吉林省长春市大气污染物暴露与脑卒中入院风险的关联性分析  

Analysis on correlation between exposure to air pollutants and hospitalization risk of stroke in Changchun city of Jilin province

作　　者：赵天业 周丽婷[1] 张雪婷 齐雯[1] 李旭 王树越[2] 叶琳[1] ZHAO Tianye;ZHOU Liting;ZHANG Xueting;QI Wen;LI Xu;WANG Shuyue;YE Lin(Department of Occupational and Environmental Health,School of Public Health,Jilin University,Changchun 130021,China;Department of Outpatients,China-Japan Union Hospital,Jilin University,Changchun 130033,China)

机构地区：[1]吉林大学公共卫生学院环境卫生与劳动卫生学教研室,吉林长春130021 [2]吉林大学中日联谊医院门诊,吉林长春130033

出　　处：《吉林大学学报（医学版）》2021年第2期505-510,共6页Journal of Jilin University：Medicine Edition

基　　金：国家自然科学基金项目(81803190);吉林省卫健委科研基金项目(2019Q010)。

摘　　要：目的:分析吉林省长春市大气污染物暴露对脑卒中入院风险的影响。方法:收集2018年10月1日—2019年10月30日在吉林大学第一医院入院的脑卒中病例和同期长春市大气污染物监测数据。采用病例交叉研究进行单污染物和多污染物模型条件Logistic回归分析。通过单污染模型分析各大气污染物对脑卒中入院风险的滞后效应,根据最大比值比(OR)确定各大气污染物最佳滞后期,通过多污染物模型分析大气污染物对脑卒中入院风险的影响。结果:共纳入病例3633例。单污染物模型确定的大气污染物对脑卒中入院的最佳滞后期为发病前4 d。多污染物模型分析,发病前4 d的大气细颗粒物(PM_(2.5))、二氧化硫(SO_2)、一氧化碳(CO)和臭氧(O_3)浓度可影响脑卒中入院风险。PM_(2.5)浓度每升高10μg·m^(-3),脑卒中入院风险增加3.0%[95%可信区间(CI(1.007,1.054))];SO_2浓度每升高10μg·m^(-3),脑卒中入院风险增加22.6%[95%CI(1.165,1.291)];CO浓度每升高10 mg·m^(-3),脑卒中入院风险增加14%[95%CI(1.101,1.180)];O_3浓度每升高10μg·m^(-3),脑卒中入院风险增加3.7%[95%CI(1.029,1.046)]。结论:大气污染物对脑卒中入院的影响有滞后效应。长春市大气中PM_(2.5)、SO_2、CO和O_3浓度升高可增加当地脑卒中入院风险。Objective:To analyze the influence of atmospheric pollutant exposure in stroke hospitalization risk in Changchun City,Jilin University.Methods:The stroke cases admitted at the First Hospital of Jilin University from October 1,2018 to October 30,2019 and the atmospheric measurement data of Changchun city were collected.A case-cross study was conducted for Logistic regression analysis on single pollutant and multi-pollutant models.The lag effect of each air pollutant on stroke hospitalization risk was analyzed with single pollutant model,and the best lag of each air pollutant was determined according to the maximum odds ratio(OR).Multi-pollutant model was used to analyze the influence of air pullutants in the stroke hospitalization risk.Results:A total of 3633 cases were included.A single pollutatant model determined that the atmospheric abnormality for stroke admission was the best in the late stage of stay 4 d before onset.Multivariate model analysis found that atmospheric particulate matter 2.5(PM2.5),sulfur dioxide(SO2),carbon monoxide(CO),and ozone(O3)concentrations 4 d before the onset of illness could affect stroke admission risk.Every 10μg·m-3 increase in PM2.5 concentration increased stroke admission risk by 3%[95%confidence interval(CI)(1.007,1.054)];every 10μg·m-3 increase in SO2 concentration increased stroke admission risk by 22.6%[95%CI(1.165,1.291)];every 10 mg·m-3 increase in CO concentration increased stroke admission risk by 14%[95%CI(1.101,1.180)];every 10μg·m-3 increase in O3 concentration increased stroke admission risk by 3.7%[95%CI(1.029,1.046)].Conclusion:The impact of air pollutants on stroke admission risk has a lagging effect.The increase of concentrations of PM2.5,SO2,CO and O3 in the atmosphere of Changchun city can increase the risk of local stroke admission.

关 键 词：大气污染物 脑卒中 病例交叉研究 入院风险 环境暴露 

分 类 号：R122.7[医药卫生—环境卫生学]