2004―2021年中国流行性感冒流行特征及趋势

邓萍; 姜雨淇; 龙江; 赵金华; 张阳; 覃胜林

doi:10.16462/j.cnki.zhjbkz.2025.05.003

2004―2021年中国流行性感冒流行特征及趋势

doi: 10.16462/j.cnki.zhjbkz.2025.05.003

邓萍^{1, 2},
姜雨淇^{1, 2},
龙江^3, ,,
赵金华^{1, 2, ,},
张阳¹,
覃胜林¹

1.
青海大学医学院公共卫生系，西宁 810001
2.
青海省疾病预防控制中心业务部，西宁 810007
3.
重庆市疾病预防控制中心传染病预防控制所，重庆 400700

邓萍和姜雨淇为共同第一作者

基金项目:

国家自然科学基金 12371503

“昆仑英才·高原名医”人才培养项目 Qing Health Offic [2021] No.104

详细信息

通讯作者:
赵金华，E-mail: 99801973@qq.com

龙江，E-mail: 68803648@163.com

中图分类号: R181.3
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- 文章访问数: 13
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- PDF下载量: 5
- 被引次数: 0
出版历程
- 收稿日期: 2024-11-06
- 修回日期: 2025-01-25
- 刊出日期: 2025-05-10

Characteristics and trend analysis of influenza epidemic in China, 2004-2021

DENG Ping^{1, 2},
JINAG Yuqi^{1, 2},
LONG Jiang^{3
, ,},
ZHAO Jinhua^{1, 2
, ,},
ZHANG Yang¹,
QIN Shenglin¹

1.
Department of Public Health, Qinghai University Medical College, Xining 810001, China
2.
Business Department of Qinghai Provincial Center for Disease Control and Prevention, Xining 810007, China
3.
Institute of Infectious Disease Prevention and Control, Chongqing Center for Disease Control and Prevention, Chongqing 400700, China

DENG Ping and JINAG Yuqi contributed equally to this article

Funds:

National Natural Science Foundation of China 12371503

"Kunlun Talents-Plateau Famous Doctors" Project Qing Health Offic [2021] No.104

More Information

Corresponding author: LONG Jiang, E-mail: 68803648@163.com; ZHAO Jinhua, E-mail: 99801973@qq.com

