我国大气PM_(2.5)与呼吸系统疾病门诊量关系的meta分析  

Relationship between atmospheric PM_(2.5)and outpatient visits of respiratory diseases in China:a meta-analysis

作　　者：王熙蓓 周哲华[1] 吴益康 胡赞[1] 朱泽[1] 孟盼 吴大明 洪伟伟 Wang Xibei;Zhou Zhehua;Wu Yikang;Hu Zan;Zhu Ze;Meng Pan;Wu Daming;Hong Weiwei(Jiaxing Center For Disease Control And Prevention,Jiaxing 314050,China)

机构地区：[1]嘉兴市疾病预防控制中心,浙江嘉兴314050

出　　处：《中国医院统计》2022年第6期472-480,共9页Chinese Journal of Hospital Statistics

基　　金：嘉兴市科技计划项目(2020AD30123)。

摘　　要：目的系统评价我国大气PM_(2.5)与呼吸系统疾病门诊量的短期暴露效应相关性。方法计算机检索CNKI、WanFang Data、VIP、PubMed、EMbase、The Cochrane Library和Web of science数据库,搜集我国大气PM_(2.5)与呼吸系统疾病门诊量的相关研究,检索时限为2000年1月至2022年8月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险,采用Stata 14.0软件进行meta分析。结果共纳入48篇文献。采用随机效应模型进行meta分析,结果显示大气PM_(2.5)质量浓度每增加10μg·m^(-3),呼吸系统疾病门诊量增加0.66%(95%CI:0.56%~0.76%)。将纳入研究对象按人群(年龄、性别)、季节、研究地区、城市经济水平、PM_(2.5)浓度和效应类型进行亚组分析,结果显示大气PM_(2.5)质量浓度每增加10μg·m^(-3),0~14岁组呼吸系统疾病门诊增量最高0.61%(95%CI:0.50%~0.73%),其次为≥65岁组0.50%(95%CI:0.35%~0.66%)和15~64岁组0.44%(95%CI:0.32%~0.56%);春季呼吸系统疾病门诊增量最高0.61%(95%CI:0.12%~1.11%);相比于二三线城市而言,一线城市呼吸系统疾病门诊增量最高0.63%(95%CI:0.50%~0.75%);南方地区呼吸系统疾病门诊增量0.75%(95%CI:0.63%~0.88%)高于北方地区0.37%(95%CI:0.28%~0.47%);PM_(2.5)<75μg·m^(-3)组呼吸系统疾病门诊增量0.78%(95%CI:0.63%~0.88%)高于PM_(2.5)≥75μg·m^(-3)组0.26%(95%CI:0.17%~0.36%);不同性别和效应类型的呼吸系统疾病门诊量增加相差不大。敏感性分析显示本次研究结果相对稳健可靠。经漏斗图和Egger′s检验,存在一定的发表偏倚。结论我国大气PM_(2.5)与呼吸系统疾病门诊量之间呈正相关,随着大气中PM_(2.5)浓度升高,可增加呼吸系统疾病的发病风险,尤其是儿童、老年人、春季、一线城市和南方地区,呼吸系统疾病门诊量均有所增加。Objective To systematically review the short-term exposure effects of atmospheric PM_(2.5)and respiratory disease outpatient visits in China.Methods Databases including CNKI,WanFang Data,VIP,PubMed,EMbase,The Cochrane Library and Web of science databases were electronically searched to collect studies on the association between atmospheric PM_(2.5)and outpatient visits of respiratory diseases from January 2000 to August 2022 in China.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies.Meta-analysis was performed by using Stata 14.0 software.Results Forty-eight articles were included.The random effect model was used for meta-analysis.The results showed that the increase of PM_(2.5)concentration by 10μg·m^(-3)was associated with an increase of 0.66%(95%CI:0.56%-0.76%)in the number of respiratory disease outpatient visits.Subgroup analysis was conducted according to population(age,gender),season,study area,urban economic level,PM_(2.5)concentration and effect type.The results showed that for every 10μg·m^(-3)increase in atmospheric PM_(2.5)concentration,the increase of outpatient visits for respiratory diseases was the highest in the 0-14 years group 0.61%(95%CI:0.50%-0.73%),followed by≥65 years old group 0.50%(95%CI:0.35%-0.66%)and 15-64 years old group 0.44%(95%CI:0.32%-0.56%).In spring,the highest increase was 0.61%(95%CI:0.12%-1.11%).Compared with the second and third-tier cities,the increase of outpatient clinics for respiratory diseases in first-tier cities was the highest by 0.63%(95%CI:0.50%-0.75%).The increase of outpatient clinics for respiratory diseases in southern China was 0.75%(95%CI:0.63%-0.88%),higher than that in northern China 0.37%(95%CI:0.28%-0.47%).PM_(2.5)<75μg·m^(-3)groups of respiratory disease outpatient increment of 0.78%(95%CI:0.63%-0.88%)was higher than PM_(2.5)≥75μg·m^(-3)group 0.26%(95%CI:0.17%-0.36%).There was no significant difference in the increase of outpatient visits for respiratory diseases by gender and ef

关 键 词：PM_(2.5) 呼吸系统疾病 门诊量 时间序列分析 META分析 

分 类 号：R195.4[医药卫生—卫生统计学] R122[医药卫生—卫生事业管理]