四川省空气污染与慢性阻塞性肺疾病发病风险的关联研究  

Associations between air pollution and the risk of chronic obstructive pulmonary disease in Sichuan

作　　者：杨绍坤 周涵闻 谭坤 罗玉英 尉芝苗 张菊英[1] YANG Shao-kun;ZHOU Han-wen;TAN Kun;LUO Yu-ying;YU Zhi-miao;ZHANG Ju-ying(Department of Epidemiology and Biostatistics,West China School of Public Health and West China Fourth Hospital,Sichuan University,Chengdu,Sichuan 610044,China)

机构地区：[1]四川大学华西公共卫生学院/四川大学华西第四医院,流行病与卫生统计学系,四川成都610041 [2]四川省卫生信息中心/四川省医疗大数据中心 [3]成都市疾病预防控制中心

出　　处：《现代预防医学》2023年第22期4058-4063,4116,共7页Modern Preventive Medicine

基　　金：国家重点研发计划(2017YFC0907300);四川省科技计划项目(2021YFS0129);四川省卫生健康(2021ZXKY06004)。

摘　　要：目的探究空气污染物与慢性阻塞性肺疾病(COPD)发病风险的关联,识别潜在的效应修饰因子。方法基于西南区域自然人群队列于2018年5月至2019年8月收集的16688名四川省未患COPD的研究对象和2019—2020年四川省医院病案首页数据,采用Cox比例风险回归模型探究PM_(1)、PM_(2.5)、PM_(10)、NO_(2)和O_(3)与COPD发病风险的关联,使用分层分析比较关联在社会人口学及行为生活方式变量亚组内的差异。结果PM1、PM2.5、PM10、NO_(2)和O3每增加1μg/m^(3),相应的HR(95%CI)分别为1.03(1.01~1.06)、1.05(1.02~1.08)、1.04(1.02~1.06)、1.05(1.03~1.07)和1.05(1.02~1.09),且效应在性别、年龄、吸烟、家庭年收入和城乡的亚组存在差异。结论PM1、PM2.5、PM10、NO_(2)和O3可导致COPD的发病风险增加,且年龄较大、男性和吸烟人群更易感,应采取综合性干预措施来改善人群的COPD发病风险。Objective To explore the association between air pollution and the risk of chronic obstructive pulmonary disease(COPD),and to identify potential effect modifiers.Methods Based on a southwestern cohort and data collected from May 2018 to August 2019 on 16,688 study subjects without COPD in Sichuan Province and hospital discharge data from 2019 to 2020 in Sichuan Province,a Cox proportional hazards regression model was used to investigate the association between PM1,PM2.5,PM10,NO_(2),and O3 and the risk of COPD.Stratified analysis was used to compare differences in the association within subgroups of sociodemographic and behavioral lifestyle variables.Results For every increase of 1μg/m^(3)in PM_(1),PM_(2.5),PM_(10),NO_(2),and O_(3),the corresponding hazard ratios(HR)(95%confidence interval[CI])were 1.03(1.01-1.06),1.05(1.02-1.08),1.04(1.02-1.06),1.05(1.03-1.07),and 1.05(1.02-1.09),respectively.There were differences in the effects of gender,age,smoking,family income,and urban/rural subgroups.Conclusion PM1,PM2.5,PM10,NO_(2),and O3 can increase the risk of COPD,and the elderly,males,and smokers are more susceptible.Comprehensive intervention measures should be taken to improve the risk of COPD in the population.

关 键 词：慢性阻塞性肺疾病 空气污染 COX比例风险模型 效应修饰 

分 类 号：R122.7[医药卫生—环境卫生学] R563.9[医药卫生—公共卫生与预防医学]