Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai JiaoTong University School of Medicine, Shanghai, China.
National Clinical Research Center for Oral Diseases, Shanghai, China.
Environ Health Prev Med. 2019 Jun 1;24(1):38. doi: 10.1186/s12199-019-0793-9.
Few studies investigating associations between fine particulate air pollution and hemorrhagic stroke have considered subtypes. Additionally, less is known about the modification of such association by factors measured at the individual level. We aimed to investigate the risk of fatal intracerebral hemorrhage (ICH) incidence in case of PM (particles ≤ 2.5 μm in aerodynamic diameter) exposure.
Data on incidence of fatal ICH from 1 June 2012 to 31 May 2014 were extracted from the acute stroke mortality database in Shanghai Municipal Center for Disease Control and Prevention (SCDC). We used the time-stratified case-crossover approach to assess the association between daily concentrations of PM and fatal ICH incidence in Shanghai, China.
A total of 5286 fatal ICH cases occurred during our study period. The averaged concentration of PM was 77.45 μg/m. The incidence of fatal ICH was significantly associated with PM concentration. Substantial differences were observed among subjects with diabetes compared with those without; following the increase of PM in lag2, the OR (95% CI) for subjects with diabetes was 1.26 (1.09-1.46) versus 1.05 (0.98-1.12) for those without. We did not find evidence of effect modification by hypertension and cigarette smoking.
Fatal ICH incidence was associated with PM exposure. Our results also suggested that diabetes may increase the risk for ICH incidence in relation to PM.
很少有研究调查细颗粒物空气污染与出血性中风之间的关联，并考虑到其亚型。此外，对于个体水平测量的因素对这种关联的修饰作用，人们了解较少。我们旨在研究在暴露于 PM（空气动力学直径≤2.5μm 的颗粒）的情况下，致命性脑内出血（ICH）发病的风险。
从上海市疾病预防控制中心（SCDC）急性中风死亡率数据库中提取 2012 年 6 月 1 日至 2014 年 5 月 31 日期间致命性 ICH 发病的数据。我们使用时间分层病例交叉方法来评估 PM 日浓度与中国上海致命性 ICH 发病之间的关联。
在我们的研究期间，共发生了 5286 例致命性 ICH 病例。PM 的平均浓度为 77.45μg/m。致命性 ICH 的发病率与 PM 浓度显著相关。与无糖尿病者相比，糖尿病患者之间存在明显差异；在滞后 2 天 PM 增加后，糖尿病患者的 OR（95%CI）为 1.26（1.09-1.46），而无糖尿病患者为 1.05（0.98-1.12）。我们没有发现高血压和吸烟对效应修饰的证据。
致命性 ICH 发病率与 PM 暴露有关。我们的研究结果还表明，糖尿病可能会增加与 PM 相关的 ICH 发病风险。
