【摘要】： 目的隨疾病譜的變化傳染病雖不再居首位,但肺結(jié)核,病毒性肝炎、淋病、梅毒等老病死灰復(fù)燃,開始回升和蔓延,再次卷土重來。了解這些疾病的發(fā)病趨勢(shì),從理論上探索其流行規(guī)律,預(yù)測(cè)發(fā)生發(fā)展變化變化趨勢(shì),有的放矢的采取相應(yīng)的干預(yù)措施,具有重要的理論價(jià)值和實(shí)際意義。有關(guān)傳染病模型研究已廣泛引起關(guān)注,為掌握我市傳染病的流行趨勢(shì),評(píng)價(jià)預(yù)防控制措施效果,嘗試用ARIMA模型和灰色模型為分析方法,建立痢疾和肺結(jié)核疫情動(dòng)態(tài)模型,探討其在我市疾病預(yù)防控制中的實(shí)際應(yīng)用價(jià)值,為制定科學(xué)、有效的防制措施提供理論依據(jù)。 方法收集太原市1994年--2003年傳染病疫情報(bào)表和人口資料。描述1994-2003年各種傳染病的發(fā)病水平及病種分布狀況,全面了解不同傳染病的動(dòng)態(tài)變化趨勢(shì)。應(yīng)用ARIMA模型對(duì)太原市痢疾發(fā)病水平進(jìn)行模型擬合與評(píng)價(jià),并建立太原市肺結(jié)核發(fā)病率的灰色模型GM(1,1)。 結(jié)果1.痢疾、病毒性肝炎、肺結(jié)核、淋病和梅毒等五種傳染病已成為近年影響我市人群健康和生活質(zhì)量的主要傳染病;太原市1994-2003年的傳染病總發(fā)病水平維持在317.41/10萬左右,呈下降趨勢(shì)。1999年以后下降速度較快,表明近10年中各種傳染病控制效果較好,尤其是1999年以后控疫效果顯著;痢疾發(fā)病呈現(xiàn)下降趨勢(shì),有明顯的季節(jié)性,下降速度平緩,提示在高峰季節(jié)應(yīng)加大控疫力度;病毒性肝炎1997年前是以甲肝發(fā)病為主,發(fā)病率呈現(xiàn)下降趨勢(shì);乙肝的發(fā)病呈不規(guī)則波動(dòng),有明顯的上升趨勢(shì),1998年后成為病毒性肝炎的主要病型,可見在今后應(yīng)將乙肝的防制做為傳染病防制的重中之重; 1997-2003年肺結(jié)核發(fā)病大幅度上升,速度呈直線上升趨勢(shì),提示遏制結(jié)核病行動(dòng)刻不容緩;淋病與梅毒發(fā)病趨勢(shì)基本一致,1999年呈現(xiàn)一個(gè)高峰,但淋病的變化趨勢(shì)較平穩(wěn),而梅毒呈上升趨勢(shì),變化速度也較淋病大,防制性傳播疾病仍是一個(gè)持久不懈的任務(wù)。 2.經(jīng)痢疾發(fā)病時(shí)序資料分析所建ARIMA(1,0,0) (0,1,1)模型擬合效果較好,能較準(zhǔn)確地預(yù)測(cè)痢疾發(fā)病趨勢(shì)。 3.灰色模型GM(1,1)擬合肺結(jié)核發(fā)病情況效果較好,可以對(duì)肺結(jié)核的發(fā)病水平進(jìn)行預(yù)測(cè)預(yù)報(bào)。 結(jié)論1.太原市1994-2003年的傳染病發(fā)病狀況,總發(fā)病水平維持在317.41/10萬左右,呈下降趨勢(shì);主要傳染病為痢疾、病毒性肝炎、肺結(jié)核、淋病和梅毒,其中,乙肝和肺結(jié)核呈上升趨勢(shì),痢疾、甲肝、淋病和梅毒呈下降趨勢(shì)。10年來,各種傳染病得到較好控制,特別是1999年以后控疫效果顯著。預(yù)示肺結(jié)核和乙肝的防制將是今后的重點(diǎn)工作。 2.應(yīng)用ARIMA模型和灰色模型GM(1,1)對(duì)痢疾和肺結(jié)核發(fā)病率所建模型,擬合效果較好,有一定的實(shí)用價(jià)值,從而能為制定我市傳染病防制措施提供理論依據(jù)。
[Abstract]:Objective with the change of disease spectrum, infectious diseases are no longer the first, but tuberculosis, viral hepatitis, gonorrhea, syphilis and other old diseases recur, begin to rise and spread, and come back again. It is of great theoretical value and practical significance to understand the incidence trend of these diseases, to explore their epidemic law theoretically, to predict the trend of development and change, and to take corresponding intervention measures. In order to understand the epidemic trend of infectious diseases and evaluate the effect of prevention and control measures, the dynamic models of dysentery and tuberculosis were established by using ARIMA model and grey model as analysis methods. To explore its practical application value in disease prevention and control in our city, to provide theoretical basis for scientific and effective prevention and control measures. Methods the epidemic report and population data of infectious diseases were collected from 1994 to 2003 in Taiyuan. The incidence level and distribution of various infectious diseases from 1994 to 2003 were described, and the dynamic trends of different infectious diseases were comprehensively understood. The ARIMA model was used to fit and evaluate the incidence level of dysentery in Taiyuan, and the grey model GM (1 / 1) was established for the incidence of pulmonary tuberculosis in Taiyuan. Result 