季节及气象因素对广州地区急性心肌梗死发病住院的影响

Impact of seasonal and meteorological factors on the hospitalization of acute myocardial infarction in Guangzhou region

目的探讨急性心肌梗死(acute myocardial infarction,AMI)患者发病住院的季节分布特征及其与各气象因子的关系。方法收集广州市某三甲医院2008-2017年确诊为AMI的2 471例住院患者的基本资料,比较季节间AMI住院人次的差异,并分析各气象因子与AMI住院人次的关系。结果 2008-2017年AMI的住院人次高峰值均分布在冬春季节(占53.42%),男性发病比例高于女性,男女之比为2.79∶1,发病年龄主要集中在55~80岁,占总发病就诊人次的63.70%。Spearman分析显示:AMI住院人次与月平均风速关系最强且呈正相关(r=0.613,P<0.001),其次是月平均相对湿度(r=0.346,P<0.001)和平均气温(r=-0.251,P=0.006),而月平均日温差(r=0.128,P=0.163)及月平均气压(r=-0.019,P=0.836)与AMI住院人次无显著关联。多元逐步回归结果表明月平均风速、月平均相对湿度、月平均日温差及月平均气温对AMI住院人次有独立影响。结论掌握AMI患者的住院特征和季节分布可为本院科学地管理科室工作提供依据。AMI发病住院与气象因子的关系还可为患者有效加强自我保健提供依据。

Objective To explore the seasonal distribution characteristics of hospitalization in patients with acute myocardial infarction(AMI) and their relationships with meteorological factors. Methods We collected the general information about 2,471 inpatients diagnosed as AMI from 2008 to 2017 in a third-grade class-A hospital in Guangzhou city. The numbers of AMI inpatients in different seasons were compared, and the relationships between meteorological factors and the number of AMI inpatients were evaluated. Results During the period of 2008-2017, the numbers of AMI inpatients were found to be higher in winter and spring(accounting for 53.42%). The proportion of AMI onset was higher in males than in females, and the ratio of male to female was 2.79∶1. Most of the inpatients ranged in age from 55 to 80 years, accounting for 63.70% of the total number of AMI outpatients. Spearman’s correlation analysis showed that the number of AMI inpatients had the strongest positive relationship with monthly average wind speed(r=0.613, P<0.001), followed by monthly average relative humidity(r=0.346, P<0.001) and monthly average temperature(r=-0.251, P=0.006). However, monthly average diurnal temperature range(r=0.128, P=0.163) and monthly mean pressure(r=-0.019, P=0.836) were not significantly related to the number of AMI inpatients. The results of multiple stepwise regression indicated that the number of AMI inpatients was independently affected by monthly average wind speed, monthly average relative humidity, monthly average diurnal temperature range, and monthly average temperature. Conclusions Mastering the hospitalization characteristics and seasonal distribution of AMI patients can provide a basis for scientifically managing the departments in this hospital;meanwhile, the findings of the relationships between AMI hospitalization and meteorological factors can also provide evidence for effectively strengthening patients’ self-health care consciousness.