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浙江大学学报（医学版）
浙江大学学报（医学版）  2016, Vol. 45 Issue (6): 607-613    DOI: 10.3785/j.issn.1008-9292.2016.11.08
原著     
宁波市鄞州区大气可吸入颗粒物暴露与冠心病就诊人数的时间序列分析
叶臻华1,2, 郑培雯1,2, 沈鹏3, 张振宇1,2, 陆怀初3, 金明娟1,2, 林鸿波3, 王建炳1,2, 陈坤1,2
1. 浙江大学公共卫生学院流行病与卫生统计学系, 浙江 杭州 310058;
2. 浙江大学空气污染与健康研究中心, 浙江 杭州 310058;
3. 宁波市鄞州区疾病预防控制中心, 浙江 宁波 315100
Time-series analysis of particulate matter and daily hospital visits for coronary heart disease in Yinzhou district, Ningbo area
YE Zhenhua1,2, ZHENG Peiwen1,2, SHEN Peng3, ZHANG Zhenyu1,2, LU Huaichu3, JIN Mingjuan1,2, LIN Hongbo3, WANG Jianbing1,2, CHEN Kun1,2
1. Department of Epidemiology, School of Public Health, Zhejiang University, Hangzhou 310058, China;
2. Air Pollution and Health Research Center of Zhejiang University, Hangzhou 310058, China;
3. Center for Disease Control and Prevention of Yinzhou District, Ningbo 315100, China
 全文: PDF(1073 KB)  
摘要：

目的：研究大气中可吸入颗粒物（PM）的浓度与冠心病门诊人数的关系。方法：收集宁波市鄞州区卫生信息系统2014年1月至2015年6月冠心病患者的就诊信息，同期收集宁波市环境监测中心的大气PM浓度以及宁波市气象局的气象监测资料。采用时间序列的类泊松—广义相加模型，控制长期趋势、气象因素、星期几效应等因素的影响，分析在研究期间宁波市鄞州区PM浓度与冠心病就诊数之间的关系。结果：大气PM2.5浓度每升高一个四分位数间距（IQR），冠心病门诊数增加1.98%（95%CI：-0.59%～4.63%）。在女性和年龄≥75岁老年人群中，PM2.5暴露与冠心病就诊人数具有统计学关联，ER值分别为2.70%（95%CI：0.01%～5.47%）和3.35%（95%CI：0.12%～6.69%）。在校正了PM2.5后，粗颗粒物（PM2.5~10）对冠心病就诊数的影响降低。结论：宁波市鄞州区大气PM2.5与冠心病门诊数短期内存在一定关联，尤其在女性和老年人群中两者的关联更加明显。
关键词： 冠心病/病因;  空气污染物/副作用;  时间因素;  序列分析;  泊松分布;  门诊病人/统计学和数值数据    
Abstract:

Objective: To explore the association between particulate matter (PM) and daily hospital visits of coronary heart diseases in Ningbo. Methods: Daily data of hospital visits from January 2014 to June 2015 (516 days in total) were obtained from the Yinzhou Health Information System in Ningbo. Daily air pollution data for PM and meteorological data were collected from the database of Ningbo Environmental Monitoring Center and Ningbo Meteorological Bureau. Time-series analysis by quasi-Poisson generalized additive model was used to examine the association between air pollution and hospital visits for coronary heart diseases by adjustment of long-term trends, seasonal patterns and meteorological variables (temperature, humidity), and day of week. Results: An increase of an IQR of PM2.5 accounted for 1.98% (95%CI:-0.59%-4.63%) increase of hospital visits for coronary heart diseases. The associations between PM2.5 and hospital visits for coronary heart diseases among female and the elderly (≥75 years) were stronger (ER=2.70%,95% CI:0.01%-5.47%; ER=3.35%, 95% CI: 0.12%-6.69%). The effects of PM2.5~10 attenuated after adjustment for PM2.5. Conclusion: PM2.5 had short-term effects on daily hospital visits for coronary heart diseases in Ningbo, and such association was stronger among female and the elderly.
Key words: Coronary disease/etiology    Air pollutants/adverse effects    Time factors    Sequence analysis    Poisson distribution    Outpatients/statistics &numerical data
收稿日期: 2016-09-22
CLC:  R122  
基金资助:

