Wang Yan-Ru, Dong Ji-Yuan, Yang Ren-Qing, Liu Ning
Institute of Occupational and Environmental Health,School of Public Health,Lanzhou University,Lanzhou 730000,China.
China Government Performance Management Research Center,School of Management,Lanzhou University,Lanzhou 730000,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2022 Apr;44(2):188-198. doi: 10.3881/j.issn.1000-503X.14356.
Objective To explore the effect of air temperature on the hospitalization of rural residents with cardiovascular diseases and its lag effect in Dingxi city. Methods The meteorological data and air pollution data of Dingxi city from 2018 to 2019,as well as the daily hospitalization data of rural residents due to cardiovascular diseases,were collected.The distributed lag non-linear models were employed to analyze the relationship between daily mean air temperature and the number of inpatients with cardiovascular diseases.Meanwhile,stratified analysis was carried out according to gender,age,and disease. Results There was a non-linear relationship between air temperature and the number of hospitalized rural residents with cardiovascular diseases in Dingxi city.The exposure-response curve approximated a bell shape.The curves for different cardiovascular diseases appeared similar shapes,with different temperature thresholds.Low temperature(-7 ℃) and moderately low temperature(0 ℃) exhibited a cumulative lag effect on the number of patients hospitalized with cardiovascular diseases.With a cumulative lag of 7 days at -7 ℃ and 14 days at 0 ℃,the values peaked,which were 1.121(95% =1.002-1.255) and 1.198(95% =1.123-1.278),respectively.With a cumulative lag of 14 days at 0 ℃,the values were 1.034(95% =1.003-1.077) and 1.039(95% =1.004-1.066) for the number of hospitalized patients with ischemic heart disease and heart rhythm disorders,respectively.The cumulative lag effects of moderately high temperature(17 ℃) and high temperature(21 ℃) on ischemic heart disease,heart rhythm disorders,and cerebrovascular disease all peaked on that day.Specifically,the values at 17 ℃ and 21 ℃ were 1.148(95% =1.092-1.206) and 1.176(95% =1.096-1.261) for ischemic heart disease,1.071(95% =1.001-1.147) and 1.112(95% =1.011-1.223) for heart rhythm disorders,and 1.084(95% =1.025-1.145) and 1.094(95% =1.013-1.182) for cerebrovascular disease,respectively.There was no cumulative lag effect of air temperature on the number of hospitalized patients with heart failure.In addition,stratified analysis showed that low temperature(-7 ℃) and moderately low temperature(0 ℃) affected the number of hospitalized female patients with cardiovascular diseases,and only moderately low temperature(0 ℃) affected males.The cumulative lag effect of high temperature on females was higher than that on males.Air temperature exhibited a stronger impact on female patients than on male patients. Additionally,the population aged<65 years old was more sensitive to low temperature and high temperature than that aged ≥65 years old. Conclusions Air temperature changes increase the hospitalization risk of rural residents with cardiovascular diseases in Dingxi city,which presents a lag effect.The effects of air temperature on patients hospitalized due to cardiovascular diseases varied among different etiologies,genders,and ages.It is necessary to emphasize on the impact of temperature changes on health in residents,especially for key populations such as females,people aged<65 years old,and those with ischemic heart disease.
目的 探讨气温对定西市农村居民心血管疾病住院的影响及其滞后效应。方法 收集定西市2018 - 2019年的气象数据、空气污染数据以及农村居民心血管疾病的每日住院数据。采用分布滞后非线性模型分析日平均气温与心血管疾病住院人数之间的关系。同时,按性别、年龄和疾病进行分层分析。结果 定西市气温与农村心血管疾病住院居民人数之间存在非线性关系。暴露 - 反应曲线近似钟形。不同心血管疾病的曲线形状相似,但温度阈值不同。低温(-7℃)和中度低温(0℃)对心血管疾病住院患者人数呈现累积滞后效应。在-7℃累积滞后7天、0℃累积滞后14天时,相对危险度达到峰值,分别为1.121(95%可信区间=1.002 - 1.255)和1.198(95%可信区间=1.123 - 1.278)。在0℃累积滞后14天时,缺血性心脏病和心律失常住院患者人数的相对危险度分别为1.034(95%可信区间=1.003 - 1.077)和1.039(95%可信区间=1.004 - 1.066)。中度高温(17℃)和高温(21℃)对缺血性心脏病、心律失常和脑血管疾病的累积滞后效应均在当天达到峰值。具体而言,17℃和21℃时缺血性心脏病的相对危险度分别为1.148(95%可信区间=1.092 - 1.206)和1.176(95%可信区间=1.096 - 1.261),心律失常的相对危险度分别为1.071(95%可信区间=1.001 - 1.147)和1.112(95%可信区间=1.011 - 1.223),脑血管疾病的相对危险度分别为1.084(95%可信区间=1.025 - 1.145)和1.094(95%可信区间=1.013 - 1.182)。气温对心力衰竭住院患者人数无累积滞后效应。此外,分层分析显示低温(-7℃)和中度低温(0℃)影响心血管疾病住院女性患者人数,仅中度低温(0℃)影响男性患者。高温对女性的累积滞后效应高于男性。气温对女性患者的影响强于男性患者。此外,年龄<65岁的人群比年龄≥65岁的人群对低温和高温更敏感。结论 气温变化增加了定西市农村居民心血管疾病的住院风险,且呈现滞后效应。气温对因心血管疾病住院患者的影响因病因、性别和年龄而异。有必要重视气温变化对居民健康的影响,尤其是对女性、年龄<65岁的人群以及缺血性心脏病患者等重点人群。