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

摘要

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.%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。