气象因素与肾综合征出血热发病关系的meta分析

Meta-analysis of the relationship between meteorological factors and hemorrhagic fever with renal syndrome

目的采用meta分析方法评价气象因素对肾综合征出血热(hemorrhagic fever with renal syndrome,HFRS)发病人数的影响。方法在中国知网、维普、万方、CBM、Pubmed、Embase、Web of science数据库检索国内外关于气象因素与肾综合征出血热发病关系的相关文献,按照纳入排除标准筛选文献,进行质量评价和信息提取,利用Stata 16软件进行meta分析和亚组分析。结果共纳入14项研究,基于单滞后效应的环境温度、相对湿度、降雨量和日照时数对HFRS发病影响的合并RR分别为1.08(95%CI:1.04-1.12)、1.19(95%CI:0.99-1.43)、1.00(95%CI:1.00-1.01)和1.50(95%CI:1.06-2.12);基于累积滞后效应的环境温度对HFRS发病影响的合并RR为2.41(95%CI:1.16-5.02)。从环境因素指标、研究地点、气候带、性别、数据时间单位和疫区类型等方面对环境温度和相对湿度的效应分别进行亚组分析,结果显示各亚组内异质性均减小,平均环境温度和最低环境温度均与HFRS发病显著相关,最低环境温度的影响强于平均环境温度;平均相对湿度和最高相对湿度均与HFRS发病显著相关,平均相对湿度的影响强于最高相对湿度;各气象因素对不同地区HFRS发病的影响不同,其中对温带地区人群的发病情况影响较大;以日为单位研究的环境温度对HFRS发病的影响效应显著,各气象因素对不同类型疫区HFRS发病的影响效应不同。结论环境温度、降雨量、日照时数的升高均能增加人群HFRS的发病风险。

Objective To evaluate the influence of meteorological factors on the incidence of hemorrhagic fever with renal syndrome by a meta-analysis.Methods The relevant literatures on the relationship between meteorological factors and hemorrhagic fever with renal syndrome at home and abroad were searched in CNKI,VIP,Wanfang,CBM,PubMed,Embase and Web of science databases.Screen the literature according to the inclusion and exclusion criteria and then assess the quality of the studies included in this study using the STROBE V4 Checklist Cross-Sectional Statement.Extract the information we need,then meta-analysis and subgroup analysis were performed using Stata 16.Results A total of 14 studies were included.The pooled RR of the influence of ambient temperature,relative humidity,rainfall and sunshine hours on hemorrhagic fever with renal syndrome based on single lag effect were 1.08(95%CI:1.04-1.12),1.19(95%CI:0.99-1.43),1.00(95%CI:1.00-1.01)and 1.50(95%CI:1.06-2.12),respectively.The pooled RR of the influence of ambient temperature on hemorrhagic fever with renal syndrome based on cumulative lag effect were 2.41(95%CI:1.16-5.02).We conducted subgroup analysis based on the following variables to explore the source of heterogeneity:the index of environmental factor,study location,climate zone,gender,time resolution and the type of epidemic area.The results showed that the heterogeneity in each subgroup decreased,the average ambient temperature and minimum ambient temperature were significantly correlated with the incidence of HFRS,and the effect of minimum ambient temperature was stronger than that of average ambient temperature;the average relative humidity and maximum relative humidity were significantly correlated with the incidence of HFRS,and the effect of average relative humidity was stronger than that of maximum relative humidity;meteorological factors have different effects on the incidence of HFRS in different areas and have a great impact on the incidence of HFRS in temperate areas;The ambient temperature studied on a daily time resolution has a significant effect on the incidence of HFRS,and meteorological factors have different effects on the incidence of HFRS in different types of epidemic areas.Conclusion The increase of ambient temperature,rainfall and sunshine hours can increase the risk of HFRS.