南京市大气NO_(2)对缺血性心脏疾病患者死亡的影响分析

Effect of atmospheric NO_(2) on ischemic heart disease mortality in Nanjing

目的:探讨大气二氧化氮(NO_(2))对居民缺血性心脏疾病死亡的影响。方法:收集南京市大气主要污染物的日均质量浓度、日平均温度和人群每日缺血性心脏疾病死亡人数等。采用广义相加模型,分析大气NO_(2)与人群每日缺血性心脏疾病死亡人数的关系、滞后效应及影响。结果:2013—2020年南京市大气NO_(2)的日均质量浓度为44.11μg·m-3。期间共记录35 961条缺血性心脏疾病死亡病例,平均每天12例,其中年龄>65岁死亡数为31 455例(占87.47%)。大气NO_(2)质量浓度每增加10μg·m-3时,全人群缺血性心脏疾病死亡的风险升高2.29%(95%CI:1.48%~3.10%),其中女性风险明显高于男性(P<0.05);>65岁人群风险显著高于≤65岁人群(P<0.05)。结论:南京市大气NO_(2)污染仍须进一步监测及治理,大气NO_(2)污染可能增加人群缺血性心脏疾病死亡的风险,尤其对女性和>65岁老年人群的影响更为明显。

Objective:To investigate the effect of atmospheric nitrogen dioxide(NO_(2))on ischemic heart disease mortality.Methods:The daily average concentrations of major atmospheric pollutants,daily average temperature and daily ischemic heart disease deaths in Nanjing were collected.The generalized additive model was used to analyze the relationship between NO_(2) and daily ischemic heart disease mortality,the lag effect and related influencing factors.Results:The daily average concentration of atmospheric NO_(2) in Nanjing from 2013 to 2020 was 44.11μg·m-3.A total of 35961 deaths from ischemic heart disease were recorded during the study period,with an average of 12 cases per day.Among them,31455 cases(87.47%)died of age over 65 years old.For every 10μg·m-3 increase in atmospheric NO_(2) concentration,the risk of ischemic heart disease death in the whole population increased by 2.29%(95%CI:1.48%-3.10%).The risk of ischemic heart disease death in women was significantly higher than that in men(P<0.05),and the risk of ischemic heart disease death in people over 65 years old was significantly higher than that in people≤65 years old(P<0.05).Conclusion:The atmospheric NO_(2) pollution in Nanjing still needs further monitoring and control.Atmospheric NO_(2) pollution may increase the risk of ischemic heart disease death inNanjing,especially for women and the elderly over 65 years old.