Bao H R, Liu X J, Tan E L, Shu J, Dong J Y, Li S
Department of Gerontal Respiratory Medicine, The First Hospital of Lanzhou University, Lanzhou 730000, China.
Institute of Occupational and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2020 Apr 18;52(2):308-316. doi: 10.19723/j.issn.1671-167X.2020.02.019.
To understand the relationships of daily average temperature and relative humidity with outpatient visit frequency of patients with chronic obstructive pulmonary disease, and whether temperature and relative humidity have a lag effect.
The effects of daily average temperature, relative humidity, and their interaction in Lanzhou between January 2013 and December 2017 on the outpatient visit frequency of chronic obstructive pulmonary disease patients were analyzed using Poisson generalized linear regression model combined with distributed lag non-linear model.
There was a non-linear relationship between the daily average temperature and the outpatient visit frequency of chronic obstructive pulmonary disease patients. Between -12 °C and -8 °C, the outpatient visit frequency increased gradually with the decrease of the daily average temperature, and the outpatient visit frequency of chronic obstructive pulmonary disease patients increased by 11.60% per 1 °C of temperature drop. The daily average relative humidity also presented a non-linear effect on the outpatient visit frequency chronic obstructive pulmonary disease patients. When the daily average relative humidity was in the range of 15%-28%, the outpatient visit frequency increased gradually with the decrease of relative humidity, and the outpatient visit frequency of COPD patients increased by 37.05% for every 1% decrease of relative humidity. A synergistic effect was found between air temperature and relative humidity on chronic obstructive pulmonary disease, that is, under different relative humidity, the effect of air temperature was different. When the daily average relative humidity ≤ 50% and the daily average temperature≤11 °C, the effect of air temperature was the most obvious. For every 1 °C drop in temperature, the daily out-patient visit frequency of the whole population increased by 12.68% (5.62% in males and 7.56% in females; 5.24% in population < 65 years and 14.74% in population ≥ 65 years). When the daily average relative humidity > 50% and the daily average temperature ≤ 11 °C, the daily outpatient visit frequency of the whole population increased by 9.00% for every 1 °C drop in temperature (< 65 years, 7.11%; ≥65 years, 10.93%). When the daily average temperature > 11 °C, the temperature had no effect on the daily outpatient visit frequency of chronic obstructive pulmonary disease patients under different relative humidity.
The presence of a certain extent of interaction is observed between daily average temperature and relative humidity. Low-temperature and dry environment (relative humidity ≤50%, temperature ≤11 °C) as well as low-temperature and high-humidity environment (relative humidity > 50%, temperature ≤11 °C) can both increase the risk of outpatient visit in chronic obstructive pulmonary disease patients.
了解日平均气温和相对湿度与慢性阻塞性肺疾病患者门诊就诊频次的关系，以及气温和相对湿度是否存在滞后效应。
采用Poisson广义线性回归模型结合分布滞后非线性模型，分析2013年1月至2017年12月兰州市日平均气温、相对湿度及其交互作用对慢性阻塞性肺疾病患者门诊就诊频次的影响。
日平均气温与慢性阻塞性肺疾病患者门诊就诊频次之间存在非线性关系。在-12℃至-8℃之间，门诊就诊频次随日平均气温的降低而逐渐增加，慢性阻塞性肺疾病患者门诊就诊频次每降低1℃增加11.60%。日平均相对湿度对慢性阻塞性肺疾病患者门诊就诊频次也呈现非线性效应。当日平均相对湿度在15% - 28%范围内时，门诊就诊频次随相对湿度的降低而逐渐增加，慢性阻塞性肺疾病患者门诊就诊频次每降低1%增加37.05%。发现气温与相对湿度对慢性阻塞性肺疾病存在协同效应，即在不同相对湿度下，气温的影响不同。当日平均相对湿度≤50%且日平均气温≤11℃时，气温的影响最为明显。气温每降低1℃，全人群每日门诊就诊频次增加12.68%（男性增加5.62%，女性增加7.56%；<65岁人群增加5.24%，≥65岁人群增加14.74%）。当日平均相对湿度>50%且日平均气温≤11℃时，气温每降低1℃，全人群每日门诊就诊频次增加9.00%（<65岁人群增加7.11%，≥65岁人群增加10.93%）。当日平均气温>11℃时，在不同相对湿度下气温对慢性阻塞性肺疾病患者每日门诊就诊频次无影响。
日平均气温与相对湿度之间存在一定程度的交互作用。低温干燥环境（相对湿度≤50%，温度≤11℃）以及低温高湿环境（相对湿度>50%，温度≤11℃）均可增加慢性阻塞性肺疾病患者门诊就诊风险。
