济南市昼夜温差对麻疹发病的影响  

Effect of diurnal temperature range on incidence of measles in Jinan City

作　　者：王珮竹 郑兆磊 李润滋 许勤勤 康凤玲 许青[2] 李秀君 WANG Peizhu;ZHENG Zhaolei;LI Runzi;XU Qinqin;KANG Fengling;XU Qing;LI Xiujun(Department of Biostatistics,School of Public Health,Shandong University,Jinan 250012,Shandong,China;Shandong Center for Disease Control and Prevention,Jinan 250014,Shandong,China;Shandong University Climate Change and Health Center,Jinan 250012,Shandong,China)

机构地区：[1]山东大学公共卫生学院生物统计学系,山东济南250012 [2]山东省疾病预防控制中心,山东济南250014 [3]山东大学气候变化与健康研究中心,山东济南250012

出　　处：《山东大学学报（医学版）》2018年第8期101-106,共6页Journal of Shandong University:Health Sciences

基　　金：山东省自然科学基金(ZR2016HM75);国家自然科学基金(81673238)

摘　　要：目的探讨昼夜温差对山东省济南市麻疹发病的影响。方法收集济南市2005年1月1日至2011年12月31日麻疹发病监测数据及同期气象数据,在控制季节性和长期趋势的情况下,利用分布滞后非线性模型(DLNM),分析昼夜温差对人群麻疹发病的影响。结果 2005~2011年济南市共报告麻疹病例2 198例,男女性别比为1.28∶1;<8月龄儿童20.70%,≥8月龄且<5岁儿童28.43%,≥5岁且<18岁人群10.92%,≥18岁成人39.95%;以昼夜温差9.1℃为参照,周平均昼夜温差最大(13.2℃)且滞后2周时RR最大,为1.92(95%CI:1.47~2.50),此时有效滞后范围最大(第0~5周);昼夜温差每增加2℃,对男性和女性麻疹发病均在滞后2周时效应最强,RR分别为1.19(95%CI:1.08~1.32)和1.24(95%CI:1.12~1.38);所有年龄组中昼夜温差对≥5岁且<18岁人群在滞后2周时的效应最强,RR为1.41(95%CI:1.15~1.74),对<8月龄婴儿的影响无统计学意义。结论较大的昼夜温差对济南市麻疹发病的影响有统计学意义并存在滞后效应,女性和≥5岁且<18岁人群更易受到昼夜温差的影响。应密切关注昼夜温差的变化,适时针对重点人群采取措施,以减轻其造成的危害。Objective To investigate the effects of diurnal temperature range（ DTR） on measles in Jinan City,Shandong Province. Methods With data of daily measles cases and meteorological data from 1 January,2005 to 31 December,2011,we used a distribution lag non-linear model（ DLNM） to analyze the effects of DTR on the incidence of measles adjusted for seasonal,long-term trends and other confounding factors. Results A total of 2 198 measles cases were reported in Jinan City from 2005 to 2011,with a sex ratio of 1. 28∶ 1. Children aged 8 months accounted for20. 70% of all cases,children aged ≥8 months and 5 years accounted for 28. 43%,patients aged ≥5 and 18 years accounted for 10. 92%,and those aged ≥18 accounted for 39. 95%. Taking 9. 1 ℃ as reference,the risk was the highest when weekly average DTR was the maximum,13. 2 ℃ on lag 2 weeks,as the relative risk（ RR） was 1. 92（ 95%CI： 1. 47-2. 50）,when the significant lag range was the maximum. For a 2 ℃ increase in DTR,the risk was the highest in both male and female at 2 weeks lag,with RR values of 1. 19（ 95%CI： 1. 08-1. 32） and 1. 24（ 95%CI： 1. 12-1.38） respectively. DTR had the strongest effect on children aged ≥5 and 18 years at 2 weeks lag,with an RR of 1. 41（ 95% CI： 1. 15-1. 74） and no significant effect on infants aged 8 months and younger. Conclusion The significant impact and lag effect are found between DTR and the incidence of measles in Jinan City. Female and people aged ≥5 and 18 years are more sensitive to DTR. Attention should be paid to DTR,and timely prevention measures should be taken against susceptible population to mitigate the hazard.

关 键 词：济南 麻疹 昼夜温差 分布滞后非线性模型 相对危险度 

分 类 号：R181.3[医药卫生—流行病学]