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气象和环境因素对兰州地区分泌性中耳炎影响的研究

A Study of the Influence of Meteorological and Environmental Factors on Otitis Media with Effusion in Lanzhou.

作者信息

Tian Haiyue, Zhang Hongping, Chen Yuhao, Zhong Cuiping

机构信息

Otolaryngology Head and Neck Surgery, The 940th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army. NO, 333 Binhe Middle Road, Lanzhou, Gansu Province China.

The First Clinical College of Gansu University of Traditional Chinese Medicine, Lanzhou, China.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Dec;76(6):5234-5247. doi: 10.1007/s12070-024-04954-8. Epub 2024 Aug 17.

Abstract

In observational studies, a possible correlation between atmospheric environmental factors and the number of daily outpatient visits by Otitis media with effusion(OME) patients has been observed. However, the causal relationship is not clear.To study the relationship between the incidence of OME and meteorological factors and air pollutants in the main urban areas of Lanzhou, it is helpful to further understand the health effects of meteorological and environmental factors on OME and to prevent and treat the disease, it is of great academic and practical significance to the prevention, treatment and prognosis of diseases. The levels of AQI、PM2.5、PM10、NO、O、SO、CO、AP、RH、W and T were obtained from local monitor stations. Data of patients with OME were collected from two Grade A Level hospitals in Lanzhou from January 1, 2014 to December 31, 2016. Descriptive analysis of data was carried out for the study subjects. Spearman correlation coefficients between atmospheric environmental factors and daily visits of patients with OME were calculated by SPSS statistical software. Lag effects, relative risks(RR) and exposure-response curves were calculated by generalized additive model (GAM) with R software. (1) The incidence of OME in winter and spring was more than that in summer and autumn, which was consistent with the seasonal variation of meteorological environmental factors of Lanzhou. That was, the meteorological conditions and air quality in winter and spring were poor, while in summer and autumn they were relatively good. (2) The number of male outpatients were 1.05, 1.08 and 1.09 times of female outpatients during the period 2014-2016, respectively. And aged 0-10 years old outpatients accounted for 31% of the total OME outpatients. (3) Exposure-response curve showed that PM2.5, PM10, NO and SO were positively correlated with OME, T was negatively correlated with OME. When concentration < 1mg/m, CO was positively correlated with OME. When concentration>1mg/m, CO was negatively correlated with OME. When concentration<30 ug/m, O was positively correlated with OME. When concentration>30ug/m, O was negatively correlated with OME. (4) The factors we studied could significantly affect the number of OME outpatients within 2-3 days of single lag effects, and 3-4 days of cumulative lag effects.(5) The influential factors on OME were as follows: PM2.5、NO、SO、O、 CO and T. The daily average number of OME patients in different seasons was different in major region of Lanzhou city, with more in winter、spring and fewer in summer、autumn. Age and sex were the important factors affecting the daily average number of OME patients. Males were more susceptible to OME than females and children awere moresusceptible to OME than adults. The change of OME patients was related to air quality, air pressure and temperature. The worse the air quality, the higher the air pressure, the lower the temperature, the more the average daily number of OME patients. Meteorological environmental factors affected the visits of OME, and the lagging effect time of different factors were different. Most of the research factors within 3-4 days had a significant impact on the number of patients of OME. 1.The number of OME visits in the Lanzhou was more seasonal in winter and spring than in summer and fall. 2.Age and sex were the most important factors affecting the number of patients with OME. According to the prevalence of OME in Lanzhou, children were more likely to have OME than adults and men were more likely to have OME than women. 3.The number of OME patients was related to air quality, air pressure and temperature. 4.The meteorological factors have a delayed effect on the onset of OME, and the time of delayed effect is different for different factors. The single delayed effect of 2-3 days and the cumulative delayed effect of 3-4 days have a significant effect on the change of the number of patients with OME. To study the relationship between the incidence of OME and meteorological factors and air pollutants in the main urban areas of Lanzhou, it is helpful to further understand the health effects of meteorological and environmental factors on OME and to prevent and treat the disease, it is of great academic and practical significance to the prevention, treatment and prognosis of diseases.

摘要

在观察性研究中,已观察到大气环境因素与中耳积液(OME)患者每日门诊就诊次数之间可能存在相关性。然而,因果关系尚不清楚。为研究兰州主城区OME发病率与气象因素及空气污染物之间的关系,有助于进一步了解气象和环境因素对OME的健康影响以及疾病的防治,对疾病的预防、治疗和预后具有重要的学术和实践意义。空气质量指数(AQI)、细颗粒物(PM2.5)、可吸入颗粒物(PM10)、一氧化氮(NO)、臭氧(O₃)、二氧化硫(SO₂)、一氧化碳(CO)、气压(AP)、相对湿度(RH)、风速(W)和气温(T)的数据来自当地监测站。2014年1月1日至2016年12月31日期间,从兰州两家三甲医院收集OME患者的数据。对研究对象进行数据描述性分析。使用SPSS统计软件计算大气环境因素与OME患者每日就诊次数之间的Spearman相关系数。使用R软件通过广义相加模型(GAM)计算滞后效应、相对风险(RR)和暴露-反应曲线。(1)OME的发病率在冬季和春季高于夏季和秋季,这与兰州气象环境因素的季节变化一致。也就是说,冬季和春季的气象条件和空气质量较差,而夏季和秋季相对较好。(2)2014 - 2016年期间,男性门诊患者人数分别是女性门诊患者人数的1.05倍、1.08倍和1.09倍。0 - 10岁门诊患者占OME门诊患者总数的31%。(3)暴露-反应曲线显示,PM2.5、PM10、NO和SO₂与OME呈正相关,T与OME呈负相关。当浓度<1mg/m³时,CO与OME呈正相关。当浓度>1mg/m³时,CO与OME呈负相关。当浓度<30μg/m³时,O₃与OME呈正相关。当浓度>30μg/m³时,O₃与OME呈负相关。(4)我们研究的因素在单一滞后效应的2 - 3天内以及累积滞后效应的3 - 4天内可显著影响OME门诊患者人数。(5)对OME有影响的因素如下:PM2.5、NO、SO₂、O₃、CO和T。兰州市主要区域不同季节OME患者的日平均人数不同,冬季、春季较多,夏季、秋季较少。年龄和性别是影响OME患者日平均人数的重要因素。男性比女性更容易患OME,儿童比成年人更容易患OME。OME患者的变化与空气质量、气压和温度有关。空气质量越差、气压越高、温度越低,OME患者的日平均人数越多。气象环境因素影响OME的就诊情况,不同因素的滞后效应时间不同。3 - 4天内大多数研究因素对OME患者人数有显著影响。1. 兰州OME就诊人数在冬季和春季比夏季和秋季更具季节性。2. 年龄和性别是影响OME患者人数的最重要因素。根据兰州OME的患病率,儿童比成年人更容易患OME,男性比女性更容易患OME。3. OME患者人数与空气质量、气压和温度有关。4. 气象因素对OME发病有延迟效应,不同因素的延迟效应时间不同。2 - 3天的单一延迟效应和3 - 4天的累积延迟效应对OME患者人数变化有显著影响。为研究兰州主城区OME发病率与气象因素及空气污染物之间的关系,有助于进一步了解气象和环境因素对OME的健康影响以及疾病的防治,对疾病的预防、治疗和预后具有重要的学术和实践意义。

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