中国淄博市环境空气污染与心血管疾病门诊就诊之间的关联：一项时间序列分析
Association between ambient air pollution and outpatient visits of cardiovascular diseases in Zibo, China: a time series analysis.
作者信息
Wang Yamei, Qu Shaoning, Li Ting, Chen Liang, Yang Liping
机构信息
Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
Department of Emergency, Qilu Hospital of Shandong University, Jinan, China.
出版信息
Front Public Health. 2025 Jan 8;12:1492056. doi: 10.3389/fpubh.2024.1492056. eCollection 2024.
INTRODUCTION
Facing Mount Tai in the south and the Yellow River in the north, Zibo District is an important petrochemical base in China. The effect of air pollution on cardiovascular diseases (CVDs) in Zibo was unclear.
METHODS
Daily outpatient visits of common CVDs including coronary heart disease (CHD), stroke, and arrhythmia were obtained from 2019 to 2022 in Zibo. Air pollutants contained fine particulate matter (PM), inhalable particulate matter (PM), nitrogen dioxide (NO), sulfur dioxide (SO), ozone (O), and carbon monoxide (CO). Distributed lag non-linear models (DLNM) including single-pollutant model in single-day (lag0-lag7) and cumulative-days (lag01-lag07), concentration-response curve, subgroup analysis, and double-pollutant model were utilized to examine the relationships of daily air pollutants on CHD, stroke, and arrhythmia. Meteorological factors were incorporated to control confounding.
RESULTS
In single-pollutant model, NO was positively associated with CHD, stroke and arrhythmia, with the strongest excess risks (ERs) of 4.97% (lag07), 4.71% (lag07) and 2.16% (lag02), respectively. The highest ERs of PM on CHD, stroke and arrhythmia were 0.85% (lag01), 0.59% (lag0) and 0.84% (lag01), and for PM, the ERs were 0.37% (lag01), 0.35% (lag0) and 0.39% (lag01). SO on CHD was 0.92% (lag6), O on stroke was 0.16% (lag6), and CO on CHD, stroke, and arrhythmia were 8.77% (lag07), 5.38% (lag01), 4.30% (lag0). No threshold was found between air pollutants and CVDs. The effects of ambient pollutants on CVDs (NO&CVDs, PM&stroke, PM&stroke, CO&stroke, CO&arrhythmia) were greater in cold season than warm season. In double-pollutant model, NO was positively associated with CHD and stroke, and CO was also positively related with CHD.
CONCLUSION
Ambient pollutants, especially NO and CO were associated with CVDs in Zibo, China. And there were strong relationships between NO, PM, PM, CO and CVDs in cold season.
引言
淄博地区南靠泰山，北临黄河，是中国重要的石油化工基地。空气污染对淄博地区心血管疾病（CVDs）的影响尚不清楚。
方法
获取了淄博市2019年至2022年常见心血管疾病（包括冠心病（CHD）、中风和心律失常）的每日门诊就诊情况。空气污染物包括细颗粒物（PM）、可吸入颗粒物（PM）、二氧化氮（NO）、二氧化硫（SO）、臭氧（O）和一氧化碳（CO）。采用分布滞后非线性模型（DLNM），包括单日单污染物模型（滞后0至滞后7）和累积日模型（滞后01至滞后07）、浓度-反应曲线、亚组分析和双污染物模型，以研究每日空气污染物与冠心病、中风和心律失常之间的关系。纳入气象因素以控制混杂因素。
结果
在单污染物模型中，NO与冠心病、中风和心律失常呈正相关，分别在滞后7天、滞后7天和滞后2天出现最强的超额风险（ERs），分别为4.97%、4.71%和2.16%。PM对冠心病、中风和心律失常的最高ERs分别为0.85%（滞后01）、0.59%（滞后0）和0.84%（滞后01），对于PM，ERs分别为0.37%（滞后01）、0.35%（滞后0）和0.39%（滞后01）。SO对冠心病的影响为0.92%（滞后6），O对中风的影响为0.16%（滞后6），CO对冠心病、中风和心律失常的影响分别为8.77%（滞后07）、5.38%（滞后01）、4.30%（滞后0）。未发现空气污染物与心血管疾病之间存在阈值。在寒冷季节，环境污染物对心血管疾病（NO与心血管疾病、PM与中风、PM与中风、CO与中风、CO与心律失常）的影响大于温暖季节。在双污染物模型中，NO与冠心病和中风呈正相关，CO也与冠心病呈正相关。
结论
中国淄博地区的环境污染物，尤其是NO和CO与心血管疾病有关。在寒冷季节，NO、PM、PM、CO与心血管疾病之间存在密切关系。
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