Liu Hui, Tian Yaohua, Xu Yan, Huang Zhe, Huang Chao, Hu Yonghua, Zhang Jun
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.
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China.
Environ Pollut. 2017 Nov;230:234-241. doi: 10.1016/j.envpol.2017.06.057. Epub 2017 Jun 26.
There is growing interest in the association between ambient air pollution and stroke, but few studies have investigated the association in developing countries. The primary objective of this study was to examine the association between levels of ambient air pollutants and hospital admission for stroke in China. A time-stratified case-crossover analysis was conducted between 2014 and 2015 in 14 large Chinese cities among 200,958 ischemic stroke and 41,746 hemorrhagic stroke hospitalizations. We used conditional logistic regression to estimate the percentage changes in stroke admissions in relation to interquartile range increases in air pollutants. Air pollution was positively associated with ischemic stroke. A difference of an interquartile range of the 6-day average for particulate matter less than 10 μm in aerodynamic diameter, sulfur dioxide, nitrogen dioxide, carbon monoxide, and ozone corresponded to 0.7% (95% CI: 0%, 1.4%), 1.6% (95% CI: 1.0%, 2.3%), 2.6% (95% CI: 1.8%, 3.5%), 0.5% (95% CI: -0.2%, 1.1%), and 1.3% (95% CI: 0.3%, 2.3%) increases in ischemic stroke admissions, respectively. For hemorrhagic stroke, we observed the only significant association in relation to nitrogen dioxide on the current day (percentage change: 1.6%; 95% CI: 0.3%, 2.9%). Our findings contribute to the limited scientific literature concerning the effect of ambient air pollution on stroke in developing countries. Our findings may have significant public health implications for primary prevention of stroke in China.
环境空气污染与中风之间的关联正受到越来越多的关注，但很少有研究在发展中国家对此关联进行调查。本研究的主要目的是检验中国环境空气污染物水平与中风住院之间的关联。2014年至2015年期间，在中国14个大城市对200,958例缺血性中风和41,746例出血性中风住院病例进行了时间分层病例交叉分析。我们使用条件逻辑回归来估计中风住院病例相对于空气污染物四分位间距增加的百分比变化。空气污染与缺血性中风呈正相关。空气动力学直径小于10μm的颗粒物、二氧化硫、二氧化氮、一氧化碳和臭氧的6天平均四分位间距差异分别对应缺血性中风住院病例增加0.7%（95%CI：0%，1.4%）、1.6%（95%CI：1.0%，2.3%）、2.6%（95%CI：1.8%，3.5%）、0.5%（95%CI：-0.2%，1.1%）和1.3%（95%CI：0.3%，2.3%）。对于出血性中风，我们仅观察到与当日二氧化氮有显著关联（百分比变化：1.6%；95%CI：0.3%，2.9%）。我们的研究结果为发展中国家环境空气污染对中风影响的有限科学文献做出了贡献。我们的研究结果可能对中国中风的一级预防具有重大公共卫生意义。
