环境空气污染物和危险因素与支气管哮喘发作的相关性分析  

Correlation analysis between environmental air pollutants and risk factors on bronchial asthma attack

作　　者：刘源[1] 高福生[1] 朱峰 高艳艳[1] 刘倩[1] LIU Yuan;GAO Fusheng;ZHU Feng;GAO Yanyan;LIU Qian(Department of Respiratory Medicine,the Affiliated Hospital of Weifang Medical University,Weifang 261031,China)

机构地区：[1]潍坊医学院附属医院呼吸内科,山东潍坊261031 [2]潍坊市空气质量检测中心

出　　处：《潍坊医学院学报》2019年第6期460-463,共4页Acta Academiae Medicinae Weifang

摘　　要：目的观察环境空气污染物和哮喘危险因素对成人支气管哮喘(BA)发作的影响,分析其相关性,为哮喘的健康管理提供理论依据。方法选择潍坊市区的5个环境空气质量监测点监测2018年每日的空气质量指数(AQI)、可吸入颗粒物、细颗粒物、SO2、NO2、NO、氮氧化物、CO、O3,统计潍坊医学院附属医院呼吸内科支气管哮喘门诊哮喘发作的就诊人数和哮喘发作住院人数。哮喘危险因素采用1∶1配对病例-对照研究设计。结果 Pearson相关分析表明,病房哮喘发作每月人数与空气中的可吸入颗粒物、PM2.5、SO2、NO2、CO的浓度均呈正相关,其中与PM2.5的相关性较强。门诊哮喘发作每月人数与空气中的可吸入颗粒物、PM2.5、SO2、NO2、CO的浓度均呈正相关。多因素条件Logistic回归分析主要危险因素:①过敏性鼻炎;②支气管哮喘的不规范治疗;③过敏体质(家族遗传);④体质指数增加;⑤吸烟;⑥儿童时期患喘息性支气管炎。保护因素:教育程度。结论①哮喘发作与空气中的可吸入颗粒物、PM2.5、SO2、NO2、CO的浓度呈正相关;②PM2.5是引起哮喘发作的主要影响因素。③与哮喘发作密切相关的因素依次是过敏性鼻炎、支气管哮喘治疗不规范、家族史、体质指数增加、吸烟、儿童期患喘支。而教育程度是支气管哮喘发病的保护因素。Objective To elevate the effect of environmental air pollutants and asthma risk factors on adult bronchial asthma attack and analyze the correlation,in order to provide theoretical basis for asthma health management.Methods Five different ambient air quality monitoring sites in Weifang were selected to detect the daily air quality index(AQI),inhalable particles,fine particulate matter(PM2.5),sulfur dioxide(SO2) and nitrogen dioxide(NO2),combined with nitrogen monoxide(NO) and nitrogen oxides,as well as carbon monoxide(CO) and ozone throughout the year of 2018.The number of asthmatic outpatients and hospitalizations was counted for asthma attacks presenting in Respiratory Department of the Affiliated Hospital of Weifang Medical University.The risk factors of asthma were designed as a 1∶1 matched case-control study method.Results Pearson correlation analysis showed that the monthly case number of asthma attacks in wards was positively correlated with the atmospheric concentrations of inhalable particles,PM2.5,SO2,NO2 and CO,especially the PM2.5,and same still,the monthly case number of asthmatic outpatients was also positively correlated with those five factors mentioned above.Multivariate conditional Logistic regression analysis revealed that the main risk factors were①allergic rhinitis;②irregular treatment on bronchial asthma;③ allergic constitution(family heredity);④increased body mass index;⑤smoking;⑥asthmatic bronchitis in childhood.The Protective factor was education level.Conclusions ①Asthma attack is positively correlated with the atmospheric concentrations of inhalable particles,PM2.5,SO2,NO2 and CO;②Stepwise regression analysis indicates that PM2.5 is the main factor causing asthma attack.③Allergic rhinitis,irregular treatment family history,increased body mass index as well as smoking and asthma in childhood were closely related to asthma attack,while education level is a protective factor instead.

关 键 词：环境空气污染物 支气管哮喘 PM2.5 多元线性回归 危险因素 

分 类 号：R562.2[医药卫生—呼吸系统]