NO2对高血压患者血压和脉压的短期影响

为了探讨气态污染物NO₂对高血压患者血压水平和脉压的短期影响，本文基于前瞻性队列研究，收集甘肃省金昌市2011年1月1日~2015年11月30日逐日NO₂监测数据及同期气象观测数据，运用混合效应模型，在控制随机效应及其他混杂因素的基础上，分析NO₂与高血压患者血压水平和脉压的关联性.结果表明：（1）NO₂在滞后1d（lag1）时平均浓度每升高1个IQR，收缩压升高0.457mmHg（0.131~0.784），滞后7d（lag7）和4d（lag4）时，NO₂的平均浓度每升高1个IQR，舒张压上升0.276mmHg（0.025~0.527），脉压上升0.402mmHg（0.047~0.758），且结果均具有统计学意义.（2）性别、年龄、BMI、吸烟、饮酒、季节在NO₂对高血压患者血压水平和脉压的效应中可能具有修饰作用.多污染物模型及调整沙尘影响后，NO₂对高血压患者血压及脉压的影响保持一致.

The short-term effects of NO2 on blood pressure and pulse pressure in patients with hypertension

In order to explore the short-term effects of gaseous pollutants (NO₂) on blood pressure (BP) and pulse pressure (PP) in patients with hypertension, the NO₂ monitoring data and meteorological observation data were collected from January 1, 2011 to November 30, 2015 in Jinchang, Gansu Province. After controlling the random effect and other confounding factors, a mixed-effect model was used to analyze the association between NO₂ and BP and PP in hypertensive patients based on a prospective cohort study. The results showed that: (1) An interquartile range (IQR) increase in NO₂ at lag 1day was associated with a 0.457mmHg (95%CI: 0.131~0.784) increase in systolic blood pressure (SBP); with each IQR increase of NO₂, diastolic blood pressure (DBP) at lag 7 day and pulse pressure (PP) at lag 4 day increased 0.276mmHg (95%CI:0.025~0.527) and 0.402mmHg (95%CI:0.047~0.758), respectively. All the results was statistically significant. (2) Gender, age, BMI, smoking, drinking, and season may modify the effects of NO₂ on BP and PP among hypertensive patients. The effects of NO₂ on BP and PP remained consistent with the results in the multi-pollutant model or after adjusting dust weather.