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Abstract：
Objectives: This was a long-term retrospective study, aiming to understand the temporal and spatial trend of cirrhosis in Wuwei from 1995 to 2016, explore its spatio-temporal aggregation, and find out the high incidence areas. To provide theoretical basis for the formulation of comprehensive prevention and treatment strategy of cirrhosis in Wuwei. Methods: Herein, we extracted data of cirrhosis patients who were treated in 12 sentinel hospitals in Wuwei from their medical records. We used SAS and Joinpoint Regression Program for data analysis, SaTScan 9.4 software for clustering area detection, and ArcGIS 10.2 software for geographical distribution mapping. Results: Among 3308 patients with liver cirrhosis (average age, 55.34 years) included in this study, 15.9% were aged 50-54 years. The majority were men (2716, 65.8%), with a sex ratio of 1.92:1 and peasants by occupation (1369, 60.3%). The basic social medical insurance system covered the healthcare costs of 1271 patients (63%). A Joinpoint regression analysis done for 1995-2016 revealed an increase in the standardized cirrhosis rate [average annual percent change (AAPC) = 16.7% (95% CI, 10.2-23.5%)] with three joinpoints in 2010, 2013, and 2016. The annual percent change (APC) from 1995 to 2010 was 11.13% (95% CI: 6.5-16.0), and APC from 2010 to 2013 was 66.48% (95% CI:16.0-138.9); conversely, from 2013 to 2016, APC was 4.4% (95% CI, -7.5-17.8%). Hongshagang Town showed the highest average incidence. Each township showed a gradual increase in the incidence after 2010. The results revealed that in each township, liver cirrhosis incidence had some spatial aggregation and was nonrandom. Four liver cirrhosis clusters were noted in 75 townships in Wuwei. Data were gathered from 2011 to 2016. Conclusions: From 1995 to 2016, the incidence of cirrhosis in Wuwei still showed an increasing trend, but the growth rate slowed down since 2013. In Wuwei, the rate of standardization of cirrhosis in female patients increased steadily and faster than in male patients. It is necessary to strengthen the diagnosis, treatment, prevention, and control measures of cirrhosis-related diseases. The results of spatial scanning, basic spatial distribution, aggregation time, and time trend analysis were consistent.
摘要：
目的：这是一项长期的回顾性研究，为了解武威市1995-2016年肝硬化的时空变化趋势,找出高发地区。为制定武威市肝硬化综合防治策略提供理论依据。方法：这里，我们提取了在武威市12家哨点医院接受治疗的肝硬化患者的病历数据。我们使用SAS和Joinpoint回归程序进行数据分析，SaTScan9.4软件，用于聚类区域检测，和ArcGIS10.2软件进行地理分布制图。结果:3308例肝硬化患者(平均年龄,55.34年)纳入本研究，15.9%的人年龄在50-54岁之间。大多数是男性（2716，65.8％），性别比为1.92：1，按职业划分的农民（1369，60.3%）。基本社会医疗保险制度覆盖了1271名患者（63%）的医疗费用。1995-2016年进行的Joinpoint回归分析显示，在2010年，2013年和2016年，标准化肝硬化率[平均年度变化百分比（AAPC）=16.7％（95％CI，10.2-23.5％）]增加了三个连接点。1995年至2010年的年度百分比变化（APC）为11.13％（95％CI：6.5-16.0），2010年至2013年的APC为66.48%(95%CI：16.0-138.9)；相反，从2013年到2016年,APC为4.4%(95%CI,-7.5-17.8%).洪沙岗镇平均发病率最高。2010年以后，各乡镇的发病率逐渐上升。结果显示，在每个乡镇，肝硬化发病率有一定的空间聚集性,且是非随机的.武威市75个乡镇有4个肝硬化集群。数据收集自2011年至2016年。结论:1995-2016年武威市肝硬化发病率仍呈逐年上升趋势,但自2013年以来增速放缓。在武威,女性患者的肝硬化标准化率稳步上升，并且比男性患者快。有必要加强诊断，治疗,预防,肝硬化相关疾病的防治措施。空间扫描的结果，基本空间分布，聚合时间，和时间趋势分析是一致的。
