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[杭州细颗粒物与哮喘门诊就诊之间的关联]

[Association Between Fine Particulate Matter and Asthma Hospital Outpatient Visits in Hangzhou].

作者信息

Wang An-Xu, Chen Xi, Song Cong-Bo, Ying Song-Min, Li Qian, Wu Lin, Mao Hong-Jun

机构信息

College of Environmental Science and Engineering, Nankai University, Tianjin 300350, China.

Center for Urban Transport Emission Research(CUTER), Nankai University, Tianjin 300071, China.

出版信息

Huan Jing Ke Xue. 2018 Oct 8;39(10):4457-4462. doi: 10.13227/j.hjkx.201712090.

Abstract

To study the short-term effects of air pollution on asthma visits and differences in susceptibility to various groups of people, data for asthma visits from January 1, 2013 to December 31, 2015 were obtained from a Hangzhou hospital. Considering the nonlinear relationships among concentration of air pollutants, respiratory hospital outpatient visits and meteorological factors, Generalized Additive Models (GAM) and stratification analysis were used to explore the lag effects and differences in people stratifications. The natural cubic spline function was used for smoothing the average temperature, the average relative humidity and the long-term trend, using dummy variables to control the effect of the day of the week and of holidays. Correlation of PM, NO and SO daily mean concentrations were significant (under 0.01) in Spearman correlation analysis, while the correlations of daily mean temperature and 3 pollutants were significantly negative. The lag effects of PM concentration on outpatient visits of asthma peaked at 3-5 days. The relative risk of asthma reached maximum at lag day 5 as 1.0056 (95% CI:1.0021-1.0091), with per 10 μg·m increment of PM concentration. The relative risk of asthma outpatient visits of all groups of patients were statistically significant (<0.05). The relative risk of asthma outpatient visits of males and young and middle-aged group were statistically significant at lag days 3-5, and for females and the elderly, were statistically significant at lag day 5. With the introduction of the effects of NO, the relative risk of asthma outpatient visits increased at lag 5 day in co-pollutant models. The authors concluded that the increase of PM may be related to the increase of asthma hospital outpatient visits within 3-5 days in Hangzhou, and the effects on male group and elderly group were more definite.

摘要

为研究空气污染对哮喘就诊的短期影响以及不同人群易感性差异,获取了杭州某医院2013年1月1日至2015年12月31日期间哮喘就诊数据。考虑到空气污染物浓度、呼吸科医院门诊就诊量和气象因素之间的非线性关系,采用广义相加模型(GAM)和分层分析来探讨滞后效应以及人群分层差异。采用自然立方样条函数对平均气温、平均相对湿度和长期趋势进行平滑处理,使用哑变量控制星期几和节假日的影响。在Spearman相关性分析中,PM、NO和SO日均浓度的相关性显著(<0.01),而日均气温与这3种污染物的相关性显著为负。PM浓度对哮喘门诊就诊量的滞后效应在3 - 5天达到峰值。随着PM浓度每增加10 μg·m,哮喘的相对风险在滞后第5天达到最大值,为1.0056(95% CI:1.0021 - 1.0091)。所有患者组哮喘门诊就诊的相对风险均具有统计学意义(<0.05)。男性组以及中青年组哮喘门诊就诊的相对风险在滞后第3 - 5天具有统计学意义,女性组和老年组在滞后第5天具有统计学意义。在引入NO的影响后,在共污染物模型中,哮喘门诊就诊的相对风险在滞后第5天增加。作者得出结论,PM增加可能与杭州3 - 5天内哮喘医院门诊就诊量增加有关,对男性组和老年组的影响更明确。

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