安徽省合肥市温度变化与精神分裂症急诊的小时尺度关联  

Hourly-scale associations between temperature change and emergency department visits for schizophrenia in Hefei,Anhui Province,China

作　　者：刘锦涛 闫军伟 吴柯禺 范引光[1,2] 苏虹 程健[1,2,5,6] LIU Jintao;YAN Junwei;WU Keyu;FAN Yinguang;SU Hong;CHENG Jian(Department of Epidemiology and Biostatistics,School of Public Health,Anhui Medical University,Hefei 230032,China;Anhui Province Key Laboratory of Major Autoimmune Disease,Hefei 230032,China;Department of Science and Education,Hefei Fourth People′s Hospital,Hefei 230032,China;Jiangbei District Center for Disease Prevention and Control(Jiangbei District Health Supervision Institute),Chongqing 400020,China;The First Affiliated Hospital of Anhui Medical University North District,Hefei 230012,China;Anhui Public Health Clinical Center,Hefei 230012,China)

机构地区：[1]安徽医科大学公共卫生学院流行病与卫生统计学系,合肥230032 [2]炎症免疫性疾病安徽省实验室,合肥230032 [3]合肥市第四人民医院科教科,合肥230032 [4]重庆市江北区疾病预防控制中心(重庆市江北区卫生监督所),重庆400020 [5]安徽医科大学第一附属医院北区,合肥230012 [6]安徽省公共卫生临床中心,合肥230012

出　　处：《中华疾病控制杂志》2025年第1期67-73,88,共8页Chinese Journal of Disease Control & Prevention

基　　金：国家自然科学基金(42105165)。

摘　　要：目的 探讨安徽省合肥市温度变化与精神分裂症急诊之间的小时尺度关联。方法 收集2015年3月1日―2019年12月31日安徽省精神卫生中心精神分裂症的急诊就诊记录,并从ERA5-Land数据集提取合肥市城市水平逐小时温度数据作为暴露。以h为时间单位,采用时间分层病例交叉设计分析温度的小时尺度变化与精神分裂症急诊之间的关联,并按年龄和性别进行亚组分析。结果 共12 423例精神分裂症急诊事件被纳入分析,平均每小时0.31人次。暴露-反应关系曲线显示,在暴露的23 h内,随着温度的升高,精神分裂症急诊风险增加。暴露后的当前小时和第15 h,出现效应高峰,温度每增加1℃,精神分裂症急诊风险分别增加1.17%(95%CI:0.42%~1.92%)和1.26%(95%CI:0.25%~2.29%)。对1 d内的时间段进行细化后发现,在21:00―00:00温度每增加1℃,急诊风险增加5.61%(95%CI:1.65%~9.74%)。亚组分析发现,与温度升高相关的女性精神分裂症急诊风险高于男性。结论 温度变化与精神分裂症急诊之间存在小时尺度关联,在温度升高后的数小时内即可出现风险增加。未来应采取有效措施降低高温天气的超短期精神疾病风险,同时关注敏感暴露窗口和易感人群。Objective To investigate the hourly-scale association between ambient temperature changes and schizophrenia-related emergency department(ED) visits.Methods We conducted a retrospective analysis of ED visit records for schizophrenia at the Anhui Mental Health Centre from 1 March 2015 to 31 December 2019.Hour-by-hour temperature data at the city level of Hefei was extracted from the ERA5-Land dataset as an exposure.A time-stratified case-crossover design was used to explore the association between hourly-scale changes in temperature and schizophrenia emergencies,with subgroups analyzed by age and gender.Subgroup analyses were performed to explore potential effect modification by age and gender.Results A total of 12 423 ED events for schizophrenia were identified,averaging 0.31 events per hour.The exposure-response relationship curve revealed an increased risk of schizophrenia-related ED presentations with rising temperatures within a 23-hour exposure window.Peak effects were observed at the first and 15th hour post-exposure,with each 1 ℃ temperature increase associated with a 1.17%(95% CI:0.42%-1.92%) and 1.26%(95% CI:0.25%-2.29%) increase in ED visit risk,respectively.Further stratification by time of day revealed a significant association between a 1 ℃ temperature increase and a 5.61%(95% CI:1.65%-9.74%) elevated risk of ED visits between 21:00 and 00:00.Notably,subgroup analyses found a stronger association between temperature increases and schizophrenia-related ED visits among women compared to men.Conclusions There is an hourly-scale association between temperature change and schizophrenia emergencies,with an elevated risk emerging within hours of a temperature increase.These results underscore the need for targeted interventions to mitigate the acute risks associated with heat exposure among individuals with schizophrenia,particularly during sensitive time windows and within vulnerable subpopulations.

关 键 词：温度 小时尺度 精神分裂症 

分 类 号：R122[医药卫生—环境卫生学]