摘要

摘要: 目的分阶段分析2004―2021年中国流行性感冒(简称流感)发病和死亡情况，为流感防控策略提供科学依据。方法数据来源于公共卫生科学数据中心流感年发病和死亡数据，采用Excel 2019软件建立流感发病和死亡数据库，使用R 4.3.1软件进一步分析处理数据，运用Joinpoint 5.0.2软件分析全国、各省(市、自治区)、各年龄段流感年度变化趋势。结果 2004―2021年中国共报告8 103 459例流感病例，年均报告发病率为32.45/10万，年均报告病死率为8.82/10万。平均年度变化百分比为14.55%(95% CI: 9.00%~22.78%, P＜0.001)，整体呈上升趋势。年均报告发病率前3名的省(市、自治区)分别为北京市、浙江省、广东省; 年均报告死亡率前3位的省(市、自治区)分别为北京市、天津市、重庆市; 年均报告病死率前3名的省(市、自治区)分别为新疆维吾尔自治区(简称新疆)、青海省、山东省，仅有海南省、西藏自治区未出现死亡病例。山西省、浙江省、安徽省的年发病率上升幅度最大(均P＜0.05)。0~＜15岁年龄组为流感高发人群，占总病例数的67.40%(5 462 111/8 103 459)，年均报告死亡率与年均报告病死率最高的年龄组均为≥85岁年龄组，各年龄组年报告发病率均呈上升趋势。结论 2004―2021年中国流感发病率呈先上升(2004―2019年)后下降(2019―2021年)趋势，除天津市、贵州省外，各省(市、自治区)整体均呈上升趋势。建议在北京市、天津市等人口密集区域，以及新疆、青海省等医疗资源不丰富的城市增设流感报告监测点，减少地区间的医疗服务差距，提升儿童和老年人流感疫苗接种比例。
- 流行性感冒 /
- 报告发病率 /
- 流行特征 /
- Joinpoint回归模型
Abstract: Objective To analyze the morbidity and mortality of influenza (referred to as influenza) in China from 2004 to 2021 in stages, and to provide scientific basis for influenza prevention and control strategies. Methods The data were obtained from the annual morbidity and mortality data of influenza from the Public Health Science Data Center. Excel 2019 software was used to establish the influenza morbidity and mortality database. R 4.3.1 software was used to further analyze and process the data. And Joinpoint 5.0.2 software was used to analyze the annual change trend of influenza across China, in each province (city and autonomous region) and within each age group., and the annual trend of influenza in each age group. Results A total of 8 103 459 cases of influenza were reported in China from 2004 to 2021, with an average annual reported incidence rate of 32.45/100 000 and an average annual reported case-fatality rate of 8.82/100 000. The average annual percentage change was 14.55% (95% CI: 9.00%-22.78%, P < 0.001), with an overall increasing trend. The top 3 provinces in terms of average annual reported morbidity were Beijing, Zhejiang, and Guangdong; the top 3 provinces in terms of average annual reported mortality were Beijing, Tianjin, and Chongqing; and the top 3 provinces in terms of average annual reported morbidity and mortality were Xinjiang, Qinghai, and Shandong, with only two provinces, Hainan and Tibet, showing no fatal cases. Shanxi, Zhejiang, and Anhui had the greatest increase in annual incidence rates (all P < 0.05). The age group of 0- < 15 years old had the highest incidence of influenza, accounting for 67.40% of the total number of cases (5 462 111/8 103 459), and the age group with the highest annual average reported mortality rate and annual average reported case-fatality rate was the group of ≥85 years old, and the annual reported incidence rates of all age groups showed an increasing trend. Conclusions From 2004 to 2021, incidence rate of influenza in China showed an increasing (2004-2019) and then decreasing (2019-2021) trend, and all provinces (autonomous regions and municipalities directly under the central government), except Tianjin and Guizhou, showed an overall increasing trend. It is recommended that additional influenza reporting and surveillance sites be established in densely populated areas such as Beijing and Tianjin, and in cities that are not rich in healthcare resources, such as Xinjiang and Qinghai, to reduce the disparity of healthcare services between regions and to increase the proportion of influenza vaccination for children and the elderly.
- Influenza /
- Reported incidence /
- Epidemic characteristic /
- Joinpoint regression model

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图 1 2004―2021年中国流行性感冒年发病率和死亡率的Joinpoint分析

A：中国流行性感冒年发病率趋势图; B：中国流行性感冒年死亡率趋势图; APC：年度变化百分比。a：P＜0.05。

Figure 1. Joinpoint analysis of annual influenza morbidity and mortality in China, 2004-2021

A: the trend chart of annual incidence rate of influenza in China; B: the trend chart of annual mortality rate of influenza in China; APC: annual percentage change. a: P < 0.05.

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表 1 2004―2021年中国各省(市、自治区)流行性感冒发病和死亡情况

Table 1. Influenza morbidity and mortality in Chinese provinces (municipalities/autonomous regions), 2004-2021

地区 Region	病例数 Number of cases	发病率 Incidence rate/100 000^-1	死亡数 Number of deaths	死亡率 Mortality rate/100 000^-1	病死率 Fatality rate/100 000^-1
北京市Beijing	516 396	133.44	132	0.034 4	25.56
天津市Tianjin	52 784	19.74	21	0.007 8	39.78
河北省Hebei	510 992	38.36	30	0.002 2	5.87
山西省Shanxi	87 354	13.32	11	0.001 7	12.59
内蒙古自治区Inner Mongolia	36 706	8.18	10	0.002 2	27.24
辽宁省Liaoning	25 921	3.31	2	0.000 3	7.72
吉林省Jilin	17 434	3.56	5	0.001 0	28.68
黑龙江省Heilongjiang	18 603	2.74	6	0.000 9	32.25
上海市Shanghai	90 504	21.07	2	0.000 5	2.21
江苏省Jiangsu	183 986	12.75	21	0.001 5	11.41
浙江省Zhejiang	987 316	95.23	20	0.002 0	2.03
安徽省Anhui	270 984	24.12	25	0.002 2	9.23
福建省Fujian	140 587	20.15	9	0.001 3	6.40
江西省Jiangxi	167 740	20.37	5	0.000 6	2.98
山东省Shandong	166 642	9.29	68	0.003 8	40.81
河南省Henan	547 721	31.68	52	0.003 0	9.49
湖北省Hubei	551 781	52.05	10	0.000 9	1.81
湖南省Hunan	787 428	64.10	19	0.001 6	2.41
广东省Guangdong	1 404 988	69.83	63	0.003 2	4.48
广西壮族自治区Guangxi	252 201	28.61	35	0.004 0	13.88
海南省Hainan	41 141	24.20	0	0	0
重庆市Chongqing	155 624	28.19	40	0.007 2	25.70
四川省Sichuan	394 034	26.24	49	0.003 2	12.44
贵州省Guizhou	74 900	11.38	7	0.001 1	9.35
云南省Yunnan	102 117	11.97	15	0.001 8	14.69
西藏自治区Tibet	5 397	9.76	0	0	0
陕西省Shaanxi	328 796	47.34	15	0.002 2	4.56
甘肃省Gansu	99 639	21.27	10	0.002 1	10.04
青海省Qinghai	11 024	10.39	5	0.004 7	45.36
宁夏回族自治区Ningxia	20 528	17.53	2	0.001 7	9.74
新疆维吾尔自治区Xinjiang	52 191	12.13	26	0.006 0	49.82
全国Nationwide	8 103 459	32.45	715	0.002 9	8.82