1. Dysentery, viral hepatitis, tuberculosis, gonorrhea and syphilis have become the main infectious diseases affecting the health and quality of life of the population in our city in recent years. The total incidence level of infectious diseases in Taiyuan City from 1994 to 2003 was maintained at about 317.41 / 100 million, showing a downward trend. After 1999, the rate of decline was relatively fast, which indicated that the control effect of various infectious diseases in the recent 10 years was better, especially after 1999, the effect of epidemic control was remarkable. The incidence of dysentery showed a downward trend with obvious seasonality and a slow decreasing rate, indicating that the epidemic control should be intensified in the peak season, and the incidence of viral hepatitis was mainly due to hepatitis A before 1997, and the incidence rate showed a downward trend. The incidence of hepatitis B is irregular and fluctuating, and has an obvious upward trend. Since 1998, it has become the main type of viral hepatitis, so we should take the prevention and control of hepatitis B as the most important part of the prevention and control of infectious diseases in the future. From 1997 to 2003, the incidence of pulmonary tuberculosis increased by a large margin, and the rate of tuberculosis increased in a straight line, suggesting that the action to curb tuberculosis is urgent. The trend of gonorrhea and syphilis was basically consistent, showing a peak in 1999, but the changing trend of gonorrhea was stable, while the trend of syphilis was on the rise, and the rate of change was larger than that of gonorrhea, so it was still a persistent task to prevent and control sexually transmitted diseases. 2. The fitting effect of the ARIMA (1 / 0 / 0) (0 / 1) model based on the analysis of the time series data of dysentery incidence is good, and it can accurately predict the incidence trend of dysentery. 3. The grey model GM (1 / 1) can be used to predict the incidence level of pulmonary tuberculosis. Conclusion 1. The incidence of infectious diseases in Taiyuan City from 1994 to 2003 was maintained at about 317.41 / 100000, which showed a downward trend. The main infectious diseases are dysentery, viral hepatitis, tuberculosis, gonorrhea and syphilis. Among them, hepatitis B and tuberculosis show an upward trend, while dysentery, hepatitis A, gonorrhea and syphilis show a downward trend. Over the past 10 years, various infectious diseases have been better controlled. Especially after 1999, the effect of epidemic control was remarkable. Foreshadowing tuberculosis and hepatitis B prevention and control will be the focus of work in the future. 2. The application of ARIMA model and grey model GM (1 + 1) to the model of incidence of dysentery and tuberculosis has a good fitting effect and has certain practical value, which can provide a theoretical basis for the formulation of measures for the prevention and control of infectious diseases in our city.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2006
【分類號(hào)】：R181.8

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