Zhang Runhua, Liu Gaifen, Jiang Yong, Li Gang, Pan Yuesong, Wang Yilong, Wei Zaihua, Wang Jing, Wang Yongjun
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Beijing, China.
Front Neurol. 2018 Oct 2;9:827. doi: 10.3389/fneur.2018.00827. eCollection 2018.
A large body of literature reported the association of particulate matter (PM) with stroke in high-income countries. Few studies have examined the association between PM and stroke in middle- and low-income countries and considered the types of stroke. In this study, we examined the short-term effects of particulate matter <2.5 μm in diameter (PM) and particulate matter <10 μm in diameter (PM) on ischemic stroke mortality and hemorrhagic stroke mortality in Beijing, China. We used an ecological study design and quasi-Poisson generalized additive models to evaluate the association of PM and PM and cerebrovascular diseases mortality, as well as ischemic- and hemorrhagic stroke mortality. In the model, we controlled long-term and season trends, temperature, and relative humidity, the day of the week and air pollution. For cerebrovascular diseases mortality, we examined the effects stratified by sex and age with different lag days. A total of 48,122 deaths for cerebrovascular disease (32,799 deaths for ischemic stroke and 13,051 deaths for hemorrhagic stroke) were included in the study. PM was associated with stroke mortality. The 10 μg/m increase of PM was associated with the increase of mortality, 0.27% (95% CI, 0.12-0.43%) for cerebrovascular diseases, 0.23% (95% CI, 0.04-0.42%) for ischemic stroke and 0.37% (95% CI, 0.07-0.67%) for hemorrhagic stroke -. The associations between PM and mortality were also detected for cerebrovascular diseases and ischemic stroke, but not in hemorrhagic stroke. The stratified analysis suggested age and gender did not modify the effects of PM on mortality significantly. Our study suggested that short-term exposure to ambient PM was associated with the risk of stroke mortality.
大量文献报道了高收入国家中颗粒物（PM）与中风之间的关联。很少有研究考察中低收入国家PM与中风之间的关联并考虑中风类型。在本研究中，我们考察了直径小于2.5微米的颗粒物（PM₂.₅）和直径小于10微米的颗粒物（PM₁₀）对中国北京缺血性中风死亡率和出血性中风死亡率的短期影响。我们采用生态研究设计和拟泊松广义相加模型来评估PM₂.₅和PM₁₀与脑血管疾病死亡率以及缺血性和出血性中风死亡率之间的关联。在模型中，我们控制了长期和季节趋势、温度、相对湿度、星期几以及空气污染。对于脑血管疾病死亡率，我们按性别和年龄分层并考察不同滞后天数的影响。本研究共纳入48122例脑血管疾病死亡病例（32799例缺血性中风死亡和13051例出血性中风死亡）。PM与中风死亡率相关。PM₁₀每增加10微克/立方米，死亡率就会上升，脑血管疾病死亡率上升0.27%（95%可信区间，0.12 - 0.43%），缺血性中风死亡率上升0.23%（95%可信区间，0.04 - 0.42%），出血性中风死亡率上升0.37%（95%可信区间，0.07 - 0.67%）。对于脑血管疾病和缺血性中风，也检测到了PM与死亡率之间的关联，但在出血性中风中未检测到。分层分析表明年龄和性别并未显著改变PM对死亡率的影响。我们的研究表明，短期暴露于环境PM与中风死亡风险相关。
