南昌极端气温与冠心病的病例交叉研究  

A case-crossover design of extreme temperature on coronary heart disease in Nanchang

作　　者：张欣[1] 吴磊[1] 余超[1] 

机构地区：[1]南昌大学公共卫生学院,江西南昌330006

出　　处：《中国老年学杂志》2013年第24期6242-6245,共4页Chinese Journal of Gerontology

基　　金："十一五"国家科技支撑计划项目(No.2008BAI68BOO)

摘　　要：目的探讨极端气温(极高温、极低温、气温骤变及DTR极端值)对冠心病发病的影响,为冠心病的预防提供理论依据和措施。方法收集2003年1月1日至2010年12月31日南昌市大型综合性三级甲等医院收治的冠心病病例资料,并收集同期的气象资料。采用1∶1配对设计的病例交叉研究,比较冠心病患者病例期和对照期的极端气温暴露差异(极高温、极低温、气温骤变及DTR极端值)对冠心病的影响。考虑到极端气温对冠心病影响的滞后效应,选择冠心病发生当天和前1～3 d作为病例期,发病前4～6 d作为对照期。结果当危险期出现极端低温暴露,冠心病的OR值为1.424(95%CI:1.287～1.482)。当危险期出现骤变低温暴露,OR值为1.260(95%CI:1.215～1.306)。当危险期出现DTR极端值暴露,OR值为1.337(95%CI:1.257～1.424)。结论极端气温(极低温、气温骤变及DTR极端值)可能会造成冠心病发生的风险升高,且可能存在滞后效应,值得关注,但尚需进一步的流行病学资料加以补充和证实。Objective To evaluate the association between extreme temperature （ extremely high temperature, extremely low temperature and temperature shock） and the occurrence of coronary heart disease. Methods The daily count of coronary heart disease was ob- tained from the Level-3A hospital in Nanehang between January 2003 and December 2009 and meteorological data were collected during the same period. A 1：1 case-crossover design was used to estimate the impact of extreme temperature on coronary disease. Considering the lag time, cases were the first to third days before the date of cases （ including that very day） ; controls were fourth to sixth days. Results If the dangerous period had extreme temperature exposure, coronary heart disease OR was 1.317 （95 % CI 1. 206 - 1. 439 ）. When the extreme low temperature and shock temperature reduced in winter, OR was 1. 610 （95% C1 1. 290 - 2. 010）. When the danger period had extreme low temperature and sudden rise in temperature, OR was 1. 558 （ 95 % CI 1. 147 - 1. 416 ）. Conclusions The extreme weather in Nanehang might be a risk factor for coronary heart disease, but further study is to be improved and confirmed.

关 键 词：极端气温 冠心病 病例交叉研究 

分 类 号：R181.2[医药卫生—流行病学]