Li Lei, Huang Suli, Duan Yanran, Liu Peiyi, Lei Lin, Tian Yuchen, Xiang Ming, Peng Ji, Cheng Jinquan, Yin Ping
Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology Tongji Medical College School of Public Health, Wuhan, Hubei, China.
Department of Environment and Health, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China.
Occup Environ Med. 2021 Jan 28. doi: 10.1136/oemed-2020-106985.
Evidence on the relationship between ambient temperature and morbidity of different stroke subtypes in China is limited. This study aimed to assess the influence of ambient temperature on stroke risk in Shenzhen, China.
From 1 January 2003 to 31 December 2014, 114 552 stroke cases in Shenzhen were collected. A generalised additive model with quasi-Poisson regression combined with a distributed lag non-linear model was applied to evaluate the temperature effects on stroke subtypes. Furthermore, this study explored the variability of the effects across sex, age and education.
The immediate heat effects on ischaemic stroke (IS) and the persistent effects of ambient temperature on intracerebral haemorrhage (ICH) were significant. Overall, the cold-related relative risks (RRs) of IS, ICH and subarachnoid haemorrhage (SAH) were 1.02 (0.97-1.07), 1.16 (1.04-1.30) and 1.12 (0.61-2.04), whereas the heat-related RRs were 1.00 (0.97-1.04), 0.80 (0.73-0.88) and 1.05 (0.63-1.78), respectively. For IS, a weakly beneficial cold effect was found among men while a detrimental heat effect among both men and women, the elderly and higher-educated population at lag0. However, regarding ICH, the temperature effects in men, the young and higher-educated population are stronger at lag0-4, lag0-7 as cold reveals threat and heat reveals protection.
Responses of diverse stroke subtypes to ambient temperature varied. Effective measures should be taken to increase public awareness about the effects of ambient temperature on stroke attack and to educate the public about self-protection.
关于中国环境温度与不同类型中风发病率之间关系的证据有限。本研究旨在评估中国深圳环境温度对中风风险的影响。
收集了2003年1月1日至2014年12月31日深圳的114552例中风病例。应用具有准泊松回归的广义相加模型并结合分布滞后非线性模型来评估温度对中风亚型的影响。此外，本研究还探讨了不同性别、年龄和教育程度下这些影响的变异性。
环境温度对缺血性中风（IS）的即时热效应以及对脑出血（ICH）的持续效应显著。总体而言，与寒冷相关的IS、ICH和蛛网膜下腔出血（SAH）的相对风险（RRs）分别为1.02（0.97 - 1.07）、1.16（1.04 - 1.30）和1.12（0.61 - 2.04），而与炎热相关的RRs分别为1.00（0.97 - 1.04）、0.80（0.73 - 0.88）和1.05（0.63 - 1.78）。对于IS，在男性中发现寒冷有微弱的有益效应，而在男性和女性、老年人以及高学历人群中，在滞后0期炎热有有害效应。然而，对于ICH，在滞后0 - 4期、滞后0 - 7期，男性、年轻人和高学历人群的温度效应更强，寒冷显示出威胁而炎热显示出保护作用。
不同类型中风对环境温度的反应各不相同。应采取有效措施提高公众对环境温度对中风发作影响的认识，并教育公众进行自我保护。
