河北石家庄地区气温对儿童哮喘病就诊人数的影响

Relationship Between Air Temperature and Daily Outpatient Amount of Childhood Asthma Disease in Shijiazhuang

哮喘是儿童常见的呼吸道慢性炎症疾病,且受天气影响容易复发。为探讨气温对儿童哮喘的影响,提供分众化、针对性的预报服务,采用基于时间序列半参数广义相加模型(GAM),在控制时间趋势、气压、相对湿度等混杂因素影响后,分析2012—2014年石家庄地区气温与0—14岁儿童哮喘就诊人数的暴露—反应关系。结果发现:石家庄儿童哮喘高发年龄为0—6岁(婴幼儿),占76.5%;男性儿童占70.2%,明显多于女性;儿童哮喘就诊总人数冬季最多,其次是春秋季节转换时期,夏季最少;不同年龄段儿童哮喘表现特征有所不同:0—6岁的婴幼儿哮喘受寒冷影响更明显,7—14岁少儿哮喘对炎热反应敏感;日平均气温(T)对儿童哮喘就诊人数的影响指标为:当2.9℃<T≤12.8℃时,T每上升1℃,儿童哮喘发病就诊总人数将增加3‰;男、女不同性别的儿童哮喘受气温影响没有明显差异;0—6岁婴幼儿、7—14岁少儿哮喘受气温的影响不同:当1.7℃<T≤14.5℃和T>21.0℃时,随着T每上升1℃,7—14岁少儿哮喘发病就诊人数将增加5‰和4‰,对气温的敏感性高于0—6岁的婴幼儿。

Asthma is a chronic respiratory inflammatory disease presenting predominantly in children, which is easy to recur due to the weather influence. In order to analyze the effect of air temperature on childhood asthma, and to provide customized, individualized forecast service, according to the 0-14 years old patients who had childhood asthma from 2012 to 2014 and the corresponding air temperature data of Shijiazhuang, the exposure and response relation between them was analyzed by using the semi parametric Generalized Additive Model （ GAM ） based on time series after controlling the confounding effect of time trend, barometric pressure and relative humidity. The results suggest that the infants who are 0-6 years old were prone to get childhood asthma, with a proportion of 76. 5% , and male patients accounted for 70. 2% , which was much more than female patients. The total number of children patients peaked in winter, followed by the seasonal transformation period in spring and autumn, and reached its lowest in summer, while the reaction to temperature varies according to the age： the infants （who are 0- 6 years old） were more sensitive to chill while juveniles （who are 7 -14 years old） were more sensitive to heat. The impact index of daily mean temperature （ T） to the number of childhood asthma patients was as follows ： the total number of patients increased 3%c for every degree the air temperature rose when 2 .9℃ 〈 T≤12.8℃ .The response to temperature didn,t have a significant gender difference, meanwhile the response to temperature of the infants differed from that of the juveniles： the number of 7 - 14 years old patients increased 5%c for every degree the air temperature increased when 1. 7℃〈T≤ 14. 5℃ and 4%c when T〉 2 1 .0℃ , they were obviously more sensitive. The results have certain significance to providingmeteorological condition forecasting and technical defense service for childhood asthma.