北京市气温与脑卒中发病关系的时间序列研究

The relationship of temperature and stroke incidence in Beijing:a time-series study

目的 研究周平均温度与脑卒中发病的关系。方法 采用时间序列的Poisson广义相加模型(GAM),在控制了长期趋势、季节趋势和周平均湿度以后,研究周平均温度与脑卒中发病人数的关系,并按年龄、性别、既往病史和脑卒中类型等进行分层分析。结果 低温是诱发北京市脑卒中发病的主要气象因素,当周平均温度<8.5℃时,脑卒中的发病率开始高于基线发病率,并随着温度的降低而升高。低温对既往无脑卒中发病史的女性或≥65岁者的影响更大,而高温对既往有脑卒中发病史的女性或<65岁者的影响更大;低温对不同类型脑卒中发病均有影响,高温仅对缺血性脑卒中发病有影响。结论 周平均气温对不同年龄、性别和既往有无脑卒中病史人群的脑卒中发病影响存在差异,对不同类型的脑卒中发病影响也有所不同,建议采取各有侧重的预防措施。

Objective To study the relationship of temperature and stroke. Methods When long time trend, season and relative humidity were under control, the relationship between temperature and incidence rate of acute stroke was explored by generalized additive models (GAMs) for the whole population and stratified by age, sex, disease history and stroke type. Results Cold appeared to be a risk factor to stroke incidence. The incidence of stroke was higher than the baseline data when the temperature was lower than 8.5℃ but the incidence increased along with the decrease of temperature. Cold was more likely to affect females as well as patients older than 65-year-old with first-ever episode. However, heat was more likely to influence females and those over 65-year-old patients having had suffered stroke before. Cold endangered both haemorrhagic and ischaemic stroke while heat only affected ischaemic stroke. Conclusion The interaction between average weekly temperature and stroke was related to the types of stroke. Age, gender and history of stroke in the past had different effects on the relationship between weekly average temperature and stroke incidence.