上海市大气污染对中风死亡的影响

Effect of Ambient Air Pollution on Stroke in Shanghai

[目的]研究大气污染物与中风总死亡及两种不同类型中风死亡间的关联，确定大气污染环境中风死亡易感人群。[方法]收集上海市2003-2008年大气污染及中风死亡数据，采用时间分层一病例交叉设计方法分析两者间相关关系。[结果]所研究大气污染物与不同类型中风死亡均存在相关关系，当暴露于大气中的二氧化硫（SO2）与二氧化氮（NO2）时，心脏病患者的缺血性中风死亡风险提高。当S02与N02两种污染物每增加10μg／m^3时，导致心脏病患者死于缺血性中风的比值比（95％可信区间）分别为1．057（1．010—1．107）与1．076（1．023～1．131），高于在同等条件下非心脏病患者所面临的缺血性中风死亡风险。本研究并未发现高血压与糖尿病存在类似的修饰效应。[结论]大气污染物能够增加人群中风死亡风险，心脏病患者更易诱发中风。

[ Objective ] To investigate the risks of total, hemorrhagic and ischemic stroke mortalities associated with short-term exposure to air pollution, and to determine the susceptible population. [ Methods] In this study, daily stroke mortalities of adults aged over 50 between 2003 and 2008 in Shanghai were collected. Time-stratified ease-crossover approach was used to assess the association between daily concentrations of air pollutants and stroke mortalities. [ Results ] The mortalities from different stroke types were found to be significantly associated with all the examined air pollutants. A significantly higher risk of isehemie stroke mortality in relation to S02 and NO2 exposure was observed among people with cardiac diseases than those without; for an increase of 10μg/m^3 in S02 and NO2, the OR values of ischemic stroke mortality for people with cardiac diseases were 1.057 （1.010-1.107） and 1.076 （1.023-1.131） respectively. No evidence of effect modification was found among people with hypertension and diabetes. [ Conclusion ] This study provides new evidence for the association between exposure to ambient air pollution and stroke mortality. The results also suggest that underlying cardiac disorder may increase the risk of isehemic stroke mortality in relation to air pollution exposure.