　To analyze the spatial distribution characteristics and spatial autocorrelation of BCS in Xuzhou from 1990 to 2014，to provide reference for etiological study and prevention of BCS.Methods　The medical records of all newly diagnosed BCS patients in Xuzhou were collected from medical records information system of the Affiliated Hospital of Xuzhou Medical University，Feng Xian People's Hospital，Pei County People's Hospital，Pizhou People's Hospital，Xinyi People's Hospital and Suining People's Hospital.We summarized the personal demographic information of the cases，including name，sex，age，family address，date of hospitalization，diagnosis，etc.The incidence of BCS in Xuzhou area from 1990 to 2014 was counted every 5 years.Based on ArcGIS 10.4 software，global spatial autocorrelation Moran's I index analysis and local spatial autocorrelation Getis-Ord index analysis were used for spatial autocorrelation analysis.Results　From 1990 to 2014，there were 568 newly diagnosed BCS patients in Xuzhou.The incidence of BCS in Xuzhou increased year by year from 1990 to 2014（from 0.08 / 100 000 in 1990—1994 to 0.35 / 100 000 in 2010—2014）．The global spatial autocorrelation analysis of BCS incidence at the town level in Xuzhou area from 1990 to 2014 using Moran's I index was performed.The results showed that P values were all > 0.05，indicating that the spatial distribution of BCS incidence rates in Xuzhou from different time periods during 1990 to 2014 was not significantly correlated（P>0.05）．The results of local spatial autocorrelation analysis using Getis-Ord index showed that high-incidence（"hot spots"） areas of BCS in Xuzhou from 1990 to 1994 were boundary areas between Feng County，Xuzhou southeastern urban areas and Suining County.From 1995 to 1999，the high-incidence areas of BCS were boundary areas between Xuzhou urban areas，Feng County and Pei County，and the low-incidence（"cold spots"） areas were the boundary areas between Pizhou City and Suining County.From 2000 to 2004，the high-incidence areas of BCS were areas surrounding the Weishan Lake in Pei County，and the low-incidence area was southern Suining County.From 2005 to 2009，the high-incidence areas of BCS were areas surrounding the Weishan Lake in Pei County，and the low-incidence areas were boundary areas between Xuzhou urban areas，Feng County and Pei County.From 2010 to 2014，the high-incidence areas of BCS were southeastern Suining County，areas adjacent to the Weishan Lake in Pei County，and Xuzhou urban areas，and the low-incidence areas were eastern Pizhou City，Xinyi City and Feng County.Conclusion　In different time periods during 1990 to 2014，high-incidence areas of BCS in Xuzhou mainly were Xuzhou urban areas，Feng County，Pei County，Suining County and towns polluted by the water of the Weishan Lake，and the low-incidence areas of BCS mainly were Pizhou City and Xinyi City.The high-incidence areas of BCS are mostly in heavy industrial zones and polluted areas，suggesting that environmental pollution and heavy physical work may be the risk factors of BCS.

Key words: Budd-Chiari syndrome, Geographic information system, Spatial autocorrelation, Spatial distribution characteristics, Xuzhou

汤诚,朱帅,陈肖肖,等. 1990—2014年徐州地区布加综合征空间分布特征和空间自相关分析研究[J]. 中国全科医学, 2019, 22(33): 4142-4146. DOI: 10.12114/j.issn.1007-9572.2019.00.401.
TANG Cheng,ZHU Shuai,CHEN Xiaoxiao, et al. Spatial Distribution Characteristics and Spatial Autocorrelation Analysis of Budd-Chiari Syndrome in Xuzhou City from 1990 to 2014　[J]. Chinese General Practice, 2019, 22(33): 4142-4146. DOI: 10.12114/j.issn.1007-9572.2019.00.401.

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