中国脑卒中环境危险因素的系统评价  

Environmental risk factors for stroke in China:a systematic review

作　　者：虞莉莎 刘新靓 宋康 王蕊 龚芳燕 方亮 万跃 赵林[4] 黎浩[1,2] Li-Sha YU;Xin-Liang LIU;Kang SONG;Rui WANG;Fang-Yan GONG;Liang FANG;Yue WAN;Lin ZHAO;Hao LI(School of Public Health,Wuhan University,Wuhan 430071,China;Wuhan University Global Health Institute,Wuhan 430071,China;School of Health Sciences,the University of Manchester,Manchester M139PL,United Kingdom;School of Resource and Environmental Sciences,Wuhan University,Wuhan 430079,China;Hubei Provincial Center for Stroke Treatment,The Third People’s Hospital of Hubei Province,Wuhan 430033,China)

机构地区：[1]武汉大学公共卫生学院,武汉430071 [2]武汉大学全球健康研究中心,武汉430071 [3]英国曼彻斯特大学健康学院,曼彻斯特M139PL [4]武汉大学资源与环境科学学院,武汉430079 [5]湖北省第三人民医院湖北省脑卒中诊疗中心,武汉430033

出　　处：《医学新知》2023年第3期173-208,共36页New Medicine

基　　金：湖北省医学青年人才拔尖项目(2019-48);武汉大学研究生学分课程建设项目。

摘　　要：目的 中国脑卒中患者人数呈上升趋势,而环境危险因素对该疾病发展的影响缺乏综合性概述。本研究旨在探讨影响脑卒中的环境危险因素,为决策者制定卫生政策和干预措施提供依据。方法 检索中国知网、万方、维普、PubMed、Web of Science、Scopus数据库有关中国脑卒中环境危险因素的文献,检索时限为2012年1月至2022年5月。对环境危险因素的种类、频次进行描述性分析,对脑卒中与环境因素之间的关系进行叙述性分析。结果 初检共获取文献12 774篇,最终纳入文献215篇,涉及8类43种环境因素。研究最多的因素是气象因素(52.56%),其次是空气污染(47.44%);最常报告的指标分别是气温(40.47%)和PM_(2.5)(28.37%)。气象因素中,涉及气温的大部分研究提示其是脑卒中发生的影响因素,并发现脑卒中及其亚型存在季节性,近一半的研究发现较高的气压与较高的脑卒中及其亚型发生风险相关。对于空气污染,研究发现较高水平的PM_(2.5)、PM_(10)、CO、NO_(2)、O_(3)、SO_(2)与较高的脑卒中发生风险相关。此外,燃料暴露、被动吸烟也与脑卒中风险增加相关。结论 环境因素对中国人群脑卒中发生风险具有一定程度的影响,需进一步的研究评估这些关联,阐明涉及的具体机制,并探索更多的环境因素对脑卒中的潜在影响。Objective The number of stroke patients has been increasing in China in recent years,but a comprehensive synthesis of the environmental risk factors on the development of stroke is yet to be conducted.The aim of this study is to determine the environmental risk factors for stroke,in order to provide evidence-based recommendations for health administration bodies to make relative policies and interventions.Methods We searched China National Knowledge Infrastructure,WanFang Database,VIP-Datebase,PubMed,Web of Science,and Scopus database to select articles published from January 2012 to May 2022.Articles were included if they examined the association between an environmental risk factor and stroke and were conducted in China.Descriptive analysis was made based on the categories and frequencies of the environmental risk factors,and narrative synthesis was made covering the association between environmental risk factors and stroke.Results Of 12,774 records obtained initially from searching databases,215 articles were finally selected for our systematic review.There are 8 categories,including 43 environmental risk factors,of which 52.56%studied meteorological factors as the main environmental factor category,followed by air pollution(47.44%),and the most frequently reported indicators are air temperature(40.47%)and PM_(2.5)(28.37%).Among the meteorological factors,most of the studies involving air temperature suggest that it is the key factor influencing stroke and confirm that stroke and its subtypes are seasonal.Nearly half of the studies found that higher air pressure was associated with higher risk of stroke and its subtypes.For air pollution,this review found that higher levels of PM_(2.5),PM_(10),CO,NO_(2),O_(3) and SO_(2) are associated with greater risks.In addition,fuel exposure and passive smoking are also associated with the increased risk of stroke.Conclusion Environmental factors have a certain influence on the occurrence risk of stroke in Chinese people.Further studies are needed not only to evaluate thes

关 键 词：脑卒中 环境 气象因素 大气污染 

分 类 号：R743.3[医药卫生—神经病学与精神病学] G353.1[医药卫生—临床医学]