空气污染物个体暴露与冠心病风险的关联研究  

Relationship between individual exposure to air pollutants and risk of coronary artery disease

作　　者：汪爱莲 葛鸽 朱文娟 智宏 王莉娜[2] WANG Ai-lian;GE Ge;ZHU Wen-juan;ZHI Hong;WANG Li-na(Department of Cardiovascular Medicine,Nanjing Qixia District Hospital,Nanjing,Jiangsu 210046,China;不详)

机构地区：[1]南京市栖霞区医院心血管内科,江苏南京210046 [2]东南大学公共卫生学院流行病与卫生统计学系 [3]东南大学附属中大医院心血管内科

出　　处：《环境与健康杂志》2025年第2期155-159,共5页Journal of Environment and Health

摘　　要：目的探讨空气污染物暴露水平与冠心病风险之间的关联,为降低南京市居民的冠心病患病风险提供参考依据。方法收集2013—2019年南京市监测站点的空气污染物暴露数据,并依据《环境污染物人群暴露评估技术指南》(HJ 875—2017)中的公式转换为个体经呼吸道日均暴露量。采用病例对照研究设计,病例组选自东南大学附属中大医院心血管内科的冠心病患者,对照组来自该医院非冠心病个体和南京市栖霞区社区健康体检人群,收集所有研究对象的一般情况和临床信息。采用多因素logistic回归模型分析空气污染物与冠心病风险之间的关联。结果共纳入2250例样本,病例组入院前一年NO_(2)日均暴露水平为[28.23μg/(kg·d)],高于对照组水平[22.63μg/(kg·d)];CO日均暴露水平为[528.99μg/(kg·d)],高于对照组水平[422.23μg/(kg·d)];PM_(2.5)日均暴露水平为[32.96μg/(kg·d)],高于对照组水平[22.31μg/(kg·d)];PM_(10)日均暴露水平为[58.19μg/(kg·d)],高于对照组[44.17μg/(kg·d)];且上述差异均有统计学意义。多因素logistic回归分析结果显示,NO_(2)、CO、PM_(2.5)和PM_(10)经呼吸道日均暴露浓度每增加1μg/(kg·d),冠心病的发生风险分别增加14.6%(OR=1.146,95%CI:1.082~1.214)、0.4%(OR=1.004,95%CI:1.002~1.006)、11.1%(OR=1.111,95%CI:1.086~1.137)、4.2%(OR=1.042,95%CI:1.020~1.065)。结论本研究发现空气污染物暴露是冠心病发生的危险因素。Objective To understand the relationship between exposure levels of air pollutants and risk of coronary artery disease,and to provide a reference for reducing the risk of coronary artery disease in Nanjing residents.Methods The air pollutant data from monitoring stations in Nanjing from 2013 to 2019 were collected and converted into individual daily respiratory tract exposure according to the formula in the Technical Guidelines for the Assessment of Population Exposure to Environmental Pollutants.A case-control study design was adopted.The case group was from coronary artery disease patients in the cardiovascular department of Zhongda Hospital Affiliated to Southeast University,and the control group was from non-coronary artery disease individuals in the hospital and healthy people in Qixia District of Nanjing.General and clinical information was collected for all subjects.Multivariate Logistic regression model was used to analyze the correlation of air pollutants with the risk of coronary artery disease.Results A total of 2250 samples were collected.The mean daily exposure levels of NO_(2)in the case group one year before admission were[28.23μg/(kg·d)],higher than those in the control group[22.63μg/(kg·d)];the mean daily exposure levels of CO were[528.99μg/(kg·d)],also higher than those in the control group[422.23μg/(kg·d)];for PM_(2.5),the mean daily exposure levels were[32.96μg/(kg·d)]in the case group,exceeding the control group’s levels[22.31μg/(kg·d)],similarly,the mean daily exposure levels of PM_(10)were[58.19μg/(kg·d)]in the case group,compared to[44.17μg/(kg·d)]in the control group,and these differences were statistically significant.Logistic regression analysis showed that the risk of coronary artery disease increased by 14.6%(OR=1.146,95%CI:1.082-1.214),0.4%(OR=1.004,95%CI:1.002-1.006),11.1%(OR=1.111,95%CI:1.086-1.137),and 4.2%(OR=1.042,95%CI:1.020-1.065)for every 1μg/(kg·d)increase in the exposure concentration of NO_(2),CO,PM_(2.5),and PM_(10).Conclusion The present study shows t

关 键 词：冠心病 空气污染物 危险因素 南京市 病例对照研究 

分 类 号：R122.2[医药卫生—环境卫生学]