大气颗粒物与冠心病患者死亡率之间关系的Meta分析

Meta Analysis of Association of Atmospheric Particulates with The Mortality Coronary Heart Disease

目的为进一步了解大气污染(PM2.5、PM10)与冠心病患者死亡率的关系,采用M eta分析,依靠对以往相关文献的定量综合,从而得出比较可靠的结论,为定量评价大气颗粒物对冠心病患者危害及制定相关环境决策提供依据。方法应用Meta分析对12个有关大气颗粒物与冠心病患者死亡关系的定量研究进行综合分析。采用大气颗粒物每上升10对μg/m3,冠心病患者死亡率增加的百分比β为效应值,通过异质性检验,利用固定或随机模型效应进行效应值合并,并且对结果进行敏感分析。结果 PM 10每上升10μg/m3,人群冠心病死亡平均增加0.80%(95%CI:0.60%～1.10%);PM2.5每上升10μg/m3,人群冠心病死亡平均增加2.10%(95%CI:1.20%～3.10%);PM2.5每上升10μg/m3,女性冠心病死亡平均增加18.50%(95%CI:5.90%～31.10%),文献均采用的是固定效应模型。结论 PM2.5、PM10与冠心病患者死亡率存在正相关,但其机制仍需进一步研究。

[Objective]To adopt Meta analysis for further study of air pollution（PM2.5,PM10） relationship with coronary heart disease（CHD） mortality,to obtain more reliable conclusion based on the quantitative analysis on related literature,and provide evidence for quantitative evaluation on the hazards of atmospheric particulates on CHD and related environmental decision-making.[Methods]Meta analysis was adopted to comprehensively analyze 12 quantitative studies of CHD deaths relating with atmospheric particulates.The percentage increase of CHD mortality β for atmospheric particulates increase per 10 μg / m3 was used as effect value.Fixed or random models were adopted for effect values combination through heterogeneity test.And the sensitivity analysis was performed.[Results]By using the fixed effect model,the CHD mortality increased 0.80%（95%CI：0.60%～1.10%） in average with PM10 increasing per 10 μg/m3;the CHD mortality increased 2.10%（95%CI：1.20%～3.10%）in average with PM25 increasing per 10 μg/m3;the female CHD mortality increased 18.50%（95%CI：5.90%～31.10%）in average with PM2.5 increasing per 10 μg/m3.[Conclusion]Positive correlation exists between PM2.5,PM10 and the mortality of CHD patients,but the mechanisms need to be further investigated.