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细颗粒物空气污染与中国北京地区缺血性脑卒中的首次住院治疗

Fine Particulate Air Pollution and First Hospital Admissions for Ischemic Stroke in Beijing, China.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China.

Medical Informatics Center, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China.

出版信息

Sci Rep. 2017 Jun 20;7(1):3897. doi: 10.1038/s41598-017-04312-5.

Abstract

The primary objective of this study was to assess the association between short-term changes in ambient fine particulate matter (PM) and first hospital admissions for ischemic stroke. We identified 63,956 first hospital admissions for ischemic stroke from the Beijing Medical Claim Data for Employees from January 1, 2010, through June 30, 2012. A generalized additive Poisson model was applied to explore the association between PM and admissions for ischemic stroke. We also explore the effect modification of risk by age and gender. The exposure-response relationship between PM and admissions for ischemic stroke was approximately linear, with a relatively stable response at lower concentrations (<100 μg/m) and a steeper response at higher concentrations. A 10 μg/m increase in the same-day PM concentration was associated with 0.31% (95% CI, 0.17-0.45%, P < 1.57 × 10) increase in the daily admissions for ischemic stroke. The association was also statistically significant at lag 1, 2, 3, 0-2 and 0-4 days. Subgroup analyses showed that the association was not different between patients ≥65 years and <65 years old or between males and females. In conclusion, short-term exposure to PM was positively associated with first hospital admissions for ischemic stroke in Beijing, China.

摘要

本研究的主要目的是评估短期环境细颗粒物(PM)变化与缺血性脑卒中首次住院治疗之间的关联。我们从 2010 年 1 月 1 日至 2012 年 6 月 30 日的北京市医疗保险员工数据中确定了 63956 例缺血性脑卒中首次住院治疗。应用广义加性泊松模型探讨 PM 与缺血性脑卒中住院治疗之间的关系。我们还探讨了年龄和性别对风险的修饰作用。PM 与缺血性脑卒中住院治疗之间的暴露-反应关系近似线性,在较低浓度(<100μg/m)下反应相对稳定,在较高浓度下反应更陡峭。同一日 PM 浓度增加 10μg/m,与缺血性脑卒中每日住院人数增加 0.31%(95%CI,0.17-0.45%,P<1.57×10)相关。滞后 1、2、3、0-2 和 0-4 天的关联也具有统计学意义。亚组分析表明,≥65 岁和<65 岁患者以及男性和女性之间的关联没有差异。总之,短期暴露于 PM 与中国北京市缺血性脑卒中首次住院治疗呈正相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79bd/5478610/28221bc83c85/41598_2017_4312_Fig1_HTML.jpg

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