大气颗粒物与居民脑卒中发作或死亡之间关系的Meta分析

摘要

目的 研究大气颗粒物污染(PM10、PM25)与居民脑卒中发作或死亡之间的关系.方法 检索文献数据库,应用Meta分析法对符合文献纳入标准的16个有关大气颗粒物与居民脑卒中每日发作或死亡关系的定量研究进行综合分析.根据异质性检验结果选用固定效应模型或随机效应模型,采用大气颗粒物每上升10 μg/m3,居民脑卒中死亡的危险度(OR)为效应值进行效应值合并,做敏感性分析.结果 PM10浓度每上升10 μg/m3,居民脑卒中发作的OR=1.011(95%CI:1.001～1.021),即发作增加1.09%(95%CI:0.10%～2.08%),死亡的OR=1.007(95%CI:1.006～1.008),即死亡增加0.70%(95%CI:0.60%～0.80%),说明PM10浓度上升与居民脑卒中发作或死亡均有统计学相关,敏感性分析结果均稳定;PM25浓度每上升10 μg/m3,居民脑卒中发作的OR=1.001(95%CI:0.992～1.010),死亡的OR=1.052(95%CI:0.958～1.154).结论 研究结果表明PM10的空气污染对居民脑卒中发作率和死亡率的增加有统计学相关,PM25浓度增高与脑卒中发作或死亡无统计学相关.%Objective To analyze the associations between particulate air pollution (PM10,PM25) and stroke daily attack or mortality. Methods Meta-analysis method was used to polysynthetically analyze 16 quantitative studies about the associations between particulate air pollution and stroke daily attack or mortality. The relative odds ratio(OR) of stroke attack or mortality associated with per 10 μg/m3 increase of particulate matter concentration was used as effective value,taking a sensitivity analysis for the results. Results A 10 μg/m3 increase in PM10was associated with a 1.09% (95%CI: 0.10%-2.08% ) increase in stroke daily attack (OR=1.011,95%CI: 1.001-1.021)and 0.70% (95%CI: 0.60%-0.80% ) increase in stroke daily mortality (OR= 1.007, 95%CI: 1.006-1.008). The results of sensitivity analysis supported above results. As for PM2.5 OR appeared to be 1.001 (95%CI: 0.992-1.010) with a 10 μg/m3 increase in stroke daily attack and 1.052 (95%CI:0.958-1.154) for daily mortality. Conclusion There are positive associations between PM10 and stroke daily attack and mortality, increase of PM25 was not associated with stroke attack and mortality.