空气污染物PM2.5含量与某城区呼吸系统和心血管系统主要疾病指标阳性检出病例数的相关性研究

摘要

Objective To study the correlation between ambient particular matter (PM) 2.5 and the numbers of cases with positive detection on key indexes of respiratory and cardiovascular systems in certain district of Shanghai.Methods Total numbers of clinical cases detected with CYFRA211, NSE from respiratory system, CK-MB and LDH from cardiovascular system and CRP from all departments were collected to get the numbers of positive cases from the hospital in certain district of Shanghai.Monthly quantities of PM2.5 were collected upon published data from Environmental Protection Agent in 2015.The correlation ratio and positive detection cases caused by PM2.5 were evaluated from different seasons.Results The city and the certain district average concentration of PM2.5 were 54.7μg/m3 and 53μg/m3, respectively, and the higher QI appeared in January, February, November and December.There were 7 days with most serious pollution and 9 days with more serious pollution than average.Correlated with the quantity of PM2.5 seasonally, we found the correlation among numbers of positive detection cases of CRP, CK-MB and LDH.The positive cases of CK-MB and LDH increased by 7%-8% related to PM2.5 in the first and fourth seasons.And the positive cases of CRP also increased by 6%-7% in the first and fourth season.Conclusion Data mining from clinical laboratory can provide more information on correlation of PM2.5 with positive cases of the key indexes detected daily and support the clinical research on disease induced by pollution.%目的 探讨空气污染物PM2.5与上海市所研究区县入院病人主要的呼吸系统检验指标(CYFRA21-1、 NSE)、心血管疾病检验指标(CK-MB、LDH)以及C反应蛋白(CRP)的检出阳性病例数的相关性研究.方法 收集2015年1月至2015年12月上海市某区中心医院全年住院患者呼吸系统(CYFRA21-1、 NSE)、心血管疾病(CK-MB、LDH)以及C反应蛋白(CRP)检测结果,将研究时间范围内的总的检测病例数以及高于正常值的阳性检测病例数(阳性检出率)按照不同季度统计出来;同时收集全年PM2.5浓度值.根据单因素相关回归模型和泊松回归(Poisson)模型的统计学方法分析空气主要污染物PM2.5浓度与检验科五个检测指标阳性检测结果的相关关系.结果 评价2015年1月到12月上海全市以及某城区PM2.5月平均浓度变化,污染严重时间主要是在1、2、11和12月份,他们的平均浓度分别为为84μg/m3,65μg/m3,59μg/m3和81μg/m3.同时,全年空气污染指数(AQI)为中、重度污染的日期和相应的PM2.5日平均浓度值重度污染有7天,中度污染有9天.PM2.5月平均浓度值与呼吸系统两个主要检测指标CYFAR21-1呈负相关,与NSE无相关性.PM2.5对心血管疾病检测指标CKMB和LDH阳性检出病例有相关性,PM2.5可以引起CK-MB和LDH阳性病例数的增高7%到8%.CRP蛋白的阳性检测病例数与PM2.5的浓度呈现正相关性,其阳性检测病例数在第一和第四季度明显增高.结论 利用Poisson回归模型,PM2.5可以明显提高临床检验指标的阳性检测率,以CRP和心血管检验指标CKMB 和LDH样本病例数增高更为明显.该研究通过检验科数据库资源挖掘,为临床提供诊断和治疗提供更全面的参考依据和研究基础.