大气污染物对兰州心脑血管疾病住院影响的病例交叉研究

为探讨兰州市大气污染对心脑血管疾病住院的急性健康效应,采用单向回顾性配对病例交叉设计,分析了兰州市2001~2005年大气污染物浓度(PM10、SO2及NO2)短期升高对人群心脑血管疾病住院的影响.结果表明,单向回顾性1:2匹配病例交叉研究的效应值(ORs)最大,在控制同期天气因素后,滞后3d PM10浓度每升高10μg/m3 ,总心脑血管疾病及心血管疾病住院的ORs分别为1.002(95%CI:1.001~1.003)和1.002(95%CI:1.001~1.003);无滞后SO2浓度每升高10μg/m3对总心脑血管疾病住院的OR值为1.005(95%CI:1.000~1.009);NO2在滞后1d浓度每升高10μg/m3对总心脑血管疾病OR值为1.022(95%CI:1.014~1.030);对心血管疾病及脑血管疾病住院影响均在滞后2d达到最大,ORs值分别为1.021(95%CI:1.011~1.030) 和1.019(95%CI:1.005~1.033).在多污染物模型中,PM10仍对心血管疾病住院人数增加有统计学意义;NO2对心脑血管疾病住院的影响均较单污染物模型中大.

A case-crossover analysis of air pollution and hospital admissions for cardiovascular and cerebrovascular diseases in Lanzhou

To explore the acute effect of air pollution and hospital admissions for cardiovascular and cerebrovascular diseases in Lanzhou, unidirectional retrospective case-crossover design was used to analyze the relation of daily average concentration of air pollutants (PM10、SO2 and NO2) in short-time increased with the cardiovascular and cerebrovascular diseases hospitalizations from 2001 to 2005. The results showed that the unidirectional case-crossover design with 1:2 matched pairs had the highest odds ratios between air pollutants and hospital admissions. After being adjusted for meteorological factors, an increase of 10μg/m3 in PM10 was significantly associated with 1.002(95%CI: 1.001~1.003) and 1.002(95%CI: 1.001~1.003) at 3 days lag increase respectively for total circulatory diseases (ICD10:I00~I99) and cardiovascular disease (ICD10:I00~I52); an increase of 10μg/m3 in SO2 was associated with 1.005(95%CI:1.000~1.009) for total circulatory diseases hospitalizations; a 10μg/m3 increment in NO2 was significantly associated with hospital admissions on value of ORs 1.022(95%CI:1.014~1.030) for the total circulatory diseases at 1day lag, 1.021(95%CI: 1.011~1.030) for cardiovascular disease at 2 days lag, 1.019(95%CI:1.005~1.033) for cerebrovascular diseases (ICD10: I60~I69) at 2 days lag respectively. In the multiple air pollutant models, an increase of 10μg/m3 in PM10 was also associated with cardiovascular and cerebrovascular diseases hospitalizations, the OR values of NO2 were higher than the single pollutant models.