天津市极端气温对脑血管疾病死亡的影响研究  

Impact of extreme temperature on cerebrovascular disease mortality in Tianjin

作　　者：胡俊逸 张经纬[2] 倪洋[2] 曾强 HU Jun-yi;ZHANG Jing-wei;ZENG Qiang(School of Public Health,Tianjin Medical University,Tianjin 300070,China;不详)

机构地区：[1]天津医科大学公共卫生学院,天津300070 [2]天津市疾病预防控制中心

出　　处：《环境与健康杂志》2025年第2期145-150,共6页Journal of Environment and Health

基　　金：中国气象局-南开大学环境健康气象合作项目(CMANKUB202402);天津市卫生健康科技项目(TJWJ2022QN091);天津市自然科学基金青年项目(22JCQNJC00060);生态环境部城市空气颗粒物污染防治重点实验室开放基金(NKPMF202408)。

摘　　要：目的分析2019—2022年天津市极端气温对脑血管疾病(cerebrovascular diseases,CBVD)死亡的影响,并比较不同气温段所造成CBVD死亡的归因分值。方法通过天津市各区疾病预防控制中心获得2019年1月—2022年12月CBVD患者死亡相关信息。通过天津市气象局和环保监测站点获得了气象和空气污染相关资料。采用条件logistic回归用于量化极端气温对CBVD患者死亡的影响。推算各个环境温度段所造成的CBVD死亡归因分值。结果2019—2022年共有51193例CBVD死亡患者被纳入研究。据推算天津地区CBVD患者死亡风险最低的适宜温度为17.3℃。极端气温会增加CBVD患者死亡风险,其中极端高温在滞后0 d效应达到最大,RR值为1.26(95%CI:1.18~1.35);极端低温在滞后8 d效应最大,RR值为1.06(95%CI:1.04~1.07)。暴露于极端高温累积滞后3 d的风险值RR为1.51(95%CI:1.40~1.63);暴露于极端低温累积滞后14 d的风险值RR为1.58(95%CI:1.41~1.77)。所有CBVD患者死亡中,极端高温的归因分值为1.3%(95%CI:0.6%~2.0%),一般程度非适宜高温的归因分值为2.9%(95%CI:1.1%~4.6%);极端低温的归因分值为3.8%(95%CI:2.9%~4.7%),一般程度非适宜低温的归因分值为9.3%(95%CI:6.2%~12.4%)。结论2019—2022年极端气温会导致CBVD患者死亡风险上升;但在所有环境温度所造成的疾病死亡负担中,主要归因于一般程度的非适宜气温,而非极端气温。Objective To understand the impact of extreme temperatures on deaths from cerebrovascular diseases(CBVD)in Tianjin City from 2019 to 2022,and compare the burden of CBVD deaths caused by different temperature periods.Methods Information on deaths of patients with CBVD from January 2019 to December 2022 was collected from the Centers for Disease Control and Prevention in each district of Tianjin City.The meteorological and air pollution data were collected from the Tianjin City Meteorological Bureau and environmental protection monitoring stations.Conditional logistic regression was used to quantify the impact of extreme temperatures on mortality in patients with CBVD.The regression coefficients of the above model are used to estimate the burden of CBVD deaths caused by various environmental temperature ranges.Results A total of 51193 CBVD deaths were included in the present study.It is estimated that the minimum mortality temperature for patients with CBVD in Tianjin was 17.3℃.Exposure to extreme temperature increased the risk of death in patients with CBVD.The effect of extreme high temperatures reached its maximum at lag0,with an RR value of 1.26(95%CI:1.18-1.35).The effect of extreme high temperatures reached its maximum at lag8,with an RR value of 1.06(95%CI:1.04-1.07).The risk value RR of exposure to extreme heat with lag0-3 was 1.51(95%CI:1.40-1.63).The risk value RR of exposure to extreme cold temperatures with lag0-14 was 1.58(95%CI:1.41-1.77).Among all deaths in patients with CBVD,the attribution fraction for extreme heat was 1.3%(95%CI:0.6%-2.0%),and the attribution fraction for general non-optimal high temperature was 2.9%(95%CI:1.1%-4.6%).The attribution score for extreme low temperature was 3.8%(95%CI:2.9%-4.7%).The attribution score for general non-optimal low temperature was 9.3%(95%CI:6.2%-12.4%).Conclusion Extreme temperatures from 2019 to 2022 could increase the risk of death in patients with CBVD,but the burden of disease death caused by all environmental temperatures was mainly attributed to

关 键 词：极端气温 脑血管疾病 病例交叉研究 

分 类 号：R181.3[医药卫生—流行病学]