大气颗粒物暴露与缺血性心脏病关联的流行病学研究进展

Associations between atmospheric particulate matter exposure and ischemic heart disease:A review of epidemiological studies

缺血性心脏病(IHD)是我国除中风外的第二大心血管疾病,大气颗粒物(PM)与IHD的相关性研究值得关注。本综述搜集了国内外针对PM与IHD相关性的流行病学研究,围绕PM的粒径差异、区域差异两个方面综述二者相关性的研究进展,并分析了不同环境因素条件下PM暴露对IHD的影响。文献综合分析结果佐证了PM暴露与IHD死亡的关系,PM2.5、PM10每升高10μg·m-3,人群IHD死亡效应值分别为1.0236(95%CI:1.0184~1.0288)、1.0106(95%CI:1.0075~1.0137),并且PM暴露可增加IHD的发病率。大多数研究集中在亚洲和北美洲国家关于PM10以及PM2.5对IHD的影响,PM1与IHD的研究资料缺乏,其他地区或国家PM与IHD的研究资料也不足。不同环境因素(温度、湿度、季节)条件下PM暴露对IHD影响研究较为有限,有待进一步研究。

Ischemic heart disease(IHD)is the second most common cause of death in cardiovascular diseases in China,next to stroke,and the correlations between particulate matter(PM)exposure and IHD are noteworthy to study.This review collected domestic and foreign epidemiological studies on PM and IHD,explored the associations between PM and IHD from the perspective of particle sizes and regional differences,and analyzed the effects of PM exposure on IHD under different environmental factors.The results support the relationships between PM exposure and IHD death:for per 10μg·m-3 increase in PM2.5 and PM10 concentrations,the combined effect values of IHD mortality are 1.0236(95%CI:1.0184-1.0288)and 1.0106(95%CI:1.0075-1.0137)respectively,and also indicate that PM stimulation is tightly associated with increased IHD occurrence.Most of the studies focus on the effects of PM10 and PM2.5 on IHD in Asian and North American countries.However,the research data on PM1 exposure and IHD in Asian and North American countries and on PM and IHD in regions out of Asia and North America are insufficient.Epidemiological studies about the impacts of different environmental factors on PM-caused IHD are also scant and need to be further extended.