上海市松江区大气污染与脑卒中急性期死亡的关联性分析  

Association between ambient air pollution and fatal stroke mortality in Songjiang District of Shanghai

作　　者：蔡滨欣[1] 朱美英[1] 池方方 陆慧萍[1] 陈岚[1] CAI Binxin;ZHU Meiying;CHI Fangfang;LU Huiping;CHEN Lan(Songjiang District Center for Disease Control and Prevention,Shanghai 201620,China)

机构地区：[1]上海市松江区疾病预防控制中心,上海201620

出　　处：《上海预防医学》2022年第1期33-36,共4页Shanghai Journal of Preventive Medicine

基　　金：上海市卫生健康委员会课题(20174Y0139)。

摘　　要：【目的】探究大气污染与脑卒中急性期死亡的关联性,以及大气污染环境中脑卒中急性期死亡的易感人群情况。【方法】汇总上海市松江区2012—2014年大气污染数据,并收集户籍人口脑卒中急性期死亡的全部病例,采用时间分层-病例交叉设计方法分析两者间关系,并确立易感人群。【结果】共纳入了514例脑卒中急性期死亡病例。研究期间内,PM_(2.5)、SO_(2)、NO_(2)等污染物质量浓度分别为77.45、21.22、57.59μg·m^(-3)。NO_(2)显著增加了<65岁人群的脑卒中急性期死亡的发病风险。在Lag2和Lag03的时间点上,NO_(2)的质量浓度上升1个四分位数间距导致脑卒中急性期死亡的OR值分别为3.86(1.53~9.75)和5.83(1.40~24.34)。65岁以上人群则对PM_(2.5)质量浓度增加更加敏感。在Lag03的时间点上其导致脑卒中急性期死亡的OR值为1.28(1.00~1.64)。NO_(2)质量浓度的增加还显著增大了超重及肥胖人群的致死性脑卒中的发病风险。【结论】PM_(2.5)、NO_(2)等污染物质量浓度的上升可以显著增加敏感人群的脑卒中急性期死亡的发病风险。65岁以下及超重肥胖人群是NO_(2)导致的脑卒中急性期死亡的易感人群,65岁以上人群是SO_(2)导致的脑卒中急性期死亡的易感人群。[Objective]To investigate the risk of fatal stroke mortality associated with short-term exposure to air pollution,and to determine the susceptible population.[Methods]In this study,daily stroke mortalities of adults between 2012 and 2014 in Songjiang District,Shanghai were collected.Time-stratified case-crossover approach was used to assess the association between daily concentrations of air pollutants and fatal stroke mortalities.[Results]This study included 514 patients who died from acute strokes.The average concentrations during the study period were 77.45μg·m^(-3)for PM_(2.5),21.22μg·m^(-3)for SO_(2),and 57.59μg·m^(-3)for NO_(2).The fatal stroke mortality of adults under the age of 65 was found to be significantly associated with NO_(2).At the time of a Lag of 2 d and 03 d,a significantly higher risk of fatal stroke mortality in relation to NO_(2)exposure was observed,and the OR values of ischemic stroke mortality for people were 3.86(1.53-9.75)and 5.83(1.40-24.34)respectively.People over the age of 65 were more sensitive to increased PM_(2.5)concentrations,at the time of a Lag of 03 d,fatal strokes increased by 28%when PM_(2.5)levels increased.A significantly higher risk of fatal stroke mortality in relation to increase of NO_(2)concentration was observed among people who were overweight or obese.[Conclusion]A significantly higher risk of fatal stroke mortality is associated with the increase of PM_(2.5)and NO_(2).The results also suggest that the susceptible population should take additional precautions to avoid or reduce the risk of fatal strokes.

关 键 词：大气污染 脑卒中急性期死亡 病例交叉设计 条件LOGISTIC回归 

分 类 号：R743.3[医药卫生—神经病学与精神病学]