宁波市气温对居民慢性阻塞性肺疾病每日死亡的影响  

Study on influence of air temperature on daily chronic obstructive pulmonary disease mortality in Ningbo

作　　者：陆蓓蓓[1] 谷少华[1] 王爱红[1] 葛挺[2] 王永[1] 李晓海[1] 许国章[1] 

机构地区：[1]宁波市疾病预防控制中心,315010 [2]宁波市医疗中心李惠利医院呼吸内科,315010

出　　处：《中华流行病学杂志》2017年第11期1528-1532,共5页Chinese Journal of Epidemiology

基　　金：浙江省医学重点学科“现场流行病学”项目（07-013）;宁波市科技计划项目（2016A610198）;宁波市医学科技计划项目（2016A02）

摘　　要：目的 研究宁波市气温对居民COPD死亡影响.方法 采用时间序列的分布滞后非线性模型,控制时间长期趋势、星期几效应、大气污染和其他混杂因素,分析2011-2016年宁波市日均气温与居民每日COPD死亡的归因风险.结果 宁波市日均气温与每日COPD死亡人数呈反＂J＂形,最小死亡效应温度为25.5℃;COPD死亡存在一定的冷效应和热效应,滞后14 d累积效应分别为2.767（95%CI：1.950-3.928）和1.197（95%CI：1.021-1.404）.归因于气温暴露造成的COPD死亡人数为4963（95%CI：3469-6027）例,占总死亡的31.62%（95%CI：23.05%-38.89%）.低温的归因风险大于高温,归因死亡人数分别为4772例和192例,归因分值分别为30.41%和1.22%.女性和≥65岁人群更易受到低温和高温天气的影响,而〈65岁人群影响的差异均无统计学意义.结论 高温和低温均可增加宁波市居民COPD死亡风险,应对脆弱人群采取有效预防措施,降低COPD死亡风险.Objective To study the influence of daily air temperature on daily chronic obstructive pulmonary disease （COPD） mortality in residents in Ningbo. Methods A time-series analysis using distributional lag non-linear model （DLNM） was conducted to estimate the attributable numbers and fraction of average air temperature on the daily COPD mortality in Ningbo from 2011 to 2016, by controlling the long-term time trend, day of week, air pollutants and other weather variables. Results A reverse J-shape relationship was found between the average air temperature and COPD mortality, and the minimum-mortality temperature （MMT） was 25.5℃. The relative risks of extreme low and extreme high air temperature over lag 0-14 d were 2.767 （95%CI： 1.950-3.928） and 1.197 （95%CI：1.021-1.404）. In total, 31.62%（95%CI：23.05%-38.89%） of COPD mortality （4963 cases, 95%CI： 3469-6027） was attributable to non-MMT exposure, More attributable deaths were due to low air temperature, with a fraction of 30.41%corresponding to 4772 deaths, compared with 1.22%and 192 deaths due to high air temperature. Low air temperature and high temperature were more likely to influence the mortality in females and those aged ≥65 years, but the influence was not significant in people aged 〈65 years. Conclusion Both high and low air temperature were associated with an increased risk of COPD mortality in residents in Ningbo, especially during cold season, related measures on disease prevention should be taken to protect vulnerable population to reduce the risk of COPD mortality.

关 键 词：气温 慢性阻塞性肺疾病 日死亡人数 分布滞后非线性模型 归因风险 

分 类 号：R563.9[医药卫生—呼吸系统]