浙江大学空气污染与健康研究中心资助项目（H20151885）
通讯作者: 陈坤(1960-),男,博士,教授,博士生导师,主要从事分子流行病学与环境流行病学研究;E-mail:ck@zju.edu.cn;林鸿波(1976-),男,本科,主管技师,主要从事疾病预防和控制工作;E-mail:lin73160@163.com     E-mail: ck@zju.edu.cn;lin73160@163.com
作者简介: 叶臻华(1989-),男,硕士研究生,主要从事环境流行病学研究;E-mail:11218216@zju.edu.cn郑培雯(1992-),女,硕士研究生,主要从事环境流行病学研究;E-mail:zhpeiw6@163.com
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引用本文:

叶臻华 等. 宁波市鄞州区大气可吸入颗粒物暴露与冠心病就诊人数的时间序列分析[J]. 浙江大学学报（医学版）, 2016, 45(6): 607-613.

YE Zhenhua, ZHENG Peiwen, SHEN Peng, ZHANG Zhenyu, LU Huaichu, JIN Mingjuan, LIN Hongbo, WANG Jianbing, CHEN Kun. Time-series analysis of particulate matter and daily hospital visits for coronary heart disease in Yinzhou district, Ningbo area. Journal of ZheJiang University(Medical Science), 2016, 45(6): 607-613.

链接本文:

http://www.zjujournals.com/xueshu/med/CN/10.3785/j.issn.1008-9292.2016.11.08    或    http://www.zjujournals.com/xueshu/med/CN/Y2016/V45/I6/607

