2010~2020年中国大陆地区肺结核发病趋势分析以及短期发病趋势预测

Analysis of Tuberculosis Incidence Trends in Mainland China from 2010 to 2020 and Short-Term Incidence Trend Forecast

摘要: 目的：分析2010~2020年中国大陆地区肺结核流行数据，阐明其流行病学特征，为制定科学有效的肺结核防控策略提供理论依据。方法：数据来源于中国公共卫生科学数据中心，采用Joinpoint回归模型分析2010~2020年肺结核发病率的长期趋势；再构建自回归差分移动平均(ARIMA)模型，对2025年全年各月份肺结核发病率进行预测。结果：2010~2020年肺结核发病率整体呈下降趋势。新疆肺结核年均发病率最高(183.75/10万)，天津市最低(21.91/10万)，西藏自治区、青海、云南肺结核发病率呈上升趋势(AAPC = 5.2%, 3.9%, 1.2%)；新疆维吾尔自治区和天津市肺结核发病率变化平稳；其余各省肺结核发病率呈下降趋势。全国七大地理分区之间肺结核发病率差异显著(P < 0.05)，西北地区肺结核发病率最高(90.36/10万)，华北最低(45.17/10万)。0~14岁组肺结核年均发病率为10.20/10万，发病率呈下降趋势(AAPC = −8.60%, P < 0.001)；15~59岁组肺结核年均发病率65.40/10万，发病率无显著变化趋势(AAPC = 1.52%, P = 0.465)。ARIMA预测最优模型为ARIMA (1, 1, 1)，残差ACF (自相关函数)与PACF (偏自相关函数)均在95%可信区间内；该模型预测2025年12个月发病率呈平稳下降趋势(从3.85/10万降至2.37/10万)。结论：全国肺结核发病率呈下降趋势，但各区域及年龄组间差异显著，提示需持续优化人群防控策略。

Abstract: Objective: Analysis of tuberculosis prevalence data in Chinese mainland from 2010 to 2020, clarifying its epidemiological characteristics to provide a theoretical basis for developing scientific and effective tuberculosis prevention and control strategies. Methods: The data is sourced from the China National Public Health Science Data Center. A Joinpoint regression model was used to analyze the long-term trends in tuberculosis incidence rates from 2010 to 2020. An autoregressive integrated moving average (ARIMA) model was then constructed to forecast monthly tuberculosis incidence rates for the entire year of 2025. Results: From 2010 to 2020, the incidence rate of tuberculosis showed an overall downward trend. The annual incidence rate of tuberculosis was highest in Xinjiang Uygur Autonomous Region (183.75 per 100,000) and lowest in Tianjin (21.91 per 100,000). The incidence rates in Xizang Autonomous Region, Qinghai, and Yunnan showed an upward trend (AAPC = 5.2%, 3.9%, 1.2%); the incidence rates in Xinjiang Uygur Autonomous Region and Tianjin remained stable; the incidence rates in the remaining provinces showed a downward trend. Significant differences in tuberculosis incidence rates were observed among the seven major geographical regions in China (P < 0.05), with the highest rate in the Northwest region (90.36 per 100,000) and the lowest in North China (45.17 per 100,000). The average annual incidence rate of pulmonary tuberculosis in the 0~14 year old group was 10.20/100,000, and the incidence rate showed a downward trend (AAPC = −8.60%, P < 0.001); The annual incidence rate of tuberculosis in the 15~59 age group was 65.40 per 100,000, with no significant trend in incidence (AAPC = 1.52%, P = 0.465). The optimal model for ARIMA prediction is ARIMA (1, 1, 1), with residual ACF (autocorrelation function) and PACF (partial autocorrelation function) both within the 95% confidence interval; The model predicts that the incidence rate in the 12 months of 2025 will decline steadily (from 3.85/100,000 to 2.37/100,000). Conclusion: The incidence of tuberculosis nationwide is on a downward trend, but significant disparities exist across regions and age groups, indicating a need for continuous optimization of population-based prevention and control strategies.