【摘要】 目的 分析2010-2023年大连市甲型病毒性肝炎（甲肝）的流行特征及时空聚集性，为构建科学防控决策提供依据。方法 以街道（乡镇）为单位，收集2010-2023年大连市甲肝的疾病监测数据，使用R 4.2.2进行描述性分析，以判断疾病季节性特征，使用Joinpoint回归模型对发病率进行趋势分析，采用GeoDa 1.20软件进行全局和局部空间自相关分析，并利用SatScan v10.2.3软件进行时空扫描统计，计算对数似然比评估时空聚集性。结果 2010-2023年大连市累计报告甲型病毒性肝炎病例4 643例，呈下降趋势（AAPC=-12.88%），年均报告发病率为4.84/10万，呈现冬季和夏季双峰形式发病。各年龄组均有发病，发病率较高为36～40岁年龄组，职业为农民及渔民占总病例数的40.23%(1 868/4 643)，庄河市（16.368/10万）、长兴岛经济区（10.711/10万）和普兰店区（5.042/10万）的发病率位居前列。空间自相关显示，2012-2020均存在全局空间相关性（P<0.05）。局部空间自相关和时空扫描结果显示，历年来“高-高”聚集区主要发生在庄河市、甘井子区、金普新区，聚集呈现自大连北部向南延伸，上述地区也是甲肝I类聚集区所涵盖的主要区域，聚集半径48.07 km，对数似然比（LLR）为1 248.47(P<0.01)，表明此区域存在疾病聚集的极高可能性；Ⅱ类聚集区涉及瓦房店市全域、长兴岛经济区全域等街道，聚集半径为59.94 km,LLR为117.81(P<0.01)。结论 大连市2010-2023年甲肝发病率呈现下降趋势，存在季节性发病特征，高发人群为农民及渔民。空间聚集性方面，主要聚集区集中在庄河市、瓦房店市和普兰店区等区域，且呈现自北向南延伸，应针对这些区域实施精准防控。更多还原

【Abstract】 Objective To analyze the epidemiological characteristics and spatiotemporal clustering of hepatitis A in Dalian city from 2010 to 2023, providing a basis for constructing scientific prevention and control decisions. Methods Disease surveillance data of hepatitis A in Dalian city from 2010 to 2023 were collected by street(township) level. Descriptive analysis was performed using R 4.2.2 to determine the seasonality of the disease. Joinpoint regression model was used for trend analysis of incidence rate. GeoDa 1.20 software was used for global and local spatial autocorrelation analysis. Spatiotemporal scanning statistics were performed using SatScan v10.2.3 software, and log-likelihood ratio was calculated to assess spatiotemporal clustering. Results A total of 4 643 cases of hepatitis A were reported in Dalian city from 2010 to 2023, showing a downward trend(AAPC=-12.88%). The average annual reported incidence rate was 4.84/100 000, exhibiting a bimodal pattern of winter and summer incidence. The incidence rate was highest in the 36-40 age group, with farmers and fishermen accounting for 40.23%(1 868/4 643) of all cases. Zhuanghe city(16.368/100 000), Changxing island economic zone(10.711/100 000), and Pulandian district(5.042/100 000) had the highest incidence rates. Spatial autocorrelation showed global spatial correlation from 2012 to 2020(P<0.05). Local spatial autocorrelation and spatiotemporal scanning results show that the “high-high” clustering areas had mainly occurred in Zhuanghe city, Ganjingzi district, and Jinpu new area over the years, extending from northern Dalian to south. These areas also primarily encompass the Class I hepatitis A clustering areas, with a cluster radius of 48.07 km and a log-likelihood ratio(LLR) of 1 248.47(P<0.01), indicating a very high probability of disease clustering in these regions. Class II clustering areas involve the entire Wafangdian city and Changxing island economic zone, with a cluster radius of 59.94 km and an LLR of 117.81(P<0.01). Conclusions The incidence of hepatitis A in Dalian city from 2010 to 2023 showed a downward trend, exhibiting seasonal characteristics, with farmers and fishermen being the high-risk groups. Regarding spatial clustering, the main clustering areas were concentrated in Zhuanghe city, Wafangdian city, and Pulandian district, extending from north to south. Precise prevention and control measures should be implemented in these areas.更多还原