基于分布滞后非线性模型分析2010—2017年深圳市温度暴露与神经系统疾病急诊发生间关联  

Study on the associations between temperature exposures and nervous system diseases emergency ambulance dispatches(EADs)based on Distributed Lag Non-linear Model in Shenzhen,2010—2017

作　　者：李田 吴文静 王乐乐 宛云英[3] 周强[3] 张桦[3] 张菊英[1] LI Tian;WU Wen-jing;WANG Le-le;WAN Yun-ying;ZHOU Qiang;ZHANG Hua;ZHANG Ju-ying(不详;Department of Epidemiology and Biostatistics,West China School of Public Health and West China Fourth Hospital,Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西公共卫生学院/四川大学华西第四医院流行病与卫生统计学系,四川成都610041 [2]中山大学公共卫生学院医学统计与流行病学系 [3]深圳市急救中心

出　　处：《现代预防医学》2022年第13期2320-2325,共6页Modern Preventive Medicine

摘　　要：目的探索温度暴露[热暴露、冷暴露和温度变异(Temperature Variation,TV)暴露]与神经系统疾病急诊发生间的关联,为气候变化背景下深圳地区温度暴露的风险效应提供证据。方法采用时间序列类泊松广义相加回归和分布滞后非线性相结合的模型分析2010—2017年深圳市温度暴露对神经系统疾病急诊发生的累积效应和滞后效应。结果三种温度暴露均会导致神经系统疾病急诊发生风险增加。极端TV暴露的风险效应最高,所对应的相对危险度(Relative Risk,RR)估计值为1.60(95%CI:1.28~2.00),极端冷暴露和极端热暴露所致神经系统疾病急诊发生风险的RR估计值分别为1.32(95%CI:1.09~1.60)和1.22(95%CI:1.05~1.43);而适度TV暴露、适度冷暴露和适度热暴露的RR估计值分别为1.10(95%CI:0.97~1.24),1.28(95%CI:1.11~1.47),和1.19(95%CI:1.05~1.35)。结论热暴露、冷暴露和TV暴露均会导致神经系统疾病急诊发生风险增加。在气候变化背景下,除了热暴露与冷暴露外,更应提高对TV暴露的重视。Objective To explore the associations between temperature exposures[heat exposures,cold exposures and temperature variation(TV)exposures]and nervous system diseases emergency ambulance dispatches(EADs),then to provide evidence for the risk effects of temperature exposures under the circumstance of climate change in Shenzhen.Methods A Quasi-Poisson generalized additive models(GAM)with a Distributed Lag Non-linear Model(DLNM)were applied to examine the cumulative and lag effects of temperature exposures on nervous system diseases EADs in Shenzhen from 2010 to 2017.Results All of the three temperature exposures increased the risk of nervous system diseases EADs.The largest Relative Risk(RR)was observed in extreme TV exposures[1.60(95%CI:1.28-2.00)].The RR of extreme cold exposures and extreme heat exposures were 1.32(95%CI:1.09-1.60)and 1.22(95%CI:1.05-1.43),respectively.The RR of moderate TV exposures,moderate cold exposures,and moderate heat exposures were 1.10(95%CI:0.97-1.24),1.28(95%CI:1.11-1.47),and 1.19(95%CI:1.05-1.35),respectively.Conclusion All of heat exposures,cold exposures and TV exposures increased the risk of nervous system diseases EADs.Under the circumstance of climate change,in addition to heat exposures and cold exposures,more attention should be paid to TV exposures.

关 键 词：温度暴露 温度变异 神经系统疾病 分布滞后非线性模型 

分 类 号：R122.2[医药卫生—环境卫生学]