兰州市昼夜温差对居民脑卒中住院人数的影响  

Effect of Diurnal Temperature Range on the Number of Residents Hospitalized Due to Stroke in Lanzhou

作　　者：张润平 张万成 令江陇 董继元[1] 张莉[1] 阮烨[1] ZHANG Runping;ZHANG Wancheng;LING Jianglong;DONG Jiyuan;ZHANG Li;RUAN Ye(Institute of Occupational Health and Environmental Health,School of Public Health,Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学公共卫生学院劳动卫生与环境卫生学研究所,兰州730000

出　　处：《中国医学科学院学报》2023年第6期934-939,共6页Acta Academiae Medicinae Sinicae

基　　金：甘肃省重点研发计划(20YF3FA027)

摘　　要：目的分析兰州市昼夜温差(DTR)的变化与脑卒中住院人数的关系,为气温变化导致脑卒中发生机制的深入研究及相关部门制定脑卒中综合防治策略和措施提供科学依据。方法收集2014年1月至2019年12月兰州市脑卒中患者的住院资料及同期空气污染物(PM_(10)、SO_(2)和NO_(2))和气象资料进行相关统计学分析。采用Spearman相关分析分析空气污染物与气象因素之间的相关性,利用分布滞后非线性模型分析DTR与脑卒中住院人数的关系,并绘制三维图及不同水平DTR风险关联图,同时按照性别、年龄(<65岁和≥65岁)进行分层分析。结果2014至2019年兰州市共有92812例脑卒中住院患者,男女比例为1.35∶1。兰州市DTR与脑卒中住院人数呈非线性关系,并存在一定的滞后效应。低水平DTR(4.5℃)在累积滞后18 d时,脑卒中住院患者的RR值最大,为1.25(95%CI=1.16~1.35),高水平DTR(18.5℃)在累积滞后21 d对脑卒中患者的住院影响达到最高值,RR值为1.09(95%CI=1.01~1.18)。分层分析显示,低水平DTR对男性和<65岁脑卒中患者的住院影响较大。结论短期暴露于不同水平的DTR均会对脑卒中住院人数产生影响,但低水平DTR对脑卒中住院人数的影响略大于高水平DTR。低水平DTR时应加强对男性和<65岁人群的防护。Objective To analyze the relationship between diurnal temperature range(DTR)and the hospitalization of stroke in Lanzhou,so as to provide a scientific basis for probing into the mechanism of temperature changes in inducing stroke and formulating comprehensive prevention and control measures for stroke by relevant departments.Methods The information of the patients hospitalized due to stroke in Lanzhou during January 2014 to December 2019 and the air pollutants(PM_(10),SO_(2),and NO_(2))and meteorological data in the same period were collected for statistical analysis.Spearman rank correlation analysis was performed to analyze the correlations between air pollutants and meteorological factors.The distributed lag nonlinear model was adopted to fit the relationship between DTR and the number of stroke inpatients,and three-dimensional diagrams and the correlation diagrams of DTR against stroke risk were established.The stratified analysis was performed according to gender and age(<65 years and≥65 years).Results From 2014 to 2019,a total of 92812 stroke patients were hospitalized in Lanzhou,with a male-to-female ratio of 1.35∶1.There was a nonlinear relationship between DTR and the number of stroke inpatients in Lanzhou,which presented a lag effect.The low DTR at 4.5℃had the largest RR value of 1.25(95%CI=1.16-1.35)for stroke inpatients at a cumulative lag of 18 d.The effect of high DTR(18.5℃)on the hospitalization of stroke patients peaked at a cumulative lag of 21 d,with an RR value of 1.09(95%CI=1.01-1.18).The stratified analysis results suggested that low levels of DTR had greater effects on the hospitalization of male stroke patients and stroke patients<65 years.Conclusions Short-term exposure to different levels of DTR had an impact on the number of stroke inpatients,and low levels of DTR had a slightly greater impact on stroke inpatients than high levels of DTR.Importance should be attached to the protection of males and people aged<65 years at low levels of DTR.

关 键 词：昼夜温差 脑卒中 分布滞后非线性模型 住院人数 

分 类 号：R122[医药卫生—环境卫生学]