基于GIS技术的中国儿童矮小症的空间分布特征及环境归因分析

Height is a health indicator during the growth of children. The Short Stature is a common disability which is lower than the -2SD of the height standard. The sampling survey reveals that there are about eight million children with moderate to severe growth retardation which is increasing at the rate of 16100 every year. Height is influenced by internal hereditary, geographical environment and the external Social and economic factors and is characterized by spatial differentiation. The established standard of height in China lacks of multidimensional measure of geographical environment and social economic conditions, which makes the diagnosis of Short Stature not accurate, and further leads to misdiagnosis and overtreatment. The purpose of this study which is based on the existing multiple height development database and GIS spatial General Databases lies in explaining the spatial distribution pattern and regional differences of 0-18 years children in China ,exploring the impact of geographical environment and social economic conditions on stature, building the correction factor and monitoring standards of Short Stature in different area, estimating exactly the distribution data and regionalization of the prevention and control strategy. This study overcomes the establishment standards of sampling statistics which is divided by administrative region about the children stature, ignores the difference of regional population and Interaction between individuals of different population and its geographical environment and social and economic development， which lead to spatial differences of individual growth and development. The results depend on the exclusivity of population and geographic datain pour country, and get independent intellectual property rights research.

身高是儿童生长的健康指标。矮小症是低于身高标准-2SD的常见残障。抽样调查示，我国约有八百万中重度生长迟缓儿童，且以16.1万的年增速递增；身高受遗传内因、地理环境和社会经济外因等交互影响，存在明显空间分异特征。我国现有身高标准制定缺乏地理环境和社会经济状况的多维度衡量，使矮小症诊断存在高评或低估，造成漏诊及过度治疗。本研究依据现有多个身高发育数据库，基于GIS空间综合数据库，阐明我国0-18岁儿童身高的空间分布模式及区域性差异，探析地理环境与社会经济状况对身高生长的影响，建立不同地区矮小症校正系数及监测标准，准确判断矮小症分布数据及区域化的防治策略。该研究克服了目前对儿童身高采用的按行政划分抽样统计建立标准，忽略区域内人群的差异性、区域间不同人群个体与其地理环境和社会经济发展交互作用导致的个体生长发育的空间差异。结果依赖我国人口、地理数据独占性，获得自主知识产权研究成果。

儿童是社会可持续发展的重要资源，对人口素质及强国具有重要战略意义。由于我国地域辽阔，不同地区社会经济情况、地理环境以及饮食习惯等方面差异很大，使得不同地区身高差异较大，特别是南北差异更加明显。因此非常有必要研究儿童矮小症患病的空间差异性，并研究其社会经济及地理环境因素的控制作用。我们的研究探索了中国儿童矮小症患病率的空间分布并对影响矮小症空间分布的的社会经济及地理气候因素进行分析。研究结果显示矮小症患病率在农村和欠发达地区明显升高，同时矮小症的患病率在中国大陆存在空间聚集性，在中国的西南部地区矮小症患病率较高，而在东北部地区矮小症患病率表现为低患病率趋势。影响因素研究显示较短的地区的平均受教育年限，较高的海拔和相对湿度是矮小症高发的危险因素。研究成果提示，矮小症患病与社会经济因素及地理气候因素均存在显著相关性，一方面，本研究中的矮小症患病的热点区域如四川，贵州，广东，广西，重庆，海南，云南地区及农村和欠发达地区应作为国家矮小症防控的重点关注区域；另一方面，基于地理气候因素对矮小症的影响，矮小对于某些特定地区的人群也许并不是一种病理状态，更准确的说可能是一种适应性进化的结果，因此在评价该特定地区的儿童生长发育时，我们建议身高参照标准应尽量运用该地区儿童的统计数据，或对于矮小症的诊断，相较于全国标准，特定地区应适当降低诊断标准。