不同地区温度变化对缺血性心脑血管疾病影响的比较研究

Comparative research of the effects of temperature change on ischemic cardio-cerebrovascular diseases in different regions

本文综合探究了日平均气温、24h变温和气温日较差变化对缺血性心脑血管疾病发病人数的影响,采用分布滞后非线性模型(DLNM)与广义相加模型(GAM),分别探析了2015—2016年安徽省阜南县和贵州省锦屏县日平均气温、24h变温和气温日较差与缺血性心脑血管住院病人数的暴露—反应关系。结果表明:气温日较差大于15℃缺血性心脑血管疾病相对风险剧烈升高,并呈现明显的即时效应,且其相对风险随滞后日增加和气温日较差增加达到叠加效应的峰值。当24h内气温下降7℃以上,缺血性心脑血管疾病相对风险开始明显上升,下降10℃以上呈现显著的即时效应。统计分析发现,两县在春季达到上述阈值概率最高,因此缺血性心脑血管疾病住院人数也在春季达到峰值,特别是雨水至清明节气时段为两县住院人数共同最高峰时段;值得注意的是,地处西部的锦屏县夏季缺血性心脑血管疾病发病人数也较多。此外,降温过程与节气转换也是导致两县缺血性心脑血管疾病住院人数阶段性增多的主要天气与气候因素。

The influences of the variations of ambient temperature,daily temperature range (DTR) and temperature change between neighboring days (ΔT 24 ),respectively,on the inducement of ischemic cardio-cerebrovascular diseases (ICCVD) were investigated.Distributed lag nonlinear model (DLNM) and generalized additive model (GAM) were applied to analyze the exposure-response relationships between ICCVD inpatients and changes of ambient temperature,DTR and ΔT 24 in Fu′nan and Jinping County in Anhui province from 2015 to 2016,respectively.The results demonstrated that when DTR fluctuates more than 15 ℃,the ICCVD relative risk surges instantaneously and shows an immediate effect.Finally,the risk reaches a peak value of overlapping effect with lagging days and DTR increasing.In addition,the ICCVD relative risk increases obviously and indicates a significant immediate effect when the decreasing amplitudes of ΔT 24 are over 7 ℃ and 10 ℃,respectively.Statistical analysis results demonstrate that the probability of reaching the above- mentioned thresholds in the two counties is higher in spring than in other seasons.Therefore,it is simultaneously discovered that the amounts of ICCVD inpatients in Fu′nan and Jinping Counties tend to reach the peaks in spring,especially from Rain Water to Ching Ming in the lunar calendar.Notably,the amount of the inpatients in Jinping county located in the west of Anhui province in summer is also numerous.Moreover,periodically increasing of the amount of ICCVD inpatients is ascribed by two main weather and climate factors,that is,the cooling process and the alternation of the solar terms.