沙尘暴天气对河西走廊地区居民冠心病的影响

Influence of sandstorm weather on coronary heart disease of residents in Hexi Corridor

目的观察并分析沙尘暴天气对河西走廊地区居民冠心病的影响。方法从甘肃省气象局获取河西走廊地区(敦煌市、酒泉市、张掖市、金昌市、武威市)2016年1月1日至2020年12月31日沙尘暴天气数据,选择5个市长住居民1182例为暴露组。选择甘肃省少沙尘暴地区(天水市与陇南市)长住居民1265例为对照组,同时获取同期气象数据,对照组与暴露组相关因素匹配。对研究对象进行5年定期随访及检查,收集诊断为冠心病的门、急诊和住院病例资料;检测C反应蛋白(CRP)、白介素-1(IL-1)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和巨噬细胞炎症蛋白-2(MIP-2)等实验室指标;进行常规心电图及超声心动图检查等。结果2016年1月至2020年12月暴露组所在地区沙尘暴发作次数高于对照组所在地区(χ^(2)=6.632,P<0.05)。暴露组冠心病发病人数、门诊人次、住院人次及不稳定型心绞痛比例均高于对照组(χ^(2)=4.436、5.733、5.479、6.842,P<0.05)。暴露组CRP、IL-1、TNF-α、MIP-2水平高于对照组(t=8.340、6.787、5.369、4.734,P<0.05)。心电图检查结果显示暴露组合并心肌缺血或梗死改变及心律失常比例高于对照组(χ^(2)=4.688、5.634,P<0.05),超声心动图检查结果显示暴露组合并心腔扩大、左心室射血分数<50%比例高于对照组(χ^(2)=4.365、3.987,P<0.05)。结论河西走廊地区(敦煌市、酒泉市、张掖市、金昌市、武威市)居民心脏结构及功能的改变大于甘肃省少沙尘暴地区(天水市与陇南市)居民,推测沙尘暴天气可诱发并促进冠心病的发病和进展,当地人群需最大可能减少个人暴露,同时加强沙尘暴治理。

Objective To observe and analyze the influence of sandstorm weather on coronary heart disease of residents in Hexi corridor.Methods The sandstorm weather data in Hexi Corridor(Dunhuang City,Jiuquan City,Zhangye City,Jinchang City and Wuwei City)from January 1,2016 to December 31,2020 were obtained from Gansu Meteorological Bureau.A total of 1182 permanent residents from the five cities were selected as the exposure group.1265 residents in the less sandstorm area of Gansu Province(Tianshui City and Longnan City)were selected as the control group,and the meteorological data of the same period were obtained.The relevant factors of the control group and the exposure group were matched.The subjects were followed up for five years and examined regularly,data of outpatient,emergency and inpatient cases diagnosed with coronary heart disease were collected,C-reactive protein(CRP)、interleukin-1(IL-1)、interleukin-6(IL-6)、tumor necrosis factor-α(TNF-α)and macrophage inflammatory protein-2(MIP-2)and other laboratory indicators were detected,and routine electrocardiogram(ECG)and echocardiography examination were performed.Results The frequency of sandstorm in exposure group was higher than that in the control group from January 1,2016 to December 31,2020(χ^(2)=6.632,P<0.05).The proportions of incidence of coronary heart disease,outpatient visits,inpatient visits and unstable angina pectoris in exposure group were higher than those in control group(χ^(2)=4.436,5.733,5.479,6.842;P<0.05).CRP,IL-1,TNF-αand MIP-2 in exposure group were higher than those in the control group(t=8.340,6.787,5.369,4.734;P<0.05).The results of ECG examination showed that the ratios of myocardial ischemia or infarction changes and arrhythmia in the exposed group were higher than those in the control group(χ^(2)=4.688,5.634;P<0.05).The results of echocardiography showed that the ratios of cardiac cavity enlargement and left ventricular ejection fraction<50%in exposure group were higher than those of control group(χ^(2)=4.365,3.987;P<0.05).Conclusion The changes of cardiac structure and function of residents in Hexi Corridor area(Dunhuang City,Jiuquan City,Zhangye City,Jinchang City and Wuwei City)are lager than those in the less sandstorm area of Gansu Province(Tianshui City and Longnan City).It is speculated that sandstorm weather can induce and promote the onset and progression of coronary heart disease.The local population needs to minimize personal exposure and strengthen the management of sandstorm.