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表 2 2004―2021年中国各省(市、自治区)流行性感冒发病率Joinpoint分析

Table 2. Joinpoint analysis of influenza incidence rates by province (municipalities/autonomous region), 2004-2021

地区Region	区段1 Section 1		区段2 Section 2		区段3 Section 3		AAPC (95% CI)/%	P值 value
地区Region	年份 Year	APC (95% CI)/%	年份 Year	APC (95% CI)/%	年份 Year	APC (95% CI)/%	AAPC (95% CI)/%	P值 value
北京市Beijing	2004―2015	13.41(-30.12~47.65)	2015―2019	151.58 (124.29~204.81)^①	2019―2021	-72.97(-80.39~-66.45)^①	15.65 (1.23~34.88)	0.042
天津市Tianjin	2004―2015	-0.90(-50.02~17.46)	2015―2019	108.08(63.00~206.88)^①	2019―2021	-76.08(-89.85~-62.33)^①	-0.17(-11.89~10.53)	0.942
河北省Hebei	2004―2016	11.60(2.73~18.57)^①	2016―2019	68.31(43.68~91.54)^①	2019―2021	-57.84(-68.41~-48.70)^①	7.01(-2.99~11.42)	＜0.001
山西省Shanxi	2004―2012	48.99(9.50~102.72)^①	2012―2019	13.86(1.44~27.81)^①	2019―2021	-27.63(-62.84~40.93)	22.51(5.36~42.46)	0.008
内蒙古自治区Inner Mongolia	2004―2016	1.35(-11.75~16.40)	2016―2019	70.35(-54.60~539.15)	2019―2021	-46.66(-85.11~91.06)	3.00(-20.48~33.42)	0.823
辽宁省Liaoning	2004―2016	17.30(2.05~34.82)^①	2016―2019	43.59(-38.82~237.00)	2019―2021	-43.07(-76.26~36.53)	11.64(-6.95~33.97)	0.236
吉林省Jilin	2004―2016	13.21(-9.98~160.62)	2016―2019	84.13(40.07~129.52)^①	2019―2021	-68.51(-84.37~-49.78)^①	6.12 (-3.59~37.03)	0.181
黑龙江省Heilongjiang	2004―2016	1.95(-27.81~22.95)	2016―2019	105.16(-43.54~195.03)^①	2019―2021	-52.91(-76.55~-12.31)^①	5.32(-6.12~20.90)	0.298
上海市Shanghai	2004―2016	14.24(1.19~28.97)^①	2016―2019	85.46(-16.54~312.09)	2019―2021	-58.72(-79.35~-17.51)^①	10.39(-6.10~29.78)	0.231
江苏省Jiangsu	2004―2016	1.66(-24.40~16.67)	2016―2019	172.02(97.44~289.11)^①	2019―2021	-49.27(-69.34~-23.05)^①	11.44(-3.53~22.33)	0.004
浙江省Zhejiang	2004―2016	7.66(-9.27~23.06)	2016―2019	295.60(220.92~415.00)^①	2019―2021	-59.44(-68.80~-50.45)^①	20.77(14.66~32.47)	＜0.001
安徽省Anhui	2004―2016	24.26(-2.46~39.06)	2016―2019	93.19(59.96~127.04)^①	2019―2021	-49.78(-63.23~-35.23)^①	20.74(14.42~30.20)	＜0.001
福建省Fujian	2004―2016	18.90(-39.12~352.01)	2016―2019	50.32(26.24~83.56)^①	2019―2021	-48.75(-67.05~-25.96)^①	12.24(2.24~38.43)	0.027
江西省Jiangxi	2004―2016	14.62(-0.28~22.41)	2016―2019	61.28(36.07~85.15)^①	2019―2021	-37.05(-51.83~-19.56)^①	13.45(9.15~18.62)^①	＜0.001
山东省Shandong	2004―2016	13.06(-17.71~839.27)	2016―2019	92.54(44.15~147.30)^①	2019―2021	-29.17(-52.15~-1.02)^①	17.55(7.99~97.17)	0.002
