基于广义相加模型的郑州市大气污染与医院感染发生风险的关系分析  

Relationship between air pollution and hospital acquired infection in Zhengzhou City based on generalized additive model

作　　者：王高帅[1] 陈晓娟[2] 胡玉守 王瑞涛[4] 梁进娟[1] WANG Gaoshuai;CHEN Xiaojuan;HU Yushou;WANG Ruitao;LIANG Jinjuan(Department of Nosocomial Infection,the Second Affiliated Hospital,Zhengzhou University,Zhengzhou 450014;Ward of Radiotherapy,the Second Affiliated Hospital,Zhengzhou University,Zhengzhou 450014;RICU,the Second Affiliated Hospital,Zhengzhou University,Zhengzhou 450014;Department of Intervention,the Second Affiliated Hospital,Zhengzhou University,Zhengzhou 450014)

机构地区：[1]郑州大学第二附属医院医院感染管理科,郑州450014 [2]郑州大学第二附属医院放射治疗病房,郑州450014 [3]郑州大学第二附属医院RICU,郑州450014 [4]郑州大学第二附属医院介入科,郑州450014

出　　处：《郑州大学学报（医学版）》2020年第5期727-732,共6页Journal of Zhengzhou University(Medical Sciences)

基　　金：河南省卫计委普通攻关项目(201702081);河南省高等学校重点科研项目计划(18A320062)。

摘　　要：目的:探讨大气污染暴露与医院感染发生风险的关系。方法:收集郑州市某三甲医院2015年1月1日至2019年6月30日医院感染日报告数据,采用时间序列的广义相加模型,控制气象因素、时间趋势、星期几效应、假期效应后分析空气质量指数、PM2.5、PM10、SO2、NO2与医院感染、呼吸道感染及呼吸机相关肺炎之间的关系。结果:PM2.5每升高1μg/m3,5 d后医院感染的发生风险升高0.20%(P<0.05),PM2.5、PM10和NO2每升高1μg/m3,4 d后呼吸道感染的发生风险分别增加0.12%、0.10%和0.49%(P<0.05),而PM2.5、PM10、NO2和SO2每升高1μg/m3,5 d后呼吸道感染的发生风险增加0.12%、0.10%、0.59%和0.74%(P<0.05);PM10每升高1μg/m3,3 d和4 d后,呼吸机相关肺炎的发生风险分别增加0.05%和0.04%(P<0.05)。阈值效应分析显示,PM2.5、PM10、NO2和SO2对4 d或5 d后呼吸道感染发生风险的影响存在阈值效应;PM10对3 d和4 d后呼吸机相关肺炎发生风险的影响存在阈值效应。结论:空气中PM2.5、PM10、NO2、SO2升高会增加呼吸道感染、呼吸机相关肺炎的发生风险。Aim:To study the relationship between air pollution and hospital acquired infection(HAI)in Zhengzhou City.Methods:The daily HAI data from January 1,2015 to June 30,2019 were provided by a class 1,grade 3 general hospital.The generalized additive model of time series adjusting for the meteorological factor,secular trend,weekend and holiday was used to explore the relationship between the air pollution indexes such as AQI,PM 2.5,PM10,NO2,SO2 and HAI,respiratory tract infection(RTI),ventilator-associated pneumonia(VAP)every day.Results:The risk of HAI increased by 0.20%as the PM2.5 increased by 1μg/m3 when lagging for 5 days(P<0.05).The risk of RTI increased by 0.12%,0.10%and 0.49%as the PM2.5,PM10 and NO2 increased by 1μg/m3 when lagging for 4 days(P<0.05).The risk of RTI increased by 0.12%,0.10%,0.59%and 0.74%as the PM2.5,PM10,NO2 and SO2 increased by 1μg/m3 when lagging for 5 days(P<0.05).The risk of VAP increased by 0.05%and 0.04%as the PM10 increased by 1μg/m3 when lagging for 3 days and 4 days(P<0.05).Results of threshold effect showed that there existed threshold effect for the PM2.5,PM10,NO2 and SO2 to increase the risk of RTI and VAP.Conclusion:The increase of PM2.5,PM10,NO2 and SO2 will elevate the risk of RTI and VAP in patients.

关 键 词：PM2.5 PM10 SO2 NO2 医院感染 呼吸道感染 呼吸机相关肺炎 广义相加模型 郑州市 

分 类 号：R122[医药卫生—环境卫生学]