沙尘天气PM_(10)对多种心血管疾病日门诊人数的影响  

Association of PM_(10) derived from dust events with daily outpatient number for cardiovascular diseases

作　　者：杨振华[1] 张月霞[1] 张全喜[1] 张剑[1] 卢彬[1] 孟紫强[1] 

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

出　　处：《中国环境科学》2015年第1期277-284,共8页China Environmental Science

基　　金：国家自然科学基金(30230310;21107064);山西省自然科学基金(20031092;2012021033-4);山西省高校科技研究项目(20120010501)

摘　　要：为研究沙尘天气大气可吸入颗粒物（PM10）与心血管系统疾病每日门诊人数的联系,采用半参数广义相加泊松回归模型（GAM）,在排除了混杂因素如季节趋势、日历效应、气象因素和时间长期趋势等作用的前提下,分析2004年3月1日～5月31日沙尘暴频发区——甘肃省武威市大气PM10与多种心血管疾病每日门诊相对危险度（RR）的关系.结果表明,PM10与男、女总心血管系统疾病门诊RR均在滞后第2d（lag2）的联系有统计学意义.PM10分别在lag3和lag4对男、女性风湿性心脏病门诊RR的影响有统计学意义;PM10（lag2）与男性高血压门诊RR的联系有统计学意义.PM10在lag2对男性缺血性心血管疾病门诊RR的影响有统计学意义;PM10对男、女性心律失常以及充血性心力衰竭门诊RR的影响均无统计学意义.在调整了SO2和/或NO2后,PM10对男、女性心血管系统疾病门诊RR的作用有所下降,但在统计学上仍有意义.然而在分别调整了其他污染物后,SO2和NO2变得无统计学意义.沙尘天气PM10浓度分类模型分析表明,从正常清洁天、轻度污染天到扬沙天气、沙尘暴天气,随着PM10浓度水平的增大,心血管系统疾病（缺血性心血管疾病、充血性心力衰竭、心律失常、高血压、风湿性心脏病）门诊RR也随之增高,呈现一定的剂量效应关系.沙尘天气可吸入颗粒物可引起暴露居民多种心血管系统疾病（缺血性心血管疾病、充血性心力衰竭、心律失常、高血压、风湿性心脏病）门诊人数增多,且均呈现滞后效应.PM10浓度与心血管系统疾病门诊RR表现为一定的剂量效应关系.PM10浓度与沙尘天气强度有密切关系,随着PM10浓度与沙尘天气强度的增大,暴露居民心血管系统多种疾病日门诊RR也增大,具体为：正常清洁天＜轻度污染天＜扬沙天＜沙尘暴天.To explore the association between atmosphere particulate matter with an aerodynamic diameter less than 10 μm （PM10） and daily outpatient visits for cardiovascular diseases, all good-sized hospitals in Wuwei city in Gansu province, northwest of China, in which blowing sands and dust storm have taken place frequently, were selected. During the period from March 1st to May 31st in 2004, the association between the concentrations of PM10 and daily outpatient visits for cardiovascular diseases was investigated when dust and sand events occurred frequently. The semi-parametric generalized additive Poisson regressions model （GAM） was used to analyze the associations between PM10, NO2, SO2 and daily cardiovascular outpatient number relative risks by controlling the long time trends, season, meteorological variables, and calendar effect. The results showed that PM10 was significantly associated with increased outpatient visits from a lag of 2 days total cardiovascular diseases in the male and female patients, while PM10 was significantly related to a lag of 3 days and 4 days rheumatic heart disease for males and females, respectively. Besides, the results confirmed the positive and statistically significant association between PM10 with a lag of 2 days and the outpatient visits for male hypertension or with male ischemic cardiovascular diseases. The nonsignificant effects were observed in female hypertension visits or in arrhythmia and congestive heart failure visitors for males and females. Co-pollutant model and multi-pollutant model pointed out that, after adjusting for SO2 and/or NO2, there was a decreasing effect of PM10 on daily outpatient numbers forcardiovascular diseases, but positive significant association was still retained. Nevertheless, after adjusting for other pollutants, the association between daily outpatient numbers for cardiovascular diseases and neither SO2 nor NO2 was significant. Categorical model of PMlo showed that relative risks of cardiovascular diseases （rheumatic heart disease, hy

关 键 词：沙尘天气 PM10 心血管疾病 每日门诊RR GAM模型 

分 类 号：X503.1[环境科学与工程—环境工程]