济南市温度与老年人慢性阻塞性肺疾病死亡的时间序列分析  

Time series analysis of temperature and death of elderly patients with chronic obstructive pulmonary disease in Jinan

作　　者：付琳 张先慧[2] 马艺文 李明君[2] 陈星 吴善正 崔亮亮[2] FU Lin;ZHANG Xian-hui;MA Yi-wen;LI Ming-jun;CHEN Xing;WU Shan-zheng;CUI Liang-liang(Health Management and Policy Research Center,School of Public Health,Qilu Medical College,Shandong University,Jinan,Shandong 250012,China;不详)

机构地区：[1]山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心,山东济南250012 [2]济南市疾病预防控制中心,山东济南250012

出　　处：《现代预防医学》2023年第21期3889-3894,共6页Modern Preventive Medicine

基　　金：2021年济南市卫生健康委员会公共卫生计划专项(2021-公-02);济南市科学技术局《济南市2021年科技创新发展计划第三十四批(临床医学科技创新计划项目)》(202134008)。

摘　　要：目的 探究温度与济南市老年人慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)死亡之间的关系,识别脆弱人群。方法 收集济南市2011—2019年65岁及以上居民COPD死亡数据和气象数据,采用分布滞后非线性模型(DLNM)分析日均温度与老年人COPD死亡之间的暴露-反应关系,并按性别和年龄进行分层分析。结果 济南市日均温度和老年人COPD死亡之间的暴露—反应关系呈“U”型。极端低温对男性和65~74岁老年人的影响最大,死亡风险均在滞后第7 d达到峰值,RR值分别为1.07(95%CI:1.01~1.13)和1.15(95%CI:1.04~1.26),0~14 d的累积滞后效应最大,CRR分别为1.77(95%CI:1.00~3.14)和2.84(95%CI:1.11~7.31)。极端高温对女性、75~84岁、和≥85岁老年人群的死亡效应显著,死亡风险均在当天达到峰值,RR值分别为1.12(95%CI:1.04~1.20)、1.16(95%CI:1.08~1.25)和1.11(95%CI:1.02~1.20),0~14 d的累积滞后效应最大,CRR分别为1.61(95%CI:1.17~2.22)、1.53(95%CI:1.09~2.15)和1.54(95%CI:1.06~2.24)。结论 高温和低温均可增加老年人COPD死亡风险,以冷效应为主,并且存在性别和年龄差异。Objective To investigate the relationship between temperature and the death of chronic obstructive pulmonary disease(COPD)in the elderly in Jinan and to identify vulnerable groups.Methods The COPD mortality data and meteorological data of residents aged 65 and above in Jinan from 2011 to 2019 were collected.The exposure-response relationship between daily average temperature and COPD mortality in the elderly was analyzed by distributed lag nonlinear model(DLNM),stratified by sex and age.Results The exposure-response relationship between the average daily temperature and the death of COPD in the elderly in Jinan was U-shaped.Extreme low temperature had the greatest effect on men and people aged 65 to 74 years old,and the risk of death peaked on the 7th day after lag,and the RR values were 1.07(95%CI:1.01-1.13)and 1.15(95%CI:1.04-1.26),respectively.The cumulative lag effect of 14 days was the highest,and the CRR was 1.77(95%CI:1.00-3.14)and 2.84(95%CI:1.11-7.31),respectively.Extreme high temperature had a significant death effect on women,75-84-year-old,and≥85-year-old people,and the death risk reached the peak on the same day.The RR values were 1.12(95%CI:1.04-1.20),1.16(95%CI:1.08-1.25)and 1.11(95%CI:1.02-1.20),respectively.The cumulative lag effect of 14 days was the largest.CRR was 1.61(95%CI:1.17-2.22),1.53(95%CI:1.09-2.15),and 1.54(95%CI:1.06-2.24),respectively.Conclusion Both high temperature and low temperature can increase the risk of death of COPD in the elderly,dominated by cold effect,and there are gender and age differences.

关 键 词：温度 慢性阻塞性肺疾病 老年人 分布滞后非线性模型 

分 类 号：R563[医药卫生—呼吸系统] R122[医药卫生—内科学]