气象因素和空气污染物对中国兰州缺血性心脏病日住院人数的影响。

The First Clinical Medical School, Lanzhou University, Lanzhou, China.

Heart Center, The First Hospital of Lanzhou University, Lanzhou, China.

Cardiology. 2024;149(4):396-408. doi: 10.1159/000532069. Epub 2023 Jul 29.

INTRODUCTION

Meteorological factors and air pollutants are believed to be associated with cardiovascular disease. Ischemic heart disease (IHD) is a major public health issue worldwide. Few studies have investigated the associations among meteorological factors, air pollutants, and IHD daily hospital admissions in Lanzhou, China.

METHODS

We conducted a distributed lag nonlinear model on the basis of 5-year data, aiming at disentangling the impact of meteorological factors and air pollutants on IHD hospital admissions. All IHD daily hospital admissions recorded from January 1, 2015, and December 31, 2019, were obtained from three hospitals in Lanzhou, China. Daily air pollutant concentrations and meteorological data were synchronously collected from Gansu Meteorological Administration and Lanzhou Environmental Protection Administration. Stratified analyses were performed by sex and two age groups.

RESULTS

A total of 23,555 IHD hospital admissions were recorded, of which 10,477 admissions were for coronary artery disease (CAD) and 13,078 admissions were for acute coronary syndrome. Our results showed that there was a nonlinear (J-shaped) relationship between temperature and IHD hospital admissions. The number of IHD hospital admissions was positively correlated with NO2, O3, humidity, and pressure, indicating an increased risk of hospital admissions for IHD under NO2, O3, humidity, and pressure exposure. Meanwhile, both extremely low (-12°C) and high (30°C) temperatures reduced IHD hospital admissions, but the harmful effect increased with the lag time in Lanzhou, China, while the cold effect was more pronounced and long-lasting than the heat effect. Subgroup analysis demonstrated that the risk on CAD hospital admissions increased significantly in females and <65 years of age at -12°C.

CONCLUSION

Our findings added to the growing evidence regarding the potential impact of meteorological factors and air pollutants on policymaking from the perspective of hospital management efficiency.

简介

气象因素和空气污染物被认为与心血管疾病有关。缺血性心脏病（IHD）是全球主要的公共卫生问题。很少有研究调查气象因素、空气污染物与中国兰州 IHD 每日住院人数之间的关联。

方法

我们基于 5 年的数据进行了分布式滞后非线性模型，旨在厘清气象因素和空气污染物对 IHD 住院人数的影响。所有记录的 2015 年 1 月 1 日至 2019 年 12 月 31 日期间 IHD 每日住院人数均来自中国兰州的三家医院。逐日空气污染物浓度和气象数据均来自甘肃省气象局和兰州市环境保护局。按性别和两个年龄组进行分层分析。

结果

共记录了 23555 例 IHD 住院人数，其中 10477 例为冠心病（CAD），13078 例为急性冠状动脉综合征。结果表明，温度与 IHD 住院人数之间存在非线性（J 形）关系。IHD 住院人数与 NO2、O3、湿度和压力呈正相关，表明在 NO2、O3、湿度和压力暴露下，IHD 住院人数的风险增加。同时，极低（-12°C）和极高（30°C）温度均降低了 IHD 住院人数，但在中国兰州，有害效应随着滞后时间的增加而增加，而冷效应比热效应更明显且持续时间更长。亚组分析表明，在女性和年龄<65 岁的人群中，-12°C 时 CAD 住院人数的风险显著增加。