兰州市气温和相对湿度对慢性阻塞性肺疾病患者门诊就诊人次的影响及其交互效应

Effects of temperature and relative humidity on the number of outpatients with chronic obstructive pulmonary disease and their interaction effect in Lanzhou,China

目的:了解日均气温、日均相对湿度与慢性阻塞性肺疾病患者门诊就诊人次的关系,以及日均气温、日均相对湿度的影响是否存在滞后效应。方法:采用泊松广义线性回归模型结合分布滞后非线性模型分析2013年1月至2017年12月兰州市日均气温、日均相对湿度及其交互作用对慢性阻塞性肺疾病患者门诊就诊人次的影响。结果:日均气温与慢性阻塞性肺疾病的门诊就诊人次呈非线性关系,-12℃^-8℃时门诊就诊人次随着日均气温的下降而逐渐增加,气温每下降1℃,慢性阻塞性肺疾病门诊就诊人次增加11.60%。日均相对湿度对慢性阻塞性肺疾病的门诊就诊人次也呈非线性影响,日均相对湿度在15%~28%范围时,门诊就诊人次随着相对湿度的降低而逐渐增加,相对湿度每下降1%,慢性阻塞性肺疾病门诊就诊人次增加37.05%。气温与相对湿度对慢性阻塞性肺疾病的影响存在交互作用,即不同相对湿度条件下,气温作用有所差异,当日均相对湿度≤50%,日均气温≤11℃时,气温的效应最明显,气温每下降1℃,慢性阻塞性肺疾病日门诊就诊人次全人群增加12.68%、男性5.62%、女性7.56%、<65岁人群5.24%、≥65岁人群14.74%。当日均相对湿度>50%,日均气温≤11℃时,气温每下降1℃,慢性阻塞性肺疾病日门诊就诊人次全人群增加9.00%、<65岁人群7.11%、≥65岁人群10.93%。当日均相对湿度>50%,日均气温>11℃时和日均相对湿度≤50%,日均气温>11℃时,气温对慢性阻塞性肺疾病日门诊就诊人次无影响。结论:日均气温与日均相对湿度有一定的交互作用,低温干燥(相对湿度≤50%,气温≤11℃时)环境和低温高湿(相对湿度>50%,气温≤11℃时)环境均可增加慢性阻塞性肺疾病患者门诊就诊风险。

Objective:To understand the relationships of daily average temperature and relative humi-dity with outpatient visit frequency of patients with chronic obstructive pulmonary disease,and whether temperature and relative humidity have a lag effect.Methods:The effects of daily average temperature,relative humidity,and their interaction in Lanzhou between January 2013 and December 2017 on the outpatient visit frequency of chronic obstructive pulmonary disease patients were analyzed using Poisson generalized linear regression model combined with distributed lag non-linear model.Results:There was a non-linear relationship between the daily average temperature and the outpatient visit frequency of chronic obstructive pulmonary disease patients.Between-12℃and-8℃,the outpatient visit frequency increased gradually with the decrease of the daily average temperature,and the outpatient visit frequency of chronic obstructive pulmonary disease patients increased by 11.60%per 1℃of temperature drop.The daily average relative humidity also presented a non-linear effect on the outpatient visit frequency chronic obstructive pulmonary disease patients.When the daily average relative humidity was in the range of 15%-28%,the outpatient visit frequency increased gradually with the decrease of relative humidity,and the outpatient visit frequency of COPD patients increased by 37.05%for every 1%decrease of relative humidity.A synergistic effect was found between air temperature and relative humidity on chronic obstructive pulmonary disease,that is,under different relative humidity,the effect of air temperature was different.When the daily average relative humidity≤50%and the daily average temperature≤11℃,the effect of air temperature was the most obvious.For every 1℃drop in temperature,the daily out-patient visit frequency of the whole population increased by 12.68%(5.62%in males and 7.56%in females;5.24%in population<65 years and 14.74%in population≥65 years).When the daily average relative humidity>50%and the daily average temperature≤11℃,the daily outpatient visit frequency of the whole population increased by 9.00%for every 1℃drop in temperature(<65 years,7.11%;≥65 years,10.93%).When the daily average temperature>11℃,the temperature had no effect on the daily outpatient visit frequency of chronic obstructive pulmonary disease patients under different relative humidity.Conclusion:The presence of a certain extent of interaction is observed between daily average temperature and relative humidity.Low-temperature and dry environment(relative humidity≤50%,temperature≤11℃)as well as low-temperature and high-humidity environment(relative humidity>50%,temperature≤11℃)can both increase the risk of outpatient visit in chro-nic obstructive pulmonary disease patients.