河南省Henan	2004―2016	16.06(-19.74~37.41)	2016―2019	131.55(73.48~206.39)^①	2019―2021	-48.51(-66.12~-29.21)^①	19.15(9.71~33.42)	＜0.001
湖北省Hubei	2004―2016	6.71(-12.51~20.96)	2016―2019	208.05(150.19~293.63)^①	2019―2021	-65.42(-74.64~-55.78)^①	12.69(5.11~22.84)	0.008
湖南省Hunan	2004―2016	1.54(-24.74~22.62)	2016―2019	244.24(156.37~398.42)^①	2019―2021	-53.85(-67.67~-40.57)^①	14.80(4.07~30.12)	0.012
广东省Guangdong	2004―2016	23.59(-21.86~43.27)	2016―2019	111.33(71.06~160.18)^①	2019―2021	-69.52(-81.49~-60.28)^①	15.23(7.06~27.71)	＜0.001
广西壮族自治区Guangxi	2004―2015	-4.52(-35.87~11.63)	2015―2019	107.57(64.40~262.79)^①	2019―2021	-35.47(-63.18~-3.01)^①	9.46(3.17~20.14)	0.007
海南省Hainan	2004―2016	7.69(-22.12~30.47)	2016―2019	199.70(113.08~328.02)^①	2019―2021	-44.67(-61.72~-27.81)^①	19.29(11.14~35.75)	＜0.001
重庆市Chongqing	2004―2016	-7.32(-27.43~3.53)	2016―2019	195.64(98.58~399.56)^①	2019―2021	-48.95(-67.46~-21.55)^①	6.03(-1.45~14.72)	0.099
四川省Sichuan	2004―2016	-13.68(-43.86~0.56)	2016―2019	389.85(178.11~956.62)^①	2019―2021	-37.81(-60.88~-12.32)^①	12.83(6.10~25.11)	＜0.001
贵州省Guizhou	2004―2016	-6.29(-62.25~134.76)	2016―2019	59.01(-49.87~149.34)	2019―2021	-34.50(-74.49~55.97)	-1.37(-11.19~12.65)	0.644
云南省Yunnan	2004―2016	-9.95(-35.09~1.88)	2016―2019	157.65(68.68~302.69)^①	2019―2021	-38.84(-66.78~-0.49)^①	3.57(-4.12~11.96)	0.298
西藏自治区Tibet	2004―2006	20.17(-39.84~166.69)	2006―2012	-41.74(-79.16~264.70)	2012―2021	45.80(0.53~160.36)^①	3.10(-4.29~11.97)	0.284
陕西省Shaanxi	2004―2016	3.52(-26.08~33.76)	2016―2019	266.77(155.44~476.79)^①	2019―2021	-67.93(-81.15~-56.55)^①	12.75(1.54~34.33)	0.024
甘肃省Gansu	2004―2006	103.92 (-5.43~452.81)	2006―2019	9.27(-17.10~43.77)	2019―2021	-21.12(-47.08~15.55)	13.17(1.88~28.48)	0.015
青海省Qinghai	2004―2010	-7.81(-60.62~16.59)	2010―2019	37.28(30.78~73.88)^①	2019―2021	-44.61(-62.68~-20.61)^①	7.20(1.34~14.90)	0.020
宁夏回族自治区Ningxia	2004―2009	79.08(-37.35~639.96)	2009―2012	-21.35(-42.08~167.87)	2012―2021	4.55(-49.87~68.24)	16.48(5.36~40.06)	0.011
新疆维吾尔自治区Xinjiang	2004―2016	0.57(-19.66~11.99)	2016―2019	134.94(74.71~218.82)^①	2019―2021	-71.65(-85.25~-57.77)^①	0.65(-7.23~8.81)	0.830
全国Nationwide	2004―2016	11.54(-3.66~24.06)	2016―2019	147.06(100.71~205.07)^①	2019―2021	-57.57(-69.51~-46.73)^①	14.55(9.00~22.78)	＜0.001
注：AAPC，平均年度变化百分比。 ①表示P值＜0.05。 Note: AAPC, average annual percentage change. ① The P value＜0.05.

