2009—2019年重庆主城区人呼吸道合胞病毒日发病例数与气象参数相关性研究

The correlation study on human respiratory syncytial virus daily incidence and meteorological parameters in the main urban area of Chongqing from 2009 to 2019

目的探讨重庆主城区人呼吸道合胞病毒(HRSV)日发病例数与气象参数之间的关系。方法本研究以2009年6月至2019年6月于重庆医科大学附属儿童医院呼吸中心因急性下呼吸道感染住院患儿为研究对象,共3107例。采集患儿入院当天鼻咽抽吸物(NPA),检测HRSV及常见呼吸道病毒核酸;结合同期重庆主城区气象资料,对HRSV日发病例数及气象参数进行相关性和分布滞后非线性模型分析。结果3107例患儿的HRSV阳性率为34.53%(1073例),年龄M(Q1,Q3)为6(3,13)月龄,男性占64.31%(690例)。HRSV日发病数与最低温度(r=-0.220,P<0.001)、最高温度(r=-0.221,P<0.001)、平均温度(r=-0.221,P<0.001)、降水量(r=-0.052,P<0.001)存在负相关,与日照时间(r=0.011,P<0.001)、平均相对湿度(r=0.095,P<0.001)存在正相关。与参考温度(20℃)相比,最低气温6~10℃在滞后4~8 d时对HRSV发病的RR值为1.11~1.14,最低温度5~19℃在滞后5 d和2~19℃在滞后10 d时RR值分别为1.02~1.14和1.00~1.03。累积滞后5、10、15和21 d时,与参考温度(20℃)相比,最低温度为10.4℃的RR值(95%CI)分别为1.93(1.08~3.46)、3.49(1.64~7.45)、5.00(2.01~12.46)和6.69(2.18~20.48);最低温度为22.1℃的RR值(95%CI)分别为0.87(0.77~0.98)、0.77(0.66~0.90)、0.74(0.62~0.89)和0.68(0.55~0.85)。在累积效应中,与参考温度(20℃)相比,在不同滞后天数下最低温度对男童和女童的最大RR值(95%CI)分别为7.24(1.84~28.51)和2.19(1.07~4.46),对<6月龄儿童和≥6月龄儿童的最大RR值(95%CI)分别为4.72(1.05~21.23)和11.98(1.70~84.35)。结论在重庆主城区,儿童HRSV日发病例数与气候参数有相关性,其中最低温度对HRSV感染有滞后和累积效应,6~10℃在滞后4~8 d时对HRSV发病的影响较大,累积效应对男童及≥6月儿童HRSV发病影响更明显。

Objective To explore the relationship between the daily incidence of human respiratory syncytial virus(HRSV)and meteorological parameters in the main urban area of Chongqing.Methods This study took 3107 children hospitalized with acute lower respiratory tract infections from June 2009 to June 2019 in department of Respiratory medicine,Children′s Hospital of Chongqing Medical University(CHCMU).Nasopharyngeal aspirate(NPA)was collected on the day of admission to detect HRSV and common respiratory virus;combined with the meteorological data of the main urban area of Chongqing during the same period,the correlation and distribution lag nonlinear model analysis of the daily incidence of HRSV and meteorological parameters were carried out.Results Among 3107 children,HRSV positive accounted for 34.53%(1073 cases),the age was 6(3,13)months,and males accounted for 64.31%(690 cases).The daily incidence of HRSV was negatively correlated with minimum temperature(r=-0.220,P<0.001),maximum temperature(r=-0.221,P<0.001),average temperature(r=-0.221,P<0.001)and precipitation(r=-0.052,P<0.001),and positively correlated with sunshine time(r=0.011,P<0.001)and average relative humidity(r=0.095,P<0.001).Compared with the reference temperature(20℃),when the lowest temperature of 6-10℃lags for 4-8 d,the RR value of HRSV was 1.11-1.14,and when the lowest temperature of 5-19℃lags for 5 d and 2-19℃lags for 10 d,the RR values were 1.02-1.14 and 1.00-1.03.When the cumulative lag is 5,10,15 and 21 d,compared with the reference temperature(20℃),the RR(95%CI)values at the lowest temperature of 10.4℃were 1.93(1.08-3.46),3.49(1.64-7.45),5.00(2.01-12.46)and 6.69(2.18-20.48);the RR(95%CI)values of the lowest temperature of 22.1℃were 0.87(0.77-0.98),0.77(0.66-0.90),0.74(0.62-0.89)and 0.68(0.55-0.85).In the cumulative effect,compared with the reference temperature(20℃),the gender stratification showed that the maximum RR(95%CI)values of the lowest temperature for boys and girls under different lag days were 7.24(1.84-28.51)and 2.19(1.07-4.46),the age stratification showed that the maximum RR(95%CI)values of the lowest temperature for children<6 months old and children≥6 months old under different lag days were 4.72(1.05-21.23)and 11.98(1.70-84.35).Conclusions In the main urban area of Chongqing,the daily incidence of HRSV in children is correlated with climatic parameters.Among them,the lowest temperature has a delayed and cumulative effect on HRSV infection.6-10℃has a greater impact on the incidence of HRSV when the lag is 4-8 days.The effect has a more obvious impact on the incidence of HRSV in boys and children≥6 months.