扬州市大气NO_(2)与脑卒中急性发病的时间序列研究  

A time series analysis of atmospheric nitrogen dioxide and acute onset of stroke in Yangzhou,China

作　　者：时巧梅 夏俊鹏 解晔 李秋梅 李小琴 赵培 蒋萌 胡乃元 王猛猛 王琦玮 SHI Qiao-mei;XIA Jun-peng;XIE Ye;LI Qiu-mei;LI Xiao-qin;ZHAO Pei;JIANG Meng;HU Nai-yuan;WANG Meng-meng;WANG Qi-wei(Yangzhou City for Disease Control and Prevention,Yangzhou 225100,China)

机构地区：[1]扬州市疾病预防控制中心,扬州225100

出　　处：《环境卫生学杂志》2024年第12期969-974,994,共7页JOURNAL OF ENVIRONMENTAL HYGIENE

基　　金：扬州市卫健委科研专项资金资助项目(2023-4-23)。

摘　　要：目的分析扬州市大气NO_(2)暴露对脑卒中急性发病的影响,为脑卒中防治宣传政策的制定及疾病预防提供科学依据。方法基于江苏省慢性病管理信息平台收集扬州市2020年1月1日—2022年12月31日脑卒中急性发病数据,同时从扬州市生态环境局和扬州市气象局获取大气污染数据(PM 2.5、PM 10、SO 2、NO_(2)、CO、O 3)和气象数据(日均气温、相对湿度),采用时间序列分析方法研究NO_(2)对脑卒中发病的影响。结果2020—2022年扬州市的NO_(2)日均浓度M为25.1μg/m^(3)。单污染物模型中,NO_(2)浓度(lag02 d)每升高10μg/m^(3),居民脑卒中发病风险增加1.91%(95%CI:0.50%~3.32%);双污染物模型中,在控制其他污染物的混杂影响后,NO_(2)与脑卒中急性发作之间的正相关联仍然稳定。亚组分析显示,NO_(2)浓度(lag02)每升高10μg/m^(3),≥65岁居民脑卒中发病风险增加2.34%(95%CI:0.83%~3.85%),小学及以下文化程度人群脑卒中发病风险增加5.84%(95%CI:2.31%~9.38%),女性的发病风险增加2.20%(95%CI:0.47%~3.93%),脑梗死发病风险增加2.31%(95%CI:0.76%~3.86%)。结论扬州市NO_(2)可能会增加脑卒中急性发病的概率,尤其是脑梗死。≥65岁、小学及以下文化水平人群对NO_(2)浓度上升导致的脑卒中急性发作更易感。Objective To investigate the influence of atmospheric nitrogen dioxide(NO_(2))exposure on the acute onset of stroke in Yangzhou,China,and to provide a scientific basis for formulating propaganda policies for the prevention and treatment of stroke and strengthening disease prevention.Methods The Chronic Disease Management Information Platform of Jiangsu Province was used to collect the data on the acute onset of stroke in Yangzhou City from January 1,2020 to December 31,2022,and meanwhile,air pollution data(PM 2.5,PM 10,SO 2,NO_(2),CO,O 3)and meteorological data(mean daily temperature and relative humidity)were obtained from Yangzhou Ecological Environment Bureau and Yangzhou Meteorological Bureau,respectively.A time series analysis was performed to investigate the influence of NO_(2)on the onset of stroke.Results The median of daily concentration of NO_(2)was 25.1μg/m^(3)in Yangzhou in 2020—2022.In the single-pollutant model,the risk of stroke among residents was increased by 1.91%(95%confidence interval[CI]:0.50%-3.32%)for every 10μg/m^(3)increase in NO_(2)concentration(lag02 d),and in the dual-pollutant model,the positive association between NO_(2)and the acute onset of stroke remained stable after control of the confounding effects of other pollutants.The subgroup analysis showed that NO_(2)had statistically significant effects on stroke risk in people with different gender and education levels,among which the effect was more significant in female and people with primary school education or below.For every 10μg/m^(3)increase in NO_(2)concentration(lag02 d),the risk of stroke was increased by 2.20%(95%CI:0.47%-3.93%)in female,and the risk of stroke was increased by 5.84%(95%CI:2.31%-9.38%)in people with primary school education or below.NO_(2)had a statistically significant effect on stroke risk in patients≥65 years old.For every 10μg/m^(3)increase in NO_(2),the risk of stroke in patients≥65 years old increased by 2.34%(95%CI:0.83%-3.85%).The effect of NO_(2)on the risk of cerebral infarction was stat

关 键 词：二氧化氮 脑卒中 时间序列分析 

分 类 号：R122[医药卫生—环境卫生学]