沈阳市大气污染物分布特征及对呼吸系统疾病的影响

Characteristics of air pollutants and its effects on respiratory diseases in Shenyang

目的探讨沈阳市大气污染物分布特征及对呼吸系统疾病的影响。方法对2016年1月1日—2016年12月31日沈阳市大气污染物浓度与中国医科大学附属第四医院和平院区呼吸系统疾病门诊人次的关系采用广义相加模型进行模拟,并分析滞后效应;随机各选取40名门诊肺炎及慢性阻塞性肺部疾病(COPD)患者分别于大气污染物浓度较低的夏季和大气污染物浓度较高的冬季检测肺功能并进行健康质量问卷(SF-36)调查。结果沈阳市大气PM2.5、PM10、SO2和NO2的年平均浓度分别为57、101、41、38μg/m3,秋冬季大气PM2.5、PM10、NO2和SO2浓度最高。大气PM10、PM2.5、SO2和NO2的浓度每增加10μg/m3,呼吸系统疾病日门诊就诊人次分别增加1.29%(95%CI:1.18%~1.40%)、1.31%(95%CI:1.20%~1.43%)、2.94%(95%CI:2.75%~3.14%)、5.26%(95%CI:4.91%~5.61%),分别滞后4、1、3、1 d。冬季COPD患者肺功能和SF-36量表得分均低于夏季,差异有统计学意义(P<0.05)。结论沈阳市大气污染物导致呼吸系统疾病门诊就诊人次增加且存在滞后效应,空气污染是否导致COPD患者肺功能损伤及生活质量的降低有待进一步研究。

Objective To explore the characteristics of air pollutants in Shenyang and its effects on respiratory diseases.Methods The relationship between daily average concentrations of air pollutants and outpatients visits for respiratory diseases in Heping Division of the Fourth Affiliated Hospital of China Medical University during Jan.1-Dec.31,2016 was simulated by generalized additive model,the lag effect was analyzed also.The lung function and life quality based on SF-36 were measured among randomly collected 40 outpatients with COPD and 40 outpatients with pneumonia respectively in winter with heavier air pollution and summer with light air pollution.Results The annual concentrations for PM10,PM2.5,SO2 and NO2 were 57,101,41 and 38μg/m3 respectively.Higher concentrations of air pollutants were found in autumn and winter.An increase of 10μg/m3 PM10,PM2.5,SO2 and NO2 were associated with 1.29%(95%CI:1.18%-1.40%),1.31%(95%CI:1.20%-1.43%),2.94%(95%CI:2.75%-3.14%)and 5.26%(95%CI:4.91%-5.61%)increases of outpatients visits for respiratory diseases at lag 4,1,3 and 1 d respectively.COPD outpatients presented lower lung function and scores of SF-36 in winter compared with those in summer(P<0.05).Conclusion The increased levels of ambient pollutants in Shenyang are associated with the increased outpatients visits for respiratory diseases with lag effects,and whether have a greater impact on the lung function and quality of life of patients with chronic respiratory diseases such as COPD need further research.