上消化道出血发病的节律性及相关气象因素

Circadian Variation of the Incidence of Upper Gastrointestinal Bleeding and Its Relationship with Climatic Factors

目的研究北京地区上消化道出血(UGIB)发病的节律性特点及相关气象因素。方法收集2005年8月1日～2007年7月31日北京地区院前发病的UGIB病例及此研究期间每天的气象资料,比较昼夜、月、季之间的UGIB发病差异,分析气象因素与UGIB发病之间的关系。结果共有2580例患者入选,其中男性占73.2%;男女两性的平均年龄差异有统计学意义[(53.3±20.4)岁vs.(63.3±20.7)岁,P<0.05]。UGIB发病在季节(χ2=49.82,P<0.01)、月份(χ2=83.43,P<0.01)、日内小时(χ2=126.79,P<0.01)间的差异有统计学意义。冬春发病较多,以1月份为最高;夜间发病较多,以8pm～0am时段最高。偏相关分析结果显示,气温与UGIB发病关联最显著(r=-0.3785,P=0.001),气压次之(r=-0.3002,P=0.011);风速(P=0.086)和相对湿度(P=0.971)与发病无明显关联。结论北京地区UGIB的发病存在显著昼夜、月和季节差异。UGIB发病依次与气温和气压呈密切负相关,与风速和相对湿度无明显关联。

Objective To study the circadian patterns of the incidence of upper gastrointestinal bleeding （UGIB） and its relationship with climatic factors in Beijing. Methods We searched all UGIB records from August 1, 2005 to July 31, 2007 from Beijing Emergency Center and tracked the meteorological data during the same period.. The variation of the incidence of UGIB was compared based on day, month, and season. The relation between climatic factors and the incidence of UGIB was also analyzed. Results Totally 2 580 patients, including 1 888 males （73.2%） and 692 females （26.8%） were included in the study. The mean age was significantly different between males and females [ （ 53.3 ± 20.4 ） years vs. （ 63.3 ± 20.7 ） years, P 〈 0.05 ]. The occurrence of UGIB were significantly different among different seasons （x^2 = 49.82, P〈0.01）, months （x^2=83.43, P〈0.01）, and hours （x^2=126.79, P〈0.01）. UGIB cases were presented more frequently in winter and spring, especially in January. More UGIB cases were presented at night, especially from 8pm to midnight. Partial correlation test showed that the incidence of UGIB significantly correlated with temperature （ r = - 0. 3785, P = 0. 001 ） and barametric pressure （ r = - 0. 3002, P = 0.011 ）. No correlation was found between UGIB incidence and wind speed （P = 0. 086 ） and relative humidity （P =0. 971 ）. Conclusions The incidence of UGIB varies in different months and seasons in Beijing. Its climaterelated risk factors may include temperature and barametric pressure, but not include relative humidity and wind speed.