植被覆盖与急性冠心病预后生存期的关联研究

Association study between vegetation cover and prognostic survival of acute coronary heart disease

目的旨在研究植被覆盖与急性冠状动脉粥样硬化性心脏病(简称急性冠心病)预后生存期的关联,并探究空气污染物(PM_(2.5)、O_(3))是否介导了这种关联。方法收集2014―2020年平邑县所有急性冠心病患者的监测数据,采用病例对照研究设计(病例组为短期生存组,对照组为长期生存组)将归一化差异植被指数(normalized difference vegetation index,NDVI)、土壤调整植被指数(soil adjustment vegetation index,SAVI)作为植被覆盖暴露测量指标。采用logistic回归分析模型,依次纳入协变量构建了4个模型来探究植被覆盖与急性冠心病预后生存期的关联,然后采用亚组分析和中介分析评估空气污染物对这种关联的潜在介导作用。结果最终共纳入1796例急性冠心病患者,logistic回归分析模型分析结果显示植被覆盖指标(NDVI、SAVI)与急性冠心病患者预后生存期相关(均有P<0.05)。亚组分析显示:PM_(2.5)与植被覆盖的交互具有统计学意义(均有P<0.05),在PM_(2.5)浓度低时,植被覆盖与急性冠心病患者预后长期生存的关联更强。中介分析显示,PM_(2.5)作为中介变量介导了这种关联(均有P<0.05),对NDVI、SAVI介导的比例分别为37.0%、30.7%,而O_(3)则未发现存在中介作用。结论植被覆盖对急性冠心病患者预后长期生存起保护作用,PM_(2.5)介导了这种关联。

Objective The aim was to study the association between vegetation cover and prognostic survival of acute coronary heart disease,and to explore whether air pollutants(PM_(2.5),O_(3))mediated this association.Methods Surveillance data of all acute coronary heart disease patients in Pingyi County from 2014 to 2020 were collected,and a case-control study design was adopted(the case group was the short-term survival group,the control group was the long-term survival group),and the normalized difference vegetation index(NDVI)and soil-adjusted vegetation index(SAVI)were used as vegetation cover exposure measurements.Four logistic regression models were constructed to explore the association between vegetation cover and prognostic survival of acute coronary heart disease,followed by subgroup analysis and mediation analysis to evaluate the potential mediating effect of air pollutants on this association.Results Finally,a total of 1796 patients with acute coronary heart disease were included.Logistic regression results showed that vegetation cover indicators(NDVI,SAVI)were significantly associated with prognostic survival in patients with acute coronary heart disease(P<0.05).Subgroup analysis showed that the interaction between PM_(2.5)and vegetation cover was statistically significant(all P<0.05).When the concentration of PM_(2.5)was low,the correlation between vegetation cover and prognostic long-term survival of patients with acute coronary heart disease was stronger.The mediation analysis showed that PM_(2.5)as a mediator significantly mediated this association(all P<0.05),and the proportion of NDVI and SAVI mediated was 37.0%and 30.7%respectively,while the mediation effect of O_(3)was not significant.Conclusion Vegetation cover was protective for the prognostic long-term survival of patients with acute coronary heart disease,and PM_(2.5)significantly mediated this association.