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表 3 中国各年龄组流行性感冒发病、死亡情况及发病率Joinpoint分析

Table 3. Incidence, death and incidence rate of influenza in different age groups in China

年龄组/岁 Age group/years	发病和死亡情况 Incidence and mortality					发病率变化趋势 Change trend of incidence rate
年龄组/岁 Age group/years	病例数 Number of cases	发病率 Incidence rate/100 000^-1	死亡数 Number of deaths	死亡率 Mortality rate/100 000^-1	病死率 Case fatality rate/100 000^-1	AAPC (95% CI)/%	P值 value
0~＜1	324 636	115.72	18	0.006 5	5.54	23.80(15.60~32.58)	＜0.001
1~＜2	487 038	158.51	20	0.006 7	4.11	22.37(11.09~34.80)	＜0.001
2~＜3	504 477	162.61	29	0.009 3	5.75	12.04(12.45~30.28)	＜0.001
3~＜4	584 040	194.18	19	0.006 5	3.25	24.69(16.28~33.72)	＜0.001
4~＜5	524 714	191.19	25	0.009 1	4.76	23.33(14.48~32.87)	＜0.001
5~＜6	475 220	170.50	10	0.003 5	2.10	22.08(11.84~33.25)	＜0.001
6~＜7	506 379	182.85	14	0.005 3	2.76	20.83(9.94~32.79)	＜0.001
7~＜8	498 740	172.01	8	0.002 9	1.60	18.36(6.74~31.26)	0.002
8~＜9	369 264	124.21	8	0.002 8	2.17	15.18(-2.31~35.83)	0.093
9~＜10	284 412	102.98	8	0.002 9	2.81	14.10(-7.78~41.17)	0.225
10~＜15	903 191	64.98	16	0.001 2	1.77	8.61(-18.89~45.47)	0.579
15~＜20	376 555	26.24	10	0.000 7	2.66	7.22(-24.96~53.21)	0.702
20~＜25	245 749	14.29	15	0.000 8	6.10	10.56(-9.01~34.36)	0.313
25~＜30	347 175	17.80	25	0.001 3	7.20	13.94(2.28~26.93)	0.018
30~＜35	331 076	17.38	25	0.001 4	7.55	16.65(7.94~25.83)	＜0.001
35~＜40	226 827	12.12	35	0.001 8	15.43	16.13(8.40~24.41)	＜0.001
40~＜45	161 679	8.19	51	0.002 6	31.54	13.40(5.51~21.88)	＜0.001
45~＜50	163 546	7.46	49	0.002 1	29.96	14.41(6.18~23.28)	＜0.001
50~＜55	163 563	9.73	40	0.002 5	24.46	14.94(10.51~19.54)	＜0.001
55~＜60	145 320	9.29	37	0.002 4	25.46	16.15(6.50~26.67)	＜0.001
60~＜65	145 184	11.44	51	0.003 9	35.13	13.80(8.61~19.26)	＜0.001
65~＜70	120 651	11.98	40	0.003 8	33.15	19.38(15.31~23.59)	＜0.001
70~＜75	82 835	11.56	39	0.005 7	47.08	17.89(11.93~24.17)	＜0.001
75~＜80	58 755	11.55	38	0.007 5	64.68	19.44(13.10~26.13)	＜0.001
80~＜85	42 761	13.18	40	0.012 2	93.54	21.37(15.09~27.98)	＜0.001
≥85	29 626	16.21	45	0.026 2	151.89	21.63(13.50~30.35)	＜0.001
注：AAPC，平均年度变化百分比。 Note: AAPC, average annual percentage change.

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