基于心血管疾病死亡效应的亚热带地区最佳热浪定义研究  

Study on the optimal definition of heatwave in subtropical regions based on cardiovascular disease mortality effects

作　　者：钟雪 郑金明 何斐[2] 詹志颖 ZHONG Xue;ZHENG Jin-ming;HE Fei;ZHAN Zhi-ying(School of Health Management,Fujian Medical University,Fuzhou 350122,China;School of Public Health,Fujian Medical University,China)

机构地区：[1]福建医科大学卫生管理学院,福州350122 [2]福建医科大学公共卫生学院

出　　处：《环境卫生学杂志》2024年第8期634-640,666,共8页JOURNAL OF ENVIRONMENTAL HYGIENE

基　　金：福建省自然科学基金(2021J01728);福建医科大学引进人才启动资金(XRCZX2020017)。

摘　　要：目的本研究探索亚热带地区的热浪定义,系统评估热浪对福建省心血管疾病(cardiovascular disease,CVD)及其亚型死亡率的影响。方法收集2007-2015年福建省9个市66854例心血管疾病死亡数,联合分布滞后非线性模型(distributed lag non-linear model,DLNM)和类泊松回归模型评估热浪对各个市每日心血管疾病死亡的影响,然后用多元Meta分析计算综合效应。按CVD亚型、性别、年龄、婚姻和教育水平进行分层分析。结果热浪定义为连续≥4天日平均温度≥P 95拟合心血管疾病死亡的模型最佳。热浪效应是急剧的,热浪发生当天对CVD死亡的相对危险度为1.06(95%CI:1.01~1.12)、滞后1天为1.04(95%CI:1.00~1.07)、累计滞后0-1天相对危险度为1.10(95%CI:1.05~1.16)。热浪增加缺血性心脏病、慢性缺血性心脏病、脑血管疾病的死亡率,累计滞后0-1天的相对危险度分别为1.13(95%CI:1.04~1.23)、1.24(95%CI:1.08~1.43)和1.09(95%CI:1.02~1.16)。此外,≥65岁人群更容易受到热浪效应的影响。结论本研究认为在福建省热浪最佳定义为连续≥4天且日平均温度≥P 95,在该定义下热浪会增加CVD、缺血性心脏病、慢性缺血性心脏病、脑血管疾病的死亡率。此外,≥65岁人群是热浪对心血管疾病死亡效应的脆弱人群。Objective To explore the definition of heatwave in subtropical regions,and to systematically evaluate the effects of heatwave on the mortality of cardiovascular disease(CVD)and its subcategories in Fujian Province,China.Methods Based on 66854 CVD deaths during 2007-2015 from 9 cities in Fujian Province,a quasi-Poisson regression combined with distributed lag non-linear model was fitted to estimate the effects of heatwaves on daily CVD mortality in each city.Then the effects of heatwave on the CVD mortality of all the 9 cities were pooled using a multivariate meta-analysis to obtain the integrated effect.Stratified analyses were performed by CVD subcategory,sex,age,marital status,and educational level.Results Heatwave was defined as daily mean temperature≥P 95 with a duration of≥4 days,which fitted well with the cardiovascular disease mortality model.The heatwave effect was acute,with a relative risk of 1.06(95%confidence interval[CI]:1.01-1.12)on the lag 0 day,1.04(95%CI:1.00-1.07)on the lag 1 day,and a cumulative relative risk of 1.10(95%CI:1.05-1.16)on the lag 0-1 days.Heatwave also increased mortality from ischemic heart disease,chronic ischemic heart disease,and cerebrovascular disease,with relative risks of 1.13(95%CI:1.04-1.23),1.24(95%CI:1.08-1.43),and 1.09(95%CI:1.02-1.16)on the lag 0-1 days,respectively.In addition,population aged 65 and over were more vulnerable to heatwave effects.Conclusion This study suggests that the best definition of heatwave was daily mean temperature≥P 95 with a duration of≥4 days in Fujian Province,China.Under this definition,the heatwave increased mortality of CVD,ischemic heart disease,chronic ischemic heart disease,and cerebrovascular disease.In addition,population aged 65 and over were more vulnerable group to heatwave effects on cardiovascular disease mortality.

关 键 词：热浪 死亡风险 心血管疾病 分布滞后非线性模型 脆弱人群 

分 类 号：R122[医药卫生—环境卫生学]