【摘要】 目的 系统分析2004—2020年中国五种具有代表性的乙类呼吸道传染病(肺结核、猩红热、麻疹、流行性脑脊髓膜炎、百日咳)的时空演化规律，为制定差异化区域防控策略提供科学依据。方法 基于国家传染病报告系统数据，整合空间自相关分析(全局和局部Moran I)、重心迁移模型和标准差椭圆方法，运用ArcGIS 10.8和GeoDa 1.18.0进行多维度时空建模，揭示发病热点的迁移路径与聚集特征。结果 肺结核、流行性脑脊髓膜炎发病率持续下降，麻疹呈波动下降；猩红热和百日咳2016年后显著上升。肺结核与麻疹高-高聚类区向西北迁移，形成青藏高原-甘青新交界热点带。猩红热呈现北归，2018年后高-高聚类稳定锁定内蒙古地区(Moran I=0.354,P<0.01)。百日咳热点区南移，2020年高聚集区聚焦湘黔交界(湖南省与贵州省交界处)。流脑发病率持续走低，空间聚集性消失。结论 中国五种呼吸道传染病呈现西迁北归的格局，需建立西北地区靶向防控体系，优化流动人口监测与疫苗持久性策略。更多还原

【Abstract】 Objective To systematically analyze the spatial and temporal evolution patterns of five Category B respiratory infectious diseases(pulmonary tuberculosis(PTB), scarlet fever, measles, meningococcal meningitis(MM) and pertussis) in China(2004-2020) to guide regional prevention strategies. Methods Based on the National Notifiable Disease Reporting System(NNDRS) data, we integrated spatial autocorrelation analysis, center of gravity migration model and standard deviation ellipse method for multi-dimensional spatio-temporal modelling to reveal the migration paths and clustering characteristics of the morbidity hotspots. Results The incidence rates of PTB and MM continued to decline, which measles showed a fluctuating decline. scarlet fever and pertussis rose significantly after 2016, with a tendency to make a comeback. The high-high clustering areas of PTB and measles migrated to the northwest. Scarlet fever showed a northward return, with the high-high clustering stable and locked in Inner Mongolia after 2018(Moran I=0.354, P<0.01). Pertussis hotspot area shifted southward, and the high-high clustering area focused on Xiang-qian junction in 2020. The incidence of MM continued to be low and spatial aggregation disappeared. Conclusion These diseases exhibit westward migration and northward return, necessitating targeted control systems in northwestern China, optimized mobile population monitoring and vaccine persistence strategies.更多还原