空气污染物对兰州市特应性皮炎门诊人次的影响  

Effects of Air Pollutants on Outpatient Visits for Atopic Dermatitis in Lanzhou

作　　者：何苑 石春蕊[2] 光奇[3] 骆志成[4] 郗群[5] 韩磊 HE Yuan;SHI Chunrui;GUANG Qi;LUO Zhicheng;XI Qun;HAN Lei(Department of Dermatovenereology,The First School of Clinical Medicine,Lanzhou University,Lanzhou 730000,China;Department of Dermatology,The First Hospital of Lanzhou University,Lanzhou 730000,China;Information Center,The First Hospital of Lanzhou University,Lanzhou 730000,China;Department of Dermatology,Lanzhou University Second Hospital,Lanzhou 730000,China;Information Center,Lanzhou University Second Hospital,Lanzhou 730000,China;Department of Dermatology,Zhangye People’s Hospital Affiliated to Hexi University,Zhangye,Gansu 734000,China)

机构地区：[1]兰州大学第一临床医学院,兰州730000 [2]兰州大学第一医院皮肤科,兰州730000 [3]兰州大学第一医院信息中心,兰州730000 [4]兰州大学第二医院皮肤科,兰州730000 [5]兰州大学第二医院信息中心,兰州730000 [6]河西学院附属张掖人民医院皮肤科,甘肃张掖734000

出　　处：《中国医学科学院学报》2021年第4期521-530,共10页Acta Academiae Medicinae Sinicae

基　　金：甘肃省自然科学基金(18JR3RA337)。

摘　　要：目的定量评估兰州地区空气污染物PM_(2.5)、PM_(10)、NO_(2)和SO_(2)浓度对特应性皮炎门诊人次的影响。方法收集2013年1月至2017年12月特应性皮炎患者的门诊资料和同期气象及环境污染物资料。采用基于泊松分布广义相加模型在控制季节性和长期趋势、星期几效应基础上,研究PM_(2.5)、PM_(10)、NO_(2)和SO_(2)浓度对就诊人次影响的滞后效应。结果在单污染物模型中,PM_(2.5)、PM_(10)均在滞后当日(lag0)时对特应性皮炎门诊人次的影响最明显,但无统计学意义;NO_(2)也在lag0时影响最明显,并存在滞后效应,其浓度每增加10μg/m^(3),特应性皮炎门诊人次的超额危险度(ER)及95%可信区间(95%CI)为1.95%(95%CI=1.09%~2.82%),具有统计学意义(P=0.01);SO_(2)在滞后第6天(lag6)时影响最明显,SO_(2)浓度每升高10μg/m^(3),门诊人次增加1.52%(95%CI=0.48%~2.54%),具有统计学意义(P=0.02);对不同性别、年龄、季节分析后显示,女性比男性对PM_(10)和SO_(2)敏感,PM_(10)和SO_(2)每上升10μg/m^(3),女性门诊人次分别增加0.02%和2.47%。而男性对PM_(2.5)及NO_(2)敏感,PM_(2.5)和NO_(2)每上升10μg/m^(3),男性门诊人次分别增加0.47%和1.78%;气态污染物(NO_(2)、SO_(2))影响≤2岁人群高于其余年龄人群,NO_(2)和SO_(2)每上升10μg/m^(3),≤2岁人群门诊人次分别增加2.35%和1.57%,具有统计学意义(P=0.02)。13~59岁人群对NO_(2)浓度的升高敏感,NO_(2)每上升10μg/m^(3),13~59岁人群门诊人次分别增加1.39%;NO_(2)在冷暖季节时期对门诊人次有影响,ER值分别为2.35%和1.89%,具有统计学意义(P=0.01)。颗粒物(PM_(2.5)、PM_(10))在冬季门诊人次影响明显,但均无统计学意义。PM_(2.5)和NO_(2),PM_(10)和NO_(2)以及SO_(2)和NO_(2)对特应性皮炎总门诊人次的交互作用明显。在双污染物模型中,引入PM_(2.5)、PM_(10)和SO_(2),NO_(2)对特应性皮炎门诊人次影响较单污染物模型明显增加,且具有统计学意义(P=0.01)。结论�Objective To quantitatively evaluate the associations of PM_(2.5),PM_(10),NO_(2),and SO_(2)concentrations with the outpatient visits for atopic dermatitis in Lanzhou.Methods The data of outpatient visits,together with meteorological data and air pollutant data,from January 2013 to December 2017 were collected.The generalized additive model based on Poisson distribution was employed to study the lag effects of PM_(2.5),PM_(10),NO_(2),and SO_(2)concentrations on the visits of outpatients,with the seasonal and long-term trends and day-of-the-week effect controlled.Results The results of the single pollutant model showed that PM_(2.5)and PM_(10)had the most obvious while still insignificant impact on the outpatient visits for atopic dermatitis on the current day(lag0).NO_(2)also had the most obvious impact in the case of lag0 and showed a lag effect.For each 10μg/m^(3)increase in NO_(2)concentration,the excess risk(ER)of outpatient visits for atopic dermatitis was 1.95%(95%CI=1.09%-2.82%,P=0.01).SO_(2)had the most significant effect on lag6,and the outpatient visits increased by 1.55%(95%CI=0.48%-2.54%)for every 10μg/m^(3)rise in SO_(2)concentration(P=0.02).Females were more sensitive to PM_(10)and SO_(2)than males.For every 10μg/m^(3)increase in PM_(10)and SO_(2),the female outpatient visits increased by 0.02%and 2.47%,respectively.Males were sensitive to PM_(2.5)and NO_(2),and the every 10μg/m^(3)rise in PM_(2.5)and NO_(2)increased male outpatient visits by 0.47%and 1.78%,respectively.Gaseous pollutants(NO_(2)and SO_(2))had more significant effect on people≤2 years old than on those of other ages.Every 10μg/m^(3)rise in NO_(2)and SO_(2)would increase the≤2-year-old outpatient visits by 2.35%and 1.57%,respectively(P=0.02).People of 13-59 years old were sensitive to NO_(2)concentration,and every 10μg/m^(3)rise in NO_(2)concentration increased their visits by 1.39%.NO_(2)affected the outpatient visits during the cold and warm seasons,with the ER values of 2.35%and 1.89%,respectively(P=0.01).Particulate matte

关 键 词：特应性皮炎 空气污染物 广义相加模型 

分 类 号：R758.23[医药卫生—皮肤病学与性病学]