花粉类型及气象因素与川崎病并发冠状动脉损害的关联性分析  

Association and risk assessment of Kawasaki disease complicated coronary artery damage with pollen type and meteorological factors

作　　者：曹舒婷 杨轶男[2] 党颖 胡晓斌[1] Cao Shuting;Yang Yinan;Dang Ying;Hu Xiaobin(Department of Epidemiology and Health Statistics,School of Public Health,Lanzhou University,Lanzhou 730000,China;Department of Pediatric Cardiovascular,The Second Hospital of Lanzhou University,Lanzhou 730030,China)

机构地区：[1]兰州大学公共卫生学院,甘肃兰州730000 [2]兰州大学第二医院小儿心血管科,甘肃兰州730030

出　　处：《兰州大学学报（医学版）》2023年第7期27-33,共7页Journal of Lanzhou University（Medical Sciences）

基　　金：甘肃省自然科学基金资助项目(23JRRA0969);甘肃省自然科学基金资助项目(20JR10RA599)。

摘　　要：目的探讨花粉类型及气象因素与川崎病并发冠状动脉损害间的关联及其关联强度。方法以2015年5月-2021年9月兰州大学第二医院小儿心血管科收治的川崎病患儿为研究对象,依据不同年龄阶段冠状动脉内径将其分为冠状动脉损害(CAL)组和无冠状动脉损害(NCAL)组。采用ArcGIS 10.8对研究对象的住址和最近的暴露观测点进行位置匹配,置换检验和滞后效应分析CAL与气象因素的相关性、倾向性评分匹配和多因素Logistic回归进行CAL与花粉类型和气象因素的风险评估。结果在CAL患儿中,男性患病率高于女性,呈现明显的季节性差异。滞后0 d的降水量、滞后4 d的平均风速和滞后9 d的最低温度与川崎病并发冠状动脉损害关联性最强(P<0.05)。多因素Logistic回归分析显示,CAL与蔷薇科花粉(OR=1.214,95%CI:[1.062,1.388],P<0.05)、蒿属花粉(OR=1.013,95%CI:[1.000,1.025],P<0.05)及较高的风速(OR=1.164,95%CI:[1.005,1.348],P<0.05)均呈现正相关关系。结论蔷薇科花粉和蒿属花粉是CAL的危险因素,风速是CAL的驱动因子且对病情的影响表现出一定的滞后效应。及时监测风速,控制花粉暴露对于预防和降低CAL的患病风险至关重要。Objective To explore and analyze the risk of Kawasaki disease aggravated by coronary artery damage in relation to pollen type and climatic conditions.Methods Children with Kawasaki disease admitted to the pediatric cardiovascular department of The Second Hospital of Lanzhou University from May 2015 to September 2021 were utilized as the research population,and they were separated into coronary artery lesion(CAL)and NCAL groups.ArcGIS was used for location matching of study subjects'addresses and nearest exposure observation points;substitution test and lag effect analysis for the correlation between Kawasaki disease,concurrent coronary artery damage and meteorological factors;propensity score matching and multifactor Logistic regression for risk assessment of Kawasaki disease,concurrent coronary artery damage,pollen type and meteorological factors.Results The study found that male outnumbered female in children with Kawasaki disease,with substantial seasonal changes.The factors most significantly related to Kawasaki disease exacerbated by coronary artery damage were precipitation at lag 0 day,mean wind speed at lag 4 days and the lowest temperature at lag 9 days(P<0.05).A multi-factor Logistic regression analysis revealed that Rosaceous pollen(OR=1.214,95%CI:[1.062,1.388],P<0.05),Artemisia pollen(OR=1.013,95%CI:[1.000,1.025],P<0.05)and a higher wind speed(OR=1.164,95%CI:[1.005,1.348],P<0.05)were all associated with Kawasaki disease with concurrent coronary artery damage.Conclusion In Gansu Province,Rosaceous and Artemisia pollen were risk factors for Kawasaki disease complicated coronary artery damage,with wind speed being a driver of with some lag impact.

关 键 词：川崎病 冠状动脉损害 气象因素 花粉类型 倾向性评分匹配法 

分 类 号：R122.2[医药卫生—环境卫生学] R725.4[医药卫生—公共卫生与预防医学]