重庆市PM2.5与心脑血管疾病急诊人数相关性研究

The Correlation Between PM2.5 and the Number of Emergency Patients With CVDs in Chongqing City

目的分析PM2.5与重庆市某三甲医院心脑血管疾病急诊人数的相关关系。方法收集2017-01-01/2018-12-01重庆市某三甲医院心脑血管事件急诊病例,包括心脑血管疾病、冠心病、心律失常、心衰和脑血管疾病,收集相同时间段重庆市空气污染数据,包括大气二氧化硫(SO2)、二氧化氮(NO2)、可吸入颗粒物(PM2.5)浓度。采用广义相加模型(GAM)来探索两者的关系。结果当日PM2.5每升高10μg/m3,会使总心脑血管疾病、冠心病、心律失常、心衰和脑血管疾病的急诊人数增加,其RR值分别为1.006(95%CI:1.003~1.016)、1.004(95%CI:0.995~1.012)、1.002(95%CI:0.985~1.014)、1.011(95%CI:0.997~1.023)、1.002(95%CI:0.991~1.009),但差异无统计学意义;PM2.5滞后3 d,累积前2 d和累积前3 d的PM2.5均能使总脑血管疾病、心衰和脑血管疾病的入院人数增加,但差异无统计学差异(P>0.05)。在日均温度和日均相对湿度最高的百分位数区间,PM2.5浓度每升高10个单位,总心脑血管事件分别上升1.012(95%CI:1.005~1.019)倍和1.009(95%CI:1.002~1.021)倍。结论本研究结果提示大气PM2.5浓度升高与重庆市心脑血管疾病急诊人数增加有一定关联,且气象因素对其关联有一定影响。

Objective To analyze the relationship between PM2.5 and the number of emergency patients with cardiovascular and cerebrovascular diseases(CVDs)in a tertiary grade-A hospital in Chongqing.Methods Emergency cases of CVDs including cardiovascular disease,coronary heart disease,arrhythmia,heart failure and cerebrovascular disease were collected from a tertiary grade-A hospital from 2017-01-01 to 2018-12-01 in Chongqing.The air pollution data included the concentration of SO2,NO2 and PM2.5 was collected at the same time.The generalized additive model(GAM)was used to explore the relationship between them.Result Every 10 ug/m3 increase in PM2.5 concentration on the same day would increase the number of emergency patients with total CVDs,coronary heart disease,arrhythmia,heart failure and cerebrovascular diseases,the RR values was 1.006(95%CI:1.003-1.016),1.004(95%CI:0.995-1.012),1.002(95%CI:0.985-1.014),1.011(95%CI:0.997-1.023)and 1.002(95%CI:0.991-1.009),respectively.However,the difference was not statistically significant.The cumulative effects from the same day to the next 2 days and 3 days of PM2.5 could increase the number of hospitalized patients with total CVDs,heart failure and cerebrovascular diseases,but the difference was not statistically significant(P>0.05).Every 10 units increase in PM2.5 concentration,the number of CVDs hospitalized patients would increase at the highest quantile of daily average temperature and daily average relative humanity with RR for 1.012(95%CI:1.005-1.019)and 1.009(95%CI:1.002-1.021),respectively.Conclusion This study indicates that the increase of ambient PM2.5 concentration is related to the increase of the number of emergency patients with CVDs in Chongqing and meteorological factors have a certain impact on their association.