大气PM_(2.5)对呼吸系统疾病死亡率影响的Meta分析  

Meta-analysis of the effect of PM_(2.5) on mortality of respiratory diseases

作　　者：顾雯雯[1] 杨洛贤[1] 程庆林[1] GU Wen-wen;YANG Luo-xian;CHENG Qing-lin(Hangzhou Center for Disease Control and Prevention,Hangzhou,Zhejiang 310021,China)

机构地区：[1]杭州市疾病预防控制中心,浙江杭州310021

出　　处：《预防医学》2018年第11期1100-1105,1111,共7页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：杭州市科技计划引导项目(20163501Y36)

摘　　要：目的探讨大气PM_(2.5)短期效应(<7 d)对呼吸系统疾病死亡率的影响。方法以颗粒物、PM_(2.5)、大气污染物、呼吸系统和死亡为关键词检索中国知网、万方数据知识服务平台、维普中文科技期刊数据库、PubMed和Web of Science,纳入研究中国PM_(2.5)与人群呼吸系统疾病死亡率关系的文献,以PM_(2.5)每增加10μg/m^3人群呼吸系统疾病死亡率增加的百分比(ER值)为效应指标,采用Stata 14.0软件进行Meta分析,并按照滞后类型和研究方法进行亚组分析。结果共检索到相关文献1 564篇,最终纳入符合条件的文献17篇,其中中文文献7篇,英文文献10篇。采用随机效应模型对纳入文献进行合并,显示PM_(2.5)每增加10μg/m^3,人群呼吸系统疾病死亡率增加0.48%(95%CI:0.35%~0.62%)。亚组分析显示,PM_(2.5)每增加10μg/m^3的单天滞后效应使人群呼吸系统疾病死亡率增加0.53%(95%CI:0.31%~0.74%),I^2值为65%;累积滞后效应为0.35%(95%CI:0.25%~0.45%),I^2值为44%。时间序列研究中,PM_(2.5)每增加10μg/m^3人群呼吸系统疾病死亡率增加0.51%(95%CI:0.34%~0.67%),I^2值为61%;病例交叉研究为0.32%(95%CI:0.15%~0.49%),I^2值为46%。敏感性分析未见明显差异。Egger检验P=0.005,具有发表偏倚。结论PM_(2.5)升高可能会增加人群呼吸系统疾病死亡率。Objective To explore the relationship between short-term(less than seven days)exposure to PM2.5 and daily respiratory death.Methods We searched for China National Knowledge Infrastructure,Wanfang Database,VIP Database,PubMed and Web of Science by using particulate matter,PM2.5,atmospheric pollutants,respiratory system and death as the key words.The literatures on the relationship between PM2.5 and mortality from respiratory diseases in China were included.The increasing percentage of mortality from respiratory disease while increasing by 10μg/m3 of PM2.5 was used as the effect indicator(ER).Stata 14.0 software were used to conduct meta-analysis,and subgroup analysis was performed according to the type and study methods.Results A total of 1 564 related articles were retrieved,and 17 articles that met the requirements were finally included,including 7 Chinese articles and 10 English articles.The inclusion of the literature using a random effects model showed that for every 10μg/m3 increase in PM2.5,the mortality rate of respiratory disease in the population increased by 0.48%(95%CI:0.35%-0.62%).In the subgroup analysis,the single-day lag effect of PM2.5 increased by 10μg/m3 increased the mortality of respiratory diseases in the population by 0.53%(95%CI:0.31%-0.74%),and the I2 value was 65%;the cumulative lag effect was 0.35%(95%CI:0.25%-0.45%)with an I2 value of 44%.In the time series study,respiratory disease mortality increased by 0.51%(95%CI:0.34%-0.67%)and I2 value was 61%for every 10μg/m3 increase in PM2.5,and the case crossover study was 0.32%(95%CI:0.15%-0.49%),and the I2 value was 46%.There were no significant differences in sensitivity analysis.Egger’s test showed publication bias was existing(P=0.005).Conclusion Elevated level of PM2.5 may increase mortality in respiratory diseases in the population.

关 键 词：PM2.5 呼吸系统疾病 死亡率 META分析 

分 类 号：R122.7[医药卫生—环境卫生学]