极端气温对济南市心脑血管疾病死亡的影响  

Impact of extreme temperatures on cardiovascular deaths in Jinan City

作　　者：韩京[1] 张军[1] 周林[1] 房巧玲[1] 刘守钦[1] 张济[1] 张颖[2,3] 

机构地区：[1]济南市疾病预防控制中心慢病所,山东济南250021 [2]悉尼大学公共卫生学院 [3]山东大学公共卫生学院气候与健康研究中心,山东济南250061

出　　处：《山东大学学报（医学版）》2017年第11期71-74,共4页Journal of Shandong University:Health Sciences

摘　　要：目的探讨极端气温对济南市心脑血管疾病死亡的影响,并为制定防治对策提供依据。方法收集济南市2011年至2014年居民心脑血管疾病逐日死亡资料和同时期的气象资料。极端气温定义:寒潮为每年10月至第二年3月至少连续3 d日平均温度低于济南市2011年至2014年日平均温度的第5百分位数;热浪为每年的5至8月至少连续3 d日平均温度高于济南市研究期间的日平均温度的第95百分位数。采用时间序列泊松回归模型,在控制长期趋势、滞后效应和气象因素的影响后,定量分析平均温度对心脑血管疾病日死亡人数及死亡风险的影响。结果济南市心脑血管疾病死亡分布具有明显的季节性。极端气温暴露(寒潮和热浪)期显著增加了济南市心脑血管疾病日均死亡人数(P<0.01)。泊松回归结果显示,极端气温暴露显著增加了济南市心脑血管疾病的死亡风险,寒潮期与热浪期的死亡风险分别为1.06(95%CI:1.03~1.10)和1.03(95%CI:1.00~1.06),与非极端气温暴露期比较,差异均有统计学意义(P<0.05)。全部人群不论性别与年龄均是寒潮敏感人群,仅高年龄组(≥65岁)是热浪敏感人群。结论极端气温显著增加济南市居民心脑血管疾病日死亡人数与死亡风险;应对极端气温制定公共卫生应急预警政策应覆盖全人群。Objective To investigate the relationship between extreme temperatures and daily number of cardiovascular deaths in Jinan City,and to provide theoretical basis for preventive measures. Methods Data of daily number of cardiovascular deaths and meteorological variables over the period of 2011-2014 were collected. Cold spells/Heat waves were defined as ≥3 consecutive days with mean temperature ≤5 th percentile or ≥95 th percentile,respectively. The time-series adjusted Poisson regression was adopted to assess the effects of extreme temperatures on cardiovascular deaths by controlling for lagged effects and other confounders. Results A clear seasonal distribution of daily number of cardiovascular deaths was observed. Extreme temperatures significantly increased the daily number of cardiovascular deaths（ P〈0. 01）. Both cold spell and heat wave significantly increased the risk of deaths with RR = 1. 06（ 95% CI：1. 03-1. 10） and RR = 1. 03（ 95% CI： 1. 00-1. 06）,respectively（ P〈0. 05）. The elderly group（ ≥65 years） was more vulnerable to heat wave exposure,while all population regardless of age and gender were vulnerable to cold spell.Conclusion Both could spells and heat waves increase the risk of daily cardiovascular death in Jinan City. Our findings suggest that public health policies and interventions during extreme temperatures should target the whole population.

关 键 词：极端气温事件 寒潮 热浪 心脑血管疾病 

分 类 号：R181.3[医药卫生—流行病学]