沙尘天气细颗粒物对呼吸及心血管系统疾病日门诊人数的影响  

Association of PM_(2.5)from Dust Events with the Number of Daily Outpatient for Respiratory and Cardiovascular Diseases

作　　者：孟紫强[1] 张剑[1] 杨振华[1] 卢彬[1] 

机构地区：[1]山西大学环境科学与工程研究中心,山西大学环境医学与毒理学研究所,山西太原030006

出　　处：《环境与职业医学》2008年第3期225-231,共7页Journal of Environmental and Occupational Medicine

基　　金：国家自然科学基金重点项目(编号：30230310);山西省自然科学基金项目(编号：20031092)

摘　　要：[目的]研究沙尘天气大气细颗粒物(PM_(2.5))与呼吸及心血管系统疾病每日门诊人数的关系。[方法]采用半参数广义相加泊松回归模型(GAM),在控制了时间长期趋势、季节趋势、气象因素、日历效应等混杂因素影响的基础上,分析2004年3月1日至5月31日沙尘暴频发区——甘肃省武威市大气PM_(2.5)与呼吸、心血管系统疾病日门诊人数的关系。[结果]①单污染模型分析发现,PM_(2.5)与男、女总呼吸系统疾病门诊人数分别在滞后2d(lag2)和1d(lag1)的联系有统计学意义,对男、女性气管炎门诊人数的影响分别在lag1和lag3有统计学意义,对男、女性上呼吸道感染(URTI)门诊人数的影响均在lag2有统计学意义,对男性和女性肺炎门诊人数的影响在lag3和lag2有统计学意义,对男性慢性阻塞性肺部疾病(COPD)门诊人数的影响在lag2有统计学意义而对女性无统计学意义。②PM_(2.5)与男、女总心血管系统疾病门诊人数存在正相关且均在lag3有统计学意义。PM_(2.5)对男、女性风湿性心脏病门诊人数的影响分别在lag0、lag1有统计学意义,对男性高血压门诊人数在lag1有统计学意义,对男、女性缺血性心血管疾病门诊人数的影响分别在lag1和lag5有统计学意义,对男性心律失常门诊人数的影响在lag3有统计学意义,分别在lag5和lag2对男性和女性充血性心力衰竭门诊人数的影响有统计学意义。③双(或多)污染模型分析显示,引入SO_2和(或)NO_2后,PM_(2.5)对男、女性呼吸系统疾病日门诊相对危险度(RR)的影响虽有所降低,但仍然均有统计学意义。然而,在分别引入其他污染物后,SO_2和NO_2对男、女性呼吸系统疾病日门诊RR的影响均无统计学意义。④双(或多)污染模型分析还显示,引入SO_2或NO_2后,PM_(2.5)对男、女性心血管系统疾病门诊RR的影响均有所下降,但仍有统计学意义。对于男性心血管病门诊人数,在分别引入其他污染物[ Objective ] To explore the association between the concentrations of particulate matter ≤ 2.5μm in average aerodynamic diameter （ PM2.5 ）in the atmosphere and the number of daily outpatient for respiratory and cardiovascular （ CV ） diseases. [ Methods ] All major hospitals in the city of Wuwei were selected to report the number of outpatients for respiratory and CV diseases during March 1^st to May 31^st in 2004. The association between the concentration of PM2.5 in the atmosphere and daily outpatient number for the above mentioned diseases was investigated. A semi-parametric generalized additive Poisson regressions model （ GAM ）was fitted to the logarithm of the expected values of daily outpatient number, controlling for smooth functions of long time trends, season, meteorological variables, and calendar effect. [ Results ] （ 1 ） PM2.5 concentration was significantly correlated to the number of total respiratory diseases in males and females with a lag of 2 days and 1 day respectively. PM2.5 concentration was also significantly correlated to the number of bronchitis for males and females with a lag of 1 day and 3 days, respectively; to the number of upper respiratory tract infection（ URTI ）for males and females with a lag of 2 days; to the number of pneumonia for males and females with a lag of 3 days and 2 days ; and also to the number of chronic obstructive pulmonary diseases （ COPD ） for males with a lag of 2 days ; but not significantly correlated to the number of COPD for females ; （ 2 ） There were significant correlation between PM2.5 and the number of total CV diseases for males and females with a lag of 3 days ; between PM2.5 and the number of rheumatic heart disease for males and females with a lag of 0 days and 1 day, respectively; between PM2.5 and the number of hypertension for males with a lag of 1 day, but there was no significant correlation between PM2.5 and the number of hypertension for females. PM2.5 concentration was also significantly correlated to the number

关 键 词：沙尘天气 PM25 呼吸系统疾病 心血管系统疾病 日门诊人数 GAM模型 

分 类 号：R12[医药卫生—环境卫生学]