乌鲁木齐市气象因素与空气污染物对缺血性心脏病住院量的影响  

Effects of meteorological factors and air pollutants on hospitalization volume of ischemic heart disease in Urumqi City

作　　者：武迪 王琛琛[1,3] 卢耀勤[4] 李丞[5] 时雨[1] 依里帕·依力哈木 郑彦玲 张利萍[2] WU Di;WANG Chenchen;LU Yaoqin;LI Cheng;SHI Yu;Yilipa YILIHAMU;ZHENG Yanling;ZHANG Liping(School of Public Health,Xinjiang Medical University,Urumqi,Xinjiang 830017,China;School of Medical Engineering and Technology,Xinjiang Medical University,Urumqi,Xinjiang 830017,China;Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention,Urumqi,Xinjiang 830002,China;Urumqi Municipal Center for Disease Control and Prevention,Urumqi,Xinjiang 830023,China;First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830054,China)

机构地区：[1]新疆医科大学公共卫生学院,新疆乌鲁木齐830017 [2]新疆医科大学医学工程技术学院,新疆乌鲁木齐830017 [3]新疆维吾尔自治区疾病预防控制中心,新疆乌鲁木齐830002 [4]乌鲁木齐市疾病预防控制中心,新疆乌鲁木齐830023 [5]新疆医科大学第一附属医院,新疆乌鲁木齐,830054

出　　处：《环境与职业医学》2024年第10期1115-1123,共9页Journal of Environmental and Occupational Medicine

基　　金：新疆维吾尔自治区“十四五”高等学校特色学科-公共卫生与预防医学(无编号)。

摘　　要：[背景]目前尚未全面了解乌鲁木齐市的气象条件和空气污染物对缺血性心脏病(IHD)住院量的影响。[目的]探究气象条件(温度、相对湿度)和常见空气污染物[颗粒物(PM)包括细颗粒物(PM_(2.5))和可吸入颗粒物(PM_(10)),臭氧(O3),二氧化硫(SO_(2)),二氧化氮(NO_(2))以及一氧化碳(CO)]对IHD日住院量的影响,为制定针对性的预防和管理策略提供科学依据。[方法]收集2014年1月1日—2022年12月31日乌鲁木齐市90622例IHD住院患者的基本信息,收集了同期内逐日空气污染物浓度数据、气象数据。其中气象数据主要包括日均温度、日最高温度、日最低温度和日均相对湿度,常见空气污染物指标主要包括PM_(2.5)和PM_(10)、O3日最大8 h的平均浓度(O3_8 h)、SO_(2)、NO_(2)以及CO。对收集的数据进行描述性统计分析(均值、标准差、四分位数);采用基于分布滞后非线性模型(DLNM)的时间分层病例交叉设计,分析日均温度、相对湿度和不同空气污染物对该市IHD住院人数的滞后效应(RR)以及累积滞后效应(RRcum),并对性别和年龄(<60岁和≥60岁)进行分层分析。随后采用广义相加模型(GAM)探讨寒潮(等于或小于每日最低温度的P5且持续≥3 d)与热浪(等于或大于每日最高温度的P95且持续≥3 d)对IHD住院量的影响,并分析温度与影响较大的空气污染物(PM和O3_8 h)对IHD住院量的交互作用。[结果]2014年1月1日—2022年12月31日乌鲁木齐市IHD单日住院最大人数为100人,每日平均住院患者为27人。日均温度、相对湿度以及空气污染物与IHD住院量存在不同的非线性关系和滞后性。极低温(<P1,即<–18℃)在累积滞后31 d(lag0-31)时,IHD总人群入院风险最大(RRcum=2.092,95%CI:1.261~3.471),女性[lag0-31:RRcum及其95%CI为3.416(2.296~5.082)]和≥60岁[lag0-31:RRcum及其95%CI为2.356(1.681~3.303)]人群对极低温更敏感。寒潮在滞后20 d(lag20)时,IHD住院风险最大(RR=1.242,95%CI:1.053[Background]The effects of meteorological factors and air pollutants on ischemic heart disease(IHD)hospitalizations in Urumqi have not been fully understood.[Objective]To investigate the effects of meteorological conditions(temperature,relative humidity)and common air pollutants[fine particulate matter(PM_(2.5)),inhalable particulate matter(PM_(10)),ozone(O3),sulfur dioxide(SO_(2)),nitrogen dioxide(NO_(2)),and carbon monoxide(CO)]on the daily hospitalization volume of IHD,and to provide a scientific basis for the development of targeted prevention and management strategies.[Methods]Basic information of 90622 IHD hospitalized patients in Urumqi City was collected from January 1,2014 to December 31,2022,and daily air pollutant concentration data and meteorological data were collected during the same period.The meteorological data included daily mean temperature,daily maximum temperature,daily minimum temperature,and daily mean relative humidity,and the common air pollutants included PM_(2.5),PM_(10),daily maximum 8-h average concentration of O3(O3_8 h),SO_(2),NO_(2),and CO.Descriptive statistical analyses(mean,standard deviation,and quartiles)were performed on the collected data.A distribution lag nonlinear model(DLNM)based on time-stratified case-crossover design was established to estimate the lagged effects(RR)as well as the cumulative lagged effects(RRcum)of daily mean temperature,relative humidity,and different air pollutants on the number of IHD admissions,stratified by gender and age(<60 and≥60 years).Subsequently,a generalized additive model(GAM)was used to explore the effects of cold waves(≤P5 of the daily minimum temperature and lasting≥3 d)versus heat waves(≥P95 of the daily maximum temperature and lasting≥3 d)on IHD hospitalizations and the potential interactions between temperature and the more influential air pollutants[particulate matter(PM)and O3_8 h]on IHD hospitalizations.[Results]The maximum number of IHD hospitalizations in a single day in Urumqi from January 1,2014 to December 31,2022

关 键 词：空气污染物 气象因素 缺血性心脏病 交互作用 时间分层病例交叉设计 

分 类 号：R122.2[医药卫生—环境卫生学]