【摘要】：腎綜合征出血熱(Hemorrhagic Fever with Renal Syndrome，HFRS)是一種自然疫源性疾病。HFRS在世界上分布廣泛，危害較大。我國是HFRS流行最為嚴重的國家，占世界發(fā)病人數(shù)的90％以上；HFRS是嚴重危害我國居民健康的重要傳染病之一，在《全國疾病預(yù)防控制工作第十個五年計劃綱要》(衛(wèi)生部衛(wèi)辦疾控發(fā)[2002]31號)中被列為重點防治的傳染病。研究表明，在中國流行的HFRS病毒株主要為漢坦病毒(Hantan virus，HV)，至少存在漢灘(Hantaan，HTN)型和漢城(Seoul，SEO)型。目前，雖已基本弄清了我國HFRS疫源地類型及其時空分布特征，但尚未闡明HFRS發(fā)病水平和疫源地類型連續(xù)變化的時空動態(tài)特征。因而，以往的疫苗免疫和滅鼠等預(yù)防措施未能依據(jù)其時空動態(tài)變化特征進行適時調(diào)整，致使HFRS的流行仍十分嚴重，老疫區(qū)范圍不斷擴大，新疫區(qū)時有發(fā)生，呈現(xiàn)出疫情難以控制的嚴重局面。因此，研究HFRS的時空流行動態(tài)特征不僅對闡明HFRS的流行病學規(guī)律具有重要的理論意義，，而且對制定切實可行的因時、因地制宜的HFRS預(yù)防控制措施具有重要的現(xiàn)實意義。 鑒于山東省是我國HFRS流行最嚴重的疫區(qū)，其發(fā)病人數(shù)始終占全國發(fā)病總數(shù)的1/3左右；流行的HFRS病毒株也主要為HTN型和SEO型；在海拔高度和地理緯度上恰恰位于第三階梯內(nèi)低緯度穩(wěn)定的Ⅲ型疫區(qū)和高緯度Ⅰ型疫區(qū)之間的過渡區(qū)；經(jīng)歷了由單純型疫源地到混合型疫源地的演化過程，且疫區(qū)結(jié)構(gòu)仍處在動態(tài)變化之中。因而，山東省是研究HFRS時空流行動態(tài)特征的最典型、最具代表性的HFRS疫區(qū)之一。為此，本研究利用山東省1974年～2004年以縣(市、區(qū))為單位的歷年HFRS發(fā)病水平(年均發(fā)病率和逐月發(fā)病率)、HFRS既往病例血清學檢測、宿主動物監(jiān)測(鼠密度、鼠種構(gòu)成及其帶毒率)等資料，將地理流行病學、血清流行病學、地質(zhì)統(tǒng)計學和混沌分形理論等學科的分析方法相結(jié)合，定量分析山東省HFRS發(fā)病水平和疫源地類型連續(xù)變化的時空動態(tài)特征。以期闡明山東省HFRS疫源地時空動態(tài)演化規(guī)律，為制定切實可行的HFRS預(yù)防控制措施提供理論
[Abstract]:Hemorrhagic fever with renal syndrome (Hemorrhagic Fever with Renal Syndrome,HFRS) is a natural epidemic disease. HFRS is widely distributed and harmful in the world. China is the country with the most serious HFRS epidemic, accounting for more than 90% of the world, HFRS is one of the most important infectious diseases that seriously endanger the health of the residents in our country. In the outline of the Tenth Five-Year Plan of National Disease Prevention and Control (Health Office of the Ministry of Health [2002] 31), it was listed as the key infectious disease prevention and control. The results showed that the most prevalent HFRS strains in China were Hantavirus (Hantan virus,HV), at least Hantaan,HTN and Seoul,SEO. At present, although the types of HFRS foci and their temporal and spatial distribution in China have been basically clarified, the spatiotemporal dynamic characteristics of the continuous changes of HFRS incidence level and foci types have not been clarified. As a result, previous preventive measures such as vaccine immunization and rodent control failed to adjust timely according to their temporal and spatial dynamic changes, resulting in a very serious epidemic of HFRS. The scope of the old epidemic area continued to expand, and new epidemic areas occurred from time to time. There is a serious situation in which the epidemic is difficult to control. Therefore, the study of spatiotemporal epidemic dynamics of HFRS is not only of great theoretical significance to clarify the epidemiological law of HFRS, but also of practical significance to make measures to prevent and control HFRS according to local conditions. In view of the fact that Shandong Province is the most serious epidemic area of HFRS in our country, the number of people suffering from the disease always accounts for about one third of the total incidence in China, and the prevalent HFRS virus strains are mainly HTN type and SEO type. In the altitude and geographical latitude, the transition area between the type 鈪

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