气温对定西市农村居民心血管疾病住院人数的影响  

Air Temperature Affects the Hospital Admission for Cardiovascular Diseases among Rural Residents in Dingxi City

作　　者：王雁茹 董继元[1] 杨仁庆 刘宁 WANG Yanru;DONG Jiyuan;YANG Renqing;LIU Ning(Institute of Occupational and Environmental Health,School of Public Health,Lanzhou University,Lanzhou 730000,China;China Government Performance Management Research Center,School of Management,Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学公共卫生学院劳动卫生与环境卫生学研究所,兰州730000 [2]兰州大学管理学院中国政府绩效管理研究中心,兰州730000

出　　处：《中国医学科学院学报》2022年第2期188-198,共11页Acta Academiae Medicinae Sinicae

基　　金：国家自然科学基金(71861026)。

摘　　要：目的探讨气温对定西市农村居民心血管疾病住院人数的影响及其滞后效应。方法利用定西市2018至2019年气象资料、空气污染资料以及农村居民每日因心血管疾病住院人数数据,采用分布滞后非线性模型,分析日均气温与心血管疾病住院人数的关系,并按性别、年龄和疾病种类进行分层分析。结果定西市气温与农村居民心血管疾病住院人数之间存在非线性关系,暴露反应曲线近似一个倒“U”形,不同类型心血管疾病的暴露反应曲线形状基本类似,但气温阈值各不相同。低温(-7℃)和较低温(0℃)对心血管疾病住院人数存在累计滞后效应。低温(-7℃)累积滞后7 d时,RR值最大,为1.121(95%CI=1.002~1.255);较低温(0℃)累积滞后14 d时,RR值最大,为1.198(95%CI=1.123~1.278);较低温(0℃)在累积滞后14 d时对缺血性心脏病和心律失常住院人数的RR值分别为1.034(95%CI=1.003~1.077)和1.039(95%CI=1.004~1.066);较高温(17℃)和高温(21℃)对缺血性心脏病均在当天RR值最大,分别为1.148(95%CI=1.092~1.206)和1.176(95%CI=1.096~1.261);较高温(17℃)和高温(21℃)对心律失常累积滞后效应均在当天最大,RR值分别为1.071(95%CI=1.001~1.147)和1.112(95%CI=1.011~1.223);较高温(17℃)和高温(21℃)对脑血管疾病累积滞后效应在当天最大,RR值分别为1.084(95%CI=1.025~1.145)和1.094(95%CI=1.013~1.182);未发现气温对心力衰竭住院人数的累积滞后效应。分层分析显示低温(-7℃)和较低温(0℃)对女性心血管疾病住院人数有影响,但仅较低温(0℃)对男性有影响;高温对女性的累积效应高于男性,相比于男性,气温对女性的影响更大,<65岁人群较≥65岁人群对低温和高温更敏感。结论气温变化会增加定西市农村居民心血管疾病住院风险,且存在滞后效应;温度对不同病因、性别及年龄心血管疾病住院患者的影响有差异,居民应注意气温变化对健康的影响,尤其是女性、<65岁和缺血Objective To explore the effect of air temperature on the hospitalization of rural residents with cardiovascular diseases and its lag effect in Dingxi city.Methods The meteorological data and air pollution data of Dingxi city from 2018 to 2019,as well as the daily hospitalization data of rural residents due to cardiovascular diseases,were collected.The distributed lag non-linear models were employed to analyze the relationship between daily mean air temperature and the number of inpatients with cardiovascular diseases.Meanwhile,stratified analysis was carried out according to gender,age,and disease.Results There was a non-linear relationship between air temperature and the number of hospitalized rural residents with cardiovascular diseases in Dingxi city.The exposure-response curve approximated a bell shape.The curves for different cardiovascular diseases appeared similar shapes,with different temperature thresholds.Low temperature(-7℃)and moderately low temperature(0℃)exhibited a cumulative lag effect on the number of patients hospitalized with cardiovascular diseases.With a cumulative lag of 7 days at-7℃and 14 days at 0℃,the RR values peaked,which were 1.121(95%CI=1.002-1.255)and 1.198(95%CI=1.123-1.278),respectively.With a cumulative lag of 14 days at 0℃,the RR values were 1.034(95%CI=1.003-1.077)and 1.039(95%CI=1.004-1.066)for the number of hospitalized patients with ischemic heart disease and heart rhythm disorders,respectively.The cumulative lag effects of moderately high temperature(17℃)and high temperature(21℃)on ischemic heart disease,heart rhythm disorders,and cerebrovascular disease all peaked on that day.Specifically,the RR values at 17℃and 21℃were 1.148(95%CI=1.092-1.206)and 1.176(95%CI=1.096-1.261)for ischemic heart disease,1.071(95%CI=1.001-1.147)and 1.112(95%CI=1.011-1.223)for heart rhythm disorders,and 1.084(95%CI=1.025-1.145)and 1.094(95%CI=1.013-1.182)for cerebrovascular disease,respectively.There was no cumulative lag effect of air temperature on the number of hospitalized pa

关 键 词：气温 心血管疾病 分布滞后非线性模型 住院人数 

分 类 号：R122.21[医药卫生—环境卫生学]