Huang Fangfang, Luo Yanxia, Guo Yuming, Tao Lixin, Xu Qin, Wang Chao, Wang Anxin, Li Xia, Guo Jin, Yan Aoshuang, Guo Xiuhua
School of Public Health, Capital Medical University, Beijing, China Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
School of Public Health, University of Queensland, Brisbane, Australia.
J Am Heart Assoc. 2016 Jul 13;5(7):e003437. doi: 10.1161/JAHA.116.003437.
The impact of particulate matter (PM) on stroke may vary by particle size, stroke subtype, and patient characteristics and temperature. We examined the association of stroke admissions with PM in different subgroups in Beijing, China, during 2013-2014.
A time-stratified case-crossover design was used to assess the relation between PM of different particle sizes and hospital admissions for ischemic and hemorrhagic stroke. Stratified analyses were performed by age, sex, and temperature. In total, there were 147 624 stroke admissions during the study period. In the whole-period analysis, both PM2.5 and PM10 were positively associated with ischemic stroke admissions on the day of hospital admission and negatively associated with ischemic stroke at lag2 and lag3 day. In warm days (>13.5°C), the odds ratios of ischemic stroke admissions were 2.071 (95% CI 1.959-2.190), 1.470 (95% CI 1.391-1.554), and 1.590 (95% CI 1.493-1.694) per IQR increase in the same-day PM2.5 (82.0 μg/m(3)), PM2.5-10 (36.6 μg/m(3)), and PM10 (93.5 μg/m(3)), respectively. For hemorrhagic stroke, the corresponding values were 1.941 (95% CI 1.658-2.273), 1.590 (95% CI 1.366-1.851), and 1.527 (95% CI 1.278-1.826). The positive associations were also observed in the other lag structures and were higher than in cold days (≤13.5°C).
This study suggests that the associations of PM2.5, PM2.5-10, and PM10 with stroke admissions differed across levels of temperature. Short-term exposure to PM2.5, PM2.5-10, and PM10 was positively associated with hospital admissions for ischemic and hemorrhagic stroke on warm days (>13.5°C).
颗粒物（PM）对中风的影响可能因颗粒大小、中风亚型、患者特征及温度而异。我们研究了2013 - 2014年中国北京不同亚组中中风入院与PM之间的关联。
采用时间分层病例交叉设计评估不同粒径PM与缺血性和出血性中风住院之间的关系。按年龄、性别和温度进行分层分析。研究期间共有147624例中风入院病例。在全周期分析中，PM2.5和PM10在入院当天均与缺血性中风入院呈正相关，在滞后2天和滞后3天与缺血性中风呈负相关。在温暖天气（>13.5°C），当日PM2.5（82.0μg/m³）、PM2.5 - 10（36.6μg/m³）和PM10（93.5μg/m³）每增加一个四分位间距，缺血性中风入院的比值比分别为2.071（95%可信区间1.959 - 2.190）、1.470（95%可信区间1.391 - 1.554）和1.590（95%可信区间1.493 - 1.694）。对于出血性中风，相应的值分别为1.941（95%可信区间1.658 - 2.273）、1.590（95%可信区间1.366 - 1.851）和1.527（95%可信区间1.278 - 1.826）。在其他滞后结构中也观察到了正相关，且高于寒冷天气（≤13.5°C）。
本研究表明，PM2.5、PM2.5 - 10和PM10与中风入院的关联在不同温度水平下有所不同。在温暖天气（>13.5°C），短期暴露于PM2.5、PM2.5 - 10和PM10与缺血性和出血性中风住院呈正相关。
