北京市寒潮天气对居民心脑血管疾病死亡影响的病例交叉研究

Impact of Cold Wave on Mortality of Cerebra-cardiovascular Diseases in Beijing:a Case-crossover Study

目的研究寒潮天气对北京市居民心脑血管疾病日死亡人数的影响。方法北京市居民死亡资料来自北京市疾病预防控制中心,气象资料来自北京城市气象研究所。运用病例交叉的设计思想,采用单向回顾性1∶1对照和双向对称性1∶2对照设计,分析北京市1998年1月1日—2000年6月30日期间6次寒潮天气与北京市城8区居民每日心血管疾病、急性心肌梗死和脑血管疾病死亡的关系。病例选取为冬季所有心脑血管疾病死亡病例,选取死亡发生前第7天和发生后第7天作为对照(或者死亡前、后第14天作为对照)。结果研究时间段内共出现6次寒潮,日最低气温下降明显且伴随有湿度下降和气压上升的第3次寒潮期间3种死因的双向对称性对照设计的滞后期均为0d,居民每日心血管疾病、急性心肌梗死、脑血管疾病死亡的OR值分别为1.500(95%CI:1.032～2.181),1.913(95%CI:1.066～3.432)、1.679(95%CI:1.139～2.474)。其他5次寒潮对心脑血管病人的死亡未见明显影响。结论研究期间北京地区的绝大多数寒潮天气未对居民心脑血管疾病的死亡产生明显影响;但是温度降幅大且伴随高气压的寒潮可能会造成心脑血管疾病死亡风险升高,值得关注。

Objective To estimate the impact of cold wave on daily death of cerebra-cardiovascular diseases in Beijing by using case-crossover design. Methods The data of death counts was provided by Beijing Center for Disease Control and Prevention while the meteorological data was provided by Institute of Urban Meteorology, China Meteorological Administration （CMA）, Beijing. The impact of six cold waves from Jan 1, 1998 to Jun 30, 2000 on daily death of cerebra-cardiovascular diseases were analyzed by Using 1：1 one-directional retrospective design and 1：2 bi-directional symmetry control design. The cases were the people who dead during winter. Controls were the seventh day before or after the date of cases （or the fourteenth day）. Results There were six cold waves in the investigation duration. The third cold wave in which minimum temperature declined obviously with decreasing humidity and increasing air pressure had significantly statistical significance in OR and the lag time of this cold wave was 0 day, the OR values were 1.500 （95%CI： 1.03：2-2.181） for cardiovascular disease （CVD）, respectively 1.913 （95%CI： 1.066- 3.432） for acute myocardial infarction, 1.679 （95%CI： 1.139-2.474） for cerebra-vascular disease（CBD） respectively. The other five cold waves do not have significant impact on cerebra-cardiovascular diseases. Conclusion Most cold waves studied in Beijing do not impact the daily death counts caused by cerebra-cardiovascular diseases. The cold wave with significant increased air pressure may increase the risk of death of cerebra-cardiovascular diseases without any lag time in Beijing.