大气颗粒物PM_(2.5)和PM_(10)暴露与人群缺血性心脏病死亡关系的荟萃分析

Meta-analysis of the relationship between atmospheric PM_(2.5) and PM_(10) exposure and ischemic heart disease mortality

目的定量评估大气颗粒物PM_(2.5)、PM_(10)暴露与人群缺血性心脏病死亡之间的关系。方法通过计算机联机检索国内外文献数据库,系统收集公开发表的相关文献。使用Stata 14.0软件进行荟萃分析,根据异质性检验的结果选择不同的效应模型进行统计量的合并,采用敏感性分析和Egger's检验对结果的稳定性及发表偏倚进行检验。结果最终共纳入56篇文献。大气PM_(2.5)、PM_(10)、PM_(10-2.5)浓度每升高10μg/m^3,人群缺血性心脏病死亡的合并效应值分别为1.0236(95%CI:1.0184～1.0288)、1.0106(95%CI:1.0075～1.0137)和0.9920(95%CI:0.9669～1.0178)。PM_(2.5)与PM_(10)暴露对缺血性心脏病死亡的急性影响的合并效应值[1.0082(95%CI:1.0057～1.0107);1.0088(95%CI:1.0064～1.0113)]低于慢性影响的合并效应值[1.2120(95%CI:1.1470～1.2806);1.0831(95%CI:0.9944～1.1797)];亚洲人群PM_(2.5)与PM_(10)暴露对缺血性心脏病死亡影响的合并效应值[1.0052(95%CI:1.0031～1.0074);1.0079(95%CI:1.0049～1.0109)]低于欧美人群的合并效应值[1.1010(95%CI:1.0756～1.1269);1.0186(95%CI:1.0083～1.0290)]。结论大气颗粒物PM_(2.5)、PM_(10)浓度的升高会导致人群缺血性心脏病死亡风险的增加。

Objective To quantitatively evaluate the relationship between atmospheric particulate matter PM 2.5,PM 10 exposure and ischemic heart disease(IHD)mortality.Methods Domestic and international database were retrieved online,and the epidemiologic studies about the association between exposure to particulate matter and IHD mortality were systematically collected.Meta-analysis was performed using Stata 14.0 software.Risk estimates were combined by different effect models according to the result of heterogeneity test.Sensitivity analysis and publication bias analysis were performed.Results A total of 56 literatures were included.With PM 2.5,PM 10 and PM 10-2.5 increasing per 10μg/m^3,the combined effect values of IHD mortality were 1.0236(95%CI:1.0184-1.0288),1.0106(95%CI:1.0075-1.0137)and 0.9920(95%CI:0.9669-1.0178),respectively.The combined effect values of acute effect of PM 2.5 and PM 10 on IHD mortality[1.0082(95%CI:1.0057-1.0107);1.0088(95%CI:1.0064-1.0113)]were less than the chronic effect[1.2120(95%CI:1.1470-1.2806);1.0831(95%CI:0.9944-1.1797)].Compared to the European and American people[1.1010(95%CI:1.0756-1.1269);1.0186(95%CI:1.0083-1.0290)],the combined effect values of exposure to PM 2.5 and PM 10 on IHD mortality in Asian population[1.0052(95%CI:1.0031-1.0074);1.0079(95%CI:1.0049-1.0109)]were much lower.Conclusions Exposure of an increase in the concentration of atmospheric particulate matter PM 2.5 and PM 10 may increase the risk of IHD mortality.