长沙市大气污染物与脑卒中急诊关系的病例交叉研究  

Relationship between air pollution and emergency hospital visits for stroke in Changsha:a case-crossover study

作　　者：周玉庆 袁洪[2,3] 黄志军[2,3] 蒋智升 段艺珠[2,3] 唐晓鸿 

机构地区：[1]郴州市第一人民医院南院老年医学科,湖南郴州423000 [2]中南大学湘雅三医院临床药理中心 [3]湖南省高血压研究中心 [4]长沙市口腔医院口腔颌面外科

出　　处：《环境与健康杂志》2014年第9期764-768,共5页Journal of Environment and Health

基　　金：国家自然科学基金(81202166);中南大学中央高校基本科研业务费专项资金(2012zzts122;2012QNZT166);湖南省社会发展支撑计划一般项目(2011SK3240;2011FJ4266)

摘　　要：目的探讨长沙市大气污染物日均浓度与脑卒中急诊的相关性。方法收集2008-2009年中南大学湘雅三医院每日脑出血和脑梗死急诊数据，及长沙市同期大气二氧化硫（SO2）、二氧化氮（NO2）、可吸人颗粒物（PM10）和相关气象数据，采用季节分层的单向回顾性1：4配对病例交叉设计建立单污染物和多污染物模型并进行分析。结果在调整气象因素（气温和相对湿度）的单污染物滞后模型中，秋季SO2、NO1、PM10日均浓度每增加10μg,／m3，滞后0～3d的脑出血与脑梗死DR值均大于1，且关联有统计学意义（P〈0．05）。多污染物模型中，控制PM10＋NO2后秋季SO2浓度每增加10μg／m3时，脑梗死急诊的0R值（95％CI）为1．446（1．130-1．850）；控制PM10＋SO2后秋季NO2浓度每增加10μg／m3时，脑出血急诊的DR值（95％CI）为1．615（1．131-2．305）；控制其他污染物后冬季NO2、PM10浓度每增加10μg／m3，脑出血急诊的0R值（95％CI）分别为1．325（1．019～1．724）和1．117（1．024—1．218），关联均有统计学意义（P〈0．05）。结论长沙市秋季SO2、NO2、PM10浓度与脑出血和脑梗死急诊均呈正向关联，其中SO2对脑梗死急诊影响更明显，NO2对脑出血急诊影响更明显；冬季NO2、PM10浓度与脑出血急诊亦呈正向关联。Objective To investigate the relationship between air pollution and emergency hospital visits （EHVs） for stroke in Changsha, China. Methods The data of daily EHVs for stroke were collected from the third Xiangya Hospital during 2008- 2009. The corresponding air pollutions, meteorological data were collected. The seasonal-stratified case-crossover design with 1：4 matched pair was used to set up single-pollution models and multi-pollution models for the data analysis. Results After adjustment for the temperature and relative humidity in single-pollution models, sulfur dioxide （SO2）, nitrogen dioxide （NO2） and particulate matters with an aerodynamic diameter of 〈10 μm （PM10） were significantly associated with EHVs of cerebral hemorrhage and cerebral infarction at lags of 0, 1, 2 and 3 days in autumn. In multi-pollution models, a 10 μg/ms increase in SO2 and NO2 were significantly associated with EHVs of cerebral infarction （OR=1.446, 95%CI： 1.130-1.850） and cerebral hemorrhage （OR=1.615, 95%CI： 1.131-2.305） respectively in autumn. A 10 μg/m3 increase in NO2 and PM10 were significantly associated with EHVs of cerebral hemorrhage on value of ORs 1.325（95%CI： 1.019-1.724） and 1.117（95%CI： 1.024-1.218） respectively in winter. Conclusion In autumn , the elevated concentration of SO2, NO2 and PM10 are associated with increased EHVs for stroke in Changsha, especially SO2 has more significant effect on cerebral infarction and NO2 has more significant effect on cerebral hemorrhage. In winter, NO2 and PM10 are both associated with increased EHVs for cerebral hemorrhage.

关 键 词：脑卒中 急诊 大气污染物 病例交叉研究 

分 类 号：R181.3[医药卫生—流行病学] R122.2[医药卫生—公共卫生与预防医学]