中国2004-2016年冬季低温与流感发病的相关性研究

Correlation between low air temperature and influenza incidence in winter in China, 2004-2016

目的:探讨中国31个省份冬季低温与流感发病之间的关联性。方法:收集31个省份2004年1月至2016年12月流感的发病数据和气象数据。运用分布滞后非线性模型,控制长期趋势、"星期几效应"等的影响,分析低温与流感发病的相关性。结果:全国流感发病率从2004年的4/10万增加到2016年的22/10万,整体呈现增高的趋势,黑龙江、辽宁、吉林等省份历年的发病率均<5/10万,处于较低的发病水平,而甘肃、河北、广东、北京等省份的流感发病率较高,部分年份的发病率>30/10万。在1-6月,随着气温的升高,流感的发病呈现逐渐降低的趋势,而在7-12月随着气温的降低,流感的发病呈现逐渐升高的趋势。低温对流感发病影响最高的省份,冬季前期是北京(RR=2.90,95%CI:2.57~3.28),冬季后期是西藏(RR=3.37,95%CI:2.03~5.58);低温对流感发病影响最高的区域,冬季前期是东北地区(RR=2.04,95%CI:1.48~2.79),冬季后期是华南地区(RR=1.77,95%CI:1.61~1.94)。冬季前期和冬季后期低温对流感发病的影响存在地区差异。结论:冬季低温与流感发病之间存在关联性,冬季前期和后期低温对流感发病的影响存在地区差异。

Objective To explore the association between low air temperature and influenza incidence in winter in 31 provinces in China.Methods Influenza incidence and meteorological data were collected from January,2004 to December,2016 in 31 provinces in China.Distributed lag nonlinear model was applied to evaluate the association between low air temperature and influenza incidence in early and late winter,after controlling for the long-term trend,as well as the effect of"day of week".Results The influenza incidence increased from 4/100000 in 2004 to 22/100000 in 2016 in China,showing an overall increasing trend.The incidences of some provinces were lower than 5/100000,such as Heilongjiang,Liaoning and Jilin,but the incidences of influenza in Gansu,Hebei,Guangdong,Beijing were higher than 30/100000 in some years.From January to June,the influenza incidence showed a decreasing trend with the increase of air temperature,but the influenza incidence showed a rising trend from July to December with the decrease of air temperature.In early winter,low air temperature had the highest influence on the incidence of influenza in Beijing,the RR was 2.90(2.57-3.28),but in late winter,low air temperature had the highest influence on the incidence of influenza in Tibet,the RR was 3.37(2.03-5.58).In early winter,low temperature had the highest influence on the incidence of influenza in northeastern China,the RR was 2.04(1.48-2.79),but in late winter,low air temperature had the highest influence in southern China,the RR was 1.77(1.61-1.94).There were area specific difference in the influence of low air temperature on the incidence of influenza between early winter and late winter.Conclusions The correlation between low air temperature in winter and influenza incidence exists.The influenza of early and late winter on influenza incidence varies with different areas.We should take appropriate protective measures according to local conditions.