上海地区大气PM_(2.5)浓度与变应性鼻炎发病的相关性研究  

Association between airborne particulate matter(PM_(2.5))concentration and the incidence of allergic rhinitis in Shanghai

作　　者：孙娜 龚静蓉[2] 郝亚楠[3] 孙臻峰[4] 黄昱 于阅尽[3] 黄卫[3] 田露芳 罗丹 汤玮[5] 范锴 余少卿[5] 章如新 SUN Na;GONG Jingrong;HAO Yanan;SUN Zhenfeng;HUANG YU;YU Yuejin;HUANG Wei;TIAN Lufang;LUO Dan;TANG Wei;FAN Kai;YU Shaoqing;ZHANG Ruxin(Department of Otolaryngology,Huadong Hospital,Fudan University,Shanghai,200040,China;Department of Otolaryngology,Fifth People's Hospital Fudan University;Department of Otolaryngology,Seventh People's Hospital,Traditional Chinese Medicine;Department of Otolaryngology,First People's Hospital,Jiao Tong University;Department of Otolaryngology,Tongji Hospital,Tongji University)

机构地区：[1]复旦大学附属华东医院耳鼻咽喉科,上海200040 [2]复旦大学附属上海市第五人民民医院耳鼻咽喉科 [3]上海中医药大学附属第七人民医院耳鼻咽喉科 [4]上海交通大学附属第一人民医院耳鼻咽喉科 [5]同济大学附属同济医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2023年第6期434-441,共8页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：国家自然科学基金资助项目(No:81974140、81670906、81371078)。

摘　　要：目的探讨上海地区大气PM_(2.5)浓度对变应性鼻炎(allergic rhinitis,AR)人群发病的影响,为AR发病的预警和防治提供策略。方法收集2017年1月1日至2019年12月31日上海市环境监测的大气污染物日平均浓度和上海地区5家三甲医院同期AR患者门诊就诊的临床数据资料。采用时间序列广义相加Poisson回归模型,分析大气PM_(2.5)日均浓度与AR患者的每日就诊量变化的相关性。结果在研究期间,采集56500例AR患者资料,PM_(2.5)的每日平均浓度为(35.28±23.07)μg/m^(3)。PM_(2.5)浓度值与AR患者数之间存在相关性。AR日均就诊数量与PM_(2.5)大气污染程度呈正相关(P<0.05)。研究发现PM_(2.5)每上升10μg/m^(3),对AR就诊人次的影响在当天、滞后第1天、滞后第2天差异均有统计学意义(P<0.05),其中当天暴露的影响最强。PM_(2.5)每上升10μg/m^(3),当天门诊人次增加0.526%(95%CI 1.00050~1.01004)。结论上海地区大气PM_(2.5)浓度与AR就诊量呈正相关,PM_(2.5)暴露是AR发病的独立因素,为AR诊断、防治提供了重要的理论依据。Objective To explore the impact of PM_(2.5)concentration in Shanghai on the incidence of allergic rhinitis(AR)in the population,and provide strategies for early warning and prevention of AR.Methods Collect daily average concentrations of atmospheric pollutants monitored in Shanghai from January 1,2017 to December 31,2019,and clinical data of AR patients from five hospitals in Shanghai during the same period.We used a time-series analysis additive Poisson regression model to analyze the correlation between PM_(2.5)levels and outpatient attendance for AR patients.Results During the study period,a total of 56500 AR patients were included,and the daily average concentration of PM_(2.5)was(35.28±23.07)μg/m^(3).There is a correlation between the concentration of PM_(2.5)and the number of outpatient attendance for AR cases.There is a positive correlation between the daily average number of outpatient for AR and levels of PM_(2.5)air pollution((P<0.05)).We found that every 10μg/m^(3)increase in PM_(2.5),the impact of on the number of AR visits was statistically significant on the same day,the first day behind,and the second day behind,with the strongest impact being the exposure on the same day.Every 10μg/m^(3)increases in PM_(2.5),the number of outpatient visits increased by 0.526%on the same day(95%CI 1.00050-1.01004).Conclusion The atmospheric PM_(2.5)concentration in Shanghai is positively correlated with the number of outpatient for AR,and PM_(2.5)exposure is an independent factor in the onset of AR.This provides an important theoretical basis for AR.

关 键 词：变应性鼻炎 大气污染 门诊就诊率 PM_(2.5) 时间序列 相关性分析 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]