湖南省洪涝灾害事件对居民心血管疾病死亡的影响  

Impact of floods on cardiovascular disease mortality in Hu'nan province

作　　者：李宜霏 王浩[2] 倪伟[1] 丁国永[3] 高璐[1] 姜宝法[1] 

机构地区：[1]山东大学公共卫生学院流行病学系,山东济南250012 [2]山东大学公共卫生学院生物统计学系 [3]泰山医学院公共卫生学院劳动卫生与环境卫生学教研室

出　　处：《环境与健康杂志》2015年第4期287-290,共4页Journal of Environment and Health

基　　金：国家重大科学研究计划(973计划)项目(2012CB955502)

摘　　要：目的研究洪涝灾害对湖南省居民心脑血管疾病日死亡人数的影响。方法首先采用描述性分析比较洪涝暴露年（2010年）和非暴露年（2009、2011年）心血管类疾病死亡人数的差别,然后选择差异有统计学意义的病种,采用1∶2双向病例交叉研究进一步进行验证。病例交叉分析结合分层Cox模型判断洪涝灾害对心血管类疾病死亡人数效应的滞后期及其风险比（HR）,同时将最高气温、平均气压、平均相对湿度作为控制变量和待研究变量一起选入Cox模型,控制混杂因素的影响。结果描述性分析发现缺血性心脏病2010年死亡人数高于2009年和2011年;病例交叉分析中,心血管疾病总死亡在滞后17 d时HR到达最大值[1.584（95%CI：1.389~1.807）],缺血性心脏病死亡在滞后20 d时HR到达最大值[1.409（95%CI：1.122~1.769）]。结论洪涝灾害事件可能导致心血管疾病尤其是缺血性心脏病死亡风险增大,值得关注。Objective To know the impacts of the floods on the daily death numbers of cardiovascular diseases among the residents in Hu＇nan province. Methods Firstly, the descriptive analysis was performed in the present study to detect the difference of cardiovascular death numbers between the flood-exposed years （2010） and non-flood-exposed years （2009 and 2011）. Secondly, the 1：2 two-way crossover study case was applied to confirm and analyze the effects further through the significant diseases selected. The lagged interval and hazard ratio （HR） of cardiovascular diseases death numbers were estimated by the mixed method between case cross analysis and cased Cox model, which inputted the max temperature, average air pressure, average relative humidity and sunshine duration in this model to control the confounding effects. Results The death numbers of ischaemic heart disease （IHD） in 2010 was higher significantly than that in 2009 and 2011; The HR value of cardiovascular diseases was the highest with 17 days lagged in the case cross analysis, which was 1.584 （95%CI： 1.389-1.807）. The HR lagged 20 days of IHD was the highest with 1.409 （95%CI： 1.122-1.769）. Conclusion It should be paid attention to that flood events may increase the risks of cardiovascular diseases, especially IHD.

关 键 词：洪涝 心血管疾病 病例交叉设计 

分 类 号：R181.3[医药卫生—流行病学]