北京市24 h变温对冠心病和脑梗死急诊人数的影响

Effect of Temperature Change Between Neighboring Days on Emergency Visits of Coronary Heart Disease and Cerebral Infarction in Beijing

利用2008—2012年北京市3家三级甲等医院冠心病和脑梗死的急诊病例共36458例,基于日-地关系对变温的根本性作用,总结不同节气的24 h变温分布特征,以此划分正、负变温主导期并分层建模,量化24 h变温对两类疾病急诊风险的短期效应。结果表明,冠心病在年内的两个发病高峰正好对应正、负变温较强的时期;而变温幅度较小且正负变温过渡的阶段,心脑血管发病人数也最少。时间序列模型揭示,正变温对冠心病的短期滞后影响较强,中青年人(≤65岁)及相对老年群体(>65岁)风险更高,相对风险值(relative risk,RR)为1.31;无论季节背景如何,老年冠心病人对负变温敏感,同样存在短期滞后性。对脑梗死病例而言,在负变温主导期发生的正变温对青年组(<45岁)影响最大(RR=1.23),效应即时产生。因此,24 h变温对心、脑血管疾病的短期影响显著,其影响程度与季节变温趋势关系密切。

The 36458 cases of coronary heart disease(CHD)and cerebral infarction(CI)in Beijing from 2008 to 2012 were collected.Based on the fundamental impact of solar-terrestrial relationship on temperature change between neighboring days(TCN),a year was divided into two periods dominated by opposite TCN period in this study.The results show that high morbidity of CHD generally occurred in periods from awakening of insects to grain rain,as well as from white dew to winter solstice,which accompanied by large TCN period.In contrast,low morbidities of both CHD and CI took place in the period from grain in ear to summer solstice,which accompanied by small TCN period.Stronger effects of positive TCN period were revealed on young and middle-aged(less than and equal to 65 years old)CHD patients than that on the old group(more than 65 years old)by time-series models,whose relative risk(RR)was up to 1.31.The elderly suffering from CHD were sensitive to negative TCN period,regardless of background temperature trends.Furthermore,in negative TCN period,positive TCN could elevate the highest CI risk for young individuals(less than 45 years old)immediately(RR was equal to 1.23).In conclusion,the short-term effects of TCN on cardiovascular and cerebrovascular diseases were significant,and seasonal temperature trends modified TCN-cardiovascular morbidity associations significantly.