2019—2021年太原市PM_(2.5)与老年人群慢性肾脏病入院例次的相关性  

Correlation between PM_(2.5) in Taiyuan city and the number of elderly patients with chronic kidney disease admitted to hospital from 2019 to 2021

作　　者：汤楠 雷立健[1] 周芸 Tang Nan;Lei Lijian;Zhou Yun(School of Public Health,Shanxi Medical University,Taiyuan 030001,China;Department of Nephrology,Shanxi Provincial People's Hospital,Taiyuan 030012,China;Department of Nephrology,Shanxi Integrated Traditional Chinese and Western Medicine Hospital,Taiyuan 030013,China)

机构地区：[1]山西医科大学公共卫生学院,太原030001 [2]山西医科大学第五临床医学院(山西省人民医院)肾内科,太原030012 [3]山西省中西医结合医院肾内科,太原030013

出　　处：《中华肾脏病杂志》2023年第3期172-178,共7页Chinese Journal of Nephrology

摘　　要：目的研究太原市大气细颗粒物(particulate matter 2.5, PM_(2.5))浓度与老年人群慢性肾脏病(chronic kidney disease, CKD)入院例次的相关性。方法采用2019—2021年太原市大气PM_(2.5)监测浓度为环境暴露数据, 以同时期太原市常住居民老年(年龄 > 60岁)人群CKD入院例次为疾病进展指标, 采用分布滞后非线性模型分析PM_(2.5)日平均浓度对CKD入院例次的总体效应和滞后效应。结果纳入因CKD入院的老年患者6 037例次, 男女比为1.36∶1。PM_(2.5)日平均浓度为52.80 μg/m^(3), 未超出中国空气质量准则标准(75 μg/m^(3)), 但秋冬季节PM_(2.5)日平均浓度大幅度超过正常参考值, 最高值达302 μg/m^(3)。PM_(2.5)日平均浓度与老年人群CKD入院例次呈非线性相关关系, 具有滞后性的特点。当PM_(2.5)日平均浓度为87 μg/m^(3)时, 滞后11 d时的老年人群CKD入院的相对危险度(RR)值最大[1.074(95%CI 1.018~1.321)]。亚组分析结果显示, 滞后10 d时的老年女性CKD入院风险较男性高, RR值为1.073(95%CI 1.001~1.151);合并高血压或糖尿病的老年人群CKD入院风险在高PM_(2.5)日平均浓度暴露时(分别为87 μg/m^(3)和88 μg/m^(3))均较高, 最大RR值分别为1.067(95%CI 1.002~1.136)和1.162(95%CI 1.021~1.320)。结论太原市大气PM_(2.5)浓度高可增加老年人群CKD的入院风险, 女性、合并高血压或糖尿病的老年人群CKD入院风险更高。Objective To investigate the correlation between atmospheric particulate matter 2.5(PM_(2.5))concentration and the number of chronic kidney disease(CKD)hospital admissions in the elderly in Taiyuan city.Methods The atmospheric PM_(2.5) concentration in Taiyuan city during 2019—2021 was used as the environmental exposure data,and the number of CKD admission of the elderly patients(>60 years old)in Taiyuan city at the same time was used as the disease progression index.The distributed lag nonlinear model was used to analyze overall and lag effects of PM_(2.5) average daily concentration on the elderly patients admitted to CKD.Results A total of 6037 cases elderly patients with CKD admitted to hospital were included,with a male-to-female ratio of 1.36∶1.The average daily concentration of PM_(2.5) was 52.80μg/m^(3),which did not exceed China's air quality standard(75μg/m³);But in autumn and winter,the average daily concentration of PM_(2.5) significantly exceeded the normal reference value,with the highest value reaching 302μg/m^(3).The relationship between the average daily concentration of PM_(2.5) and the number of elderly patients admitted to CKD was nonlinear and there was a lag effect.The relative risk(RR)value reached the maximum when PM_(2.5) average daily concentration was 87μg/m^(3) with lag time of 11 days[1.074(95%CI 1.018-1.321)].The subgroup analysis results showed that the risk of admission of elderly female CKD patients was higher than that of male patients with lag time of 10 days,and the RR was 1.073(95%CI 1.001-1.151).Elderly CKD patients with hypertension(PM_(2.5)87μg/m^(3))and diabetes(PM_(2.5)88μg/m^(3))had a higher risk of admission when exposed to PM_(2.5),with maximum RR values of 1.067(95%CI 1.002-1.136)and 1.162(95%CI 1.021-1.320),respectively.Conclusions High atmospheric PM_(2.5) concentration in Taiyuan city can increase the risk of admission in elderly patients with CKD,especially in women and patients with hypertension or diabetes.

关 键 词：肾功能不全 慢性 老年人 颗粒物 PM_(2.5) 分布滞后非线性模型 滞后效应 

分 类 号：R692[医药卫生—泌尿科学]