[1] 张远征. 冠心病发病危险因素研究现状[J]. 第四军医大学学报,2009,30(23):2888-2891. ZHANG Yuanzheng. Study on risk factors for coronary heart disease[J]. Journal of the Fourth Military Medical University, 2009, 30(23):2888-2891. (in Chinese)
[2] XIANG H, MERTZ K J, ARENA V C, et al. Estimation of short-term effects of air pollution on stroke hospital admissions in Wuhan, China[J/OL]. PLoS One, 2013, 8(4):e61168.
[3] BREITNER S, LIU L, CYRYS J, et al. Sub-micrometer particulate air pollution and cardiovascular mortality in Beijing, China[J]. Sci Total Environ, 2011, 409(24):5196-5204.
[4] ITO K, MATHES R, ROSS Z, et al. Fine particulate matter constituents associated with cardiovascular hospitalizations and mortality in New York city[J]. Environ Health Perspect, 2011, 119(4):467-473.
[5] POPE C A, BURNETT R T, THURSTON G D, et al. Cardiovascular mortality and long-term exposure to particulate air pollution:epidemiological evidence of general pathophysiological pathways of disease[J]. Circulation, 2004, 109(1):71-77.
[6] KREWSKI D, BURNETT R T, GOLDBERG M S, et al. Overview of the reanalysis of the Harvard six cities study and American Cancer Society study of particulate air pollution and mortality[J]. J Toxicol Environ Health A, 2003, 66(16-19):1507-1551.
[7] 杨春雪,阚海东,陈仁杰. 我国大气细颗粒物水平、成分、来源及污染特征[J]. 环境与健康杂志,2011,28(8):735-738. YANG Chunxue, KAN Haidong, CHEN Renjie. Research on level, composition, source and pollution characteristics of ambient fine particles in China[J]. Journal of Environment and Health, 2011, 28(8):735-738. (in Chinese)
[8] PENG R D, DOMINICI F, LOUIS T A. Model choice in time series studies of air pollution and mortality[J]. J R Statist Soc A, 2006, 169(2):179-203.
[9] YANG C, CHEN A, CHEN R, et al. Acute effect of ambient air pollution on heart failure in Guangzhou, China[J]. Int J Cardiol, 2014, 177(2):436-441.
[10] LIN H, TAO J, DU Y, et al. Particle size and chemical constituents of ambient particulate pollution associated with cardiovascular mortality in Guangzhou, China[J]. Environ Pollut, 2016, 208(Pt B):758-766.
[11] RODOPOULOU S, SAMOLI E, CHALBOT M C, et al. Air pollution and cardiovascular and respiratory emergency visits in Central Arkansas:a time-series analysis[J]. Sci Total Environ, 2015, 536:872-879.
[12] RODOPOULOU S, CHALBOT M C, SAMOLI E, et al. Air pollution and hospital emergency room and admissions for cardiovascular and respiratory diseases in Doña Ana County, New Mexico[J]. Environ Res, 2014, 129:39-46.
[13] DOMINICI F, PENG R D, BELL M L, et al. Fine particulate air pollution and hospital admission for cardiovascular and respiratory diseases[J]. JAMA, 2006, 295(10):1127-1134.
[14] POPE C A, MUHLESTEIN J B, MAY H T, et al. Ischemic heart disease events triggered by short-term exposure to fine particulate air pollution[J]. Circulation, 2006, 114(23):2443-2448.
[15] PENG R D, CHANG H H, BELL M L, et al. Coarse particulate matter air pollution and hospital admissions for cardiovascular and respiratory diseases among medicare patients[J]. JAMA, 2008, 299(18):2172-2179.
[16] POWELL H, KRALL J R, WANG Y, et al. Ambient coarse particulate matter and hospital admissions in the medicare cohort air pollution study, 1999-2010[J]. Environ Health Perspect, 2015, 123(11):1152-1158.
[17] LIN C M, KUO H W. Sex-age differences in association with particulate matter and emergency admissions for cardiovascular diseases:a hospital-based study in Taiwan[J]. Public Health, 2013, 127(9):828-833.
[18] YORIFUJI T, SUZUKI E, KASHIMA S. Cardiovascular emergency hospital visits and hourly changes in air pollution[J]. Stroke, 2014, 45(5):1264-1268.
[19] ZEKA A, ZANOBETTI A, SCHWARTZ J. Individual-level modifiers of the effects of particulate matter on daily mortality[J]. Am J Epidemiol, 2006, 163(9):849-859.
[20] SU C, BREITNER S, SCHNEIDER A, et al. Short-term effects of fine particulate air pollution on cardiovascular hospital emergency room visits:a time-series study in Beijing, China[J]. Int Arch Occup Environ Health, 2016, 89(4):641-657.
[21] KIM C S, HU S C. Regional deposition of inhaled particles in human lungs:comparison between men and women[J]. J Appl Physiol (1985), 1998, 84(6):1834-1844.
[22] MIDDLETON N, YIALLOUROS P, KLEANTHOUS S, et al. A 10-year time-series analysis of respiratory and cardiovascular morbidity in Nicosia, Cyprus:the effect of short-term changes in air pollution and dust storms[J]. Environ Health, 2008, 7:39.
[23] ZANOBETTI A, SCHWARTZ J. The effect of particulate air pollution on emergency admissions for myocardial infarction:a multicity case-crossover analysis[J]. Environ Health Perspect, 2005, 113(8):978-982.
[24] LE TERTRE A, MEDINA S, SAMOLI E, et al. Short-term effects of particulate air pollution on cardiovascular diseases in eight European cities[J]. J Epidemiol Community Health, 2002, 56(10):773-779.
[25] NUVOLONE D, BALZI D, CHINI M, et al. Short-term association between ambient air pollution and risk of hospitalization for acute myocardial infarction:results of the cardiovascular risk and air pollution in Tuscany (RISCAT) study[J]. Am J Epidemiol, 2011, 174(1):63-71.
[26] LINARES C, DÍAZ J. Short-term effect of concentrations of fine particulate matter on hospital admissions due to cardiovascular and respiratory causes among the over -75 age group in Madrid, Spain[J]. Public Health, 2010, 124(1):28-36.
[27] 魏秀兰, 李锁玲, 赵孝怀, 等. 冠心病与气象因素的关系[J]. 菏泽医学专科学校学报, 2003, 15(1):48-49. WEI Xiulan,LI Suoling,ZHAO Xiaohuai,et al. Relationship between coronary heart disease and the meteorological factors[J]. Journal of Heze Medical College, 2003, 15(1):48-49. (in Chinese)
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