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大气颗粒物与前庭功能障碍的关系。

Association between ambient particulate matter and disorders of vestibular function.

机构信息

Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea.

Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, South Korea; Environmental Health Center, Seoul National University College of Medicine, Seoul, South Korea.

出版信息

Environ Res. 2017 May;155:242-248. doi: 10.1016/j.envres.2017.02.013. Epub 2017 Mar 10.

Abstract

BACKGROUND

Exposure to environmental chemicals has been suggested to alter the physiologic state of the inner and middle ear. However, it is unknown if particulate matter exposure is associated with acute vestibular dysfunction.

OBJECTIVES

To estimate the effects of particulate matter exposure on the number of hospital visits related to three major diseases of vestibular dysfunction, Meniere's disease (MD), benign paroxysmal positional vertigo (BPPV), and vestibular neuronitis (VN).

METHODS

Our study subject is from Korean National Health Insurance Service-National Sample Cohort, which is dynamic cohort consist of 1 million participants representing the Korean population. Among total cohort participants, we used the hospital visit data of 210,000 individuals who resided in Seoul from 2007 to 2010. Time series analysis using the Poisson generalized additive model and case-crossover analysis using conditional logistic regression were used to investigate the association between daily particulate matter levels (PM, particulate matter <2.5μg/m; PM, particulate matter <10μg/m; PM, PM- PM) and number of MD, BPPV, and VN hospital visits.

RESULTS

Time series analysis showed that an interquartile range (IQR) increase in PM and PM on lag day 1 was associated with an increased risk of MD hospital visits [relative risk (RR), 95% confidence interval (CI), PM: 1.09 (1.02-1.15); PM: 1.06 (1.02-1.10)]. In addition, elderly individuals (≥60 years old) showed an increased risk of MD hospital visits after particulate matter exposure when compared to younger individuals. An IQR increase in particulate matter on lag day 1 was associated with a marginally significant increase in VN hospital visits [RR (95%CI), PM: 1.11 (0.98-1.25); PM: 1.07 (0.99-1.15); PM: 1.04 (0.99-1.09)]. However, no association between particulate matter exposure and BPPV hospital visits was noted. Case-crossover analyses showed similar results to the time-series analysis across all three diseases.

CONCLUSION

MD hospital visits were associated with ambient particulate matter exposure. Elderly individuals, in particular, were more susceptible to particulate matter exposure than younger individuals.

摘要

背景

环境化学物质暴露被认为会改变内耳和中耳的生理状态。然而,目前尚不清楚颗粒物暴露是否与急性前庭功能障碍有关。

目的

评估颗粒物暴露对三种主要前庭功能障碍疾病(梅尼埃病、良性阵发性位置性眩晕和前庭神经元炎)的医院就诊次数的影响。

方法

我们的研究对象来自韩国国民健康保险服务-国家样本队列,这是一个由 100 万人组成的动态队列,代表韩国人口。在总队列参与者中,我们使用了 2007 年至 2010 年期间居住在首尔的 21 万名参与者的医院就诊数据。使用泊松广义加性模型进行时间序列分析,使用条件逻辑回归进行病例交叉分析,以调查每日颗粒物水平(PM、颗粒物<2.5μg/m;PM、颗粒物<10μg/m;PM、PM- PM)与梅尼埃病、良性阵发性位置性眩晕和前庭神经元炎医院就诊次数之间的关系。

结果

时间序列分析显示,滞后 1 天 PM 和 PM 的四分位距(IQR)增加与梅尼埃病医院就诊次数增加相关[相对风险(RR),95%置信区间(CI),PM:1.09(1.02-1.15);PM:1.06(1.02-1.10)]。此外,与年轻个体相比,颗粒物暴露后老年(≥60 岁)个体发生梅尼埃病医院就诊的风险增加。滞后 1 天颗粒物的 IQR 增加与前庭神经元炎医院就诊次数略有增加相关[RR(95%CI),PM:1.11(0.98-1.25);PM:1.07(0.99-1.15);PM:1.04(0.99-1.09)]。然而,颗粒物暴露与良性阵发性位置性眩晕医院就诊次数之间没有关联。病例交叉分析显示,所有三种疾病的结果均与时间序列分析相似。

结论

梅尼埃病的医院就诊与环境颗粒物暴露有关。特别是老年人比年轻人更容易受到颗粒物暴露的影响。

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