沙尘天气PM10对多种心血管疾病日门诊人数的影响.docVIP

沙尘天气PM10对多种心血管疾病日门诊人数的影响 摘要[目的]研究沙尘天气大气可吸入颗粒物(PM10)与心血管系统疾病每日门诊人数的联系[方法]采用半参数广义相加泊松回归模型(GAM)在控制了时间长期趋势、季节趋势、气象因素、日历效应等混杂因素影响的基础上分析2004年3月1日~5月31日沙尘暴频发区——甘肃省武威市大气PM10与多种心血管疾病每日门诊相对危险度（RR)的关系[结果] (1) PM10与男、女总心血管系统疾病门诊RR均在lag2的联系有统计学意义PM10分别在lag3和lag4对男、女性风湿性心脏病门诊RR的影响有统计学意义PM10(lag2)与男性高血压门诊RR的联系有统计学意义PM10在lag2对男性缺血性心血管疾病门诊RR的影响有统计学意义PM10对男、女性心律失常以及充血性心力衰竭门诊RR的影响均无统计学意义(2) 在调整了SO2和/或NO2后PM10对男、女性心血管系统疾病门诊RR的影响均有所下降但仍有统计学意义然而在分别调整了其他污染物后SO2和NO2变得无统计学意义(3) 沙尘天气PM10浓度分类模型分析表明从正常清洁天、轻度污染天到扬沙天气、沙尘暴天气随着PM10浓度水平的增大本文所分析的心血管疾病（风湿性心脏病、高血压、缺血性心血管疾病、心律失常、充血性心力衰竭）门诊RRL也随之增高呈现一定的剂量效应关系 [结论] (1) 沙尘天气可吸入颗粒物可引起暴露居民多种心血管疾病（风湿性心脏病、高血压、缺血性心血管疾病、心律失常、充血性心力衰竭）门诊人数增加,且均为滞后效应.(2) PM10浓度与心血管疾病门诊相对危险度(RR)存在一定的剂量效应关系.(3) 由于PM10浓度与沙尘天气强度的关系密切,所以男性与女性居民心血管系统多种疾病日门诊相对危险度随沙尘天气的强度增大而增大：正常清洁天＜轻度污染天＜扬沙天＜沙尘暴天.关键词 中图分类号 文献标识码A 文章编号 Association of PM10 derived from dust events with daily outpatient number for cardiovascular diseases. Abstract：[Objective] To explore the association between atmosphere particulate matter with an aerodynamic diameter less than 10 μm (PM10) and daily outpatient visits for cardiovascular diseases. [Methods] All good-sized hospitals in Wuwei city in Gansu province, northwest of China, in which blowing sands and dust storm have taken place frequently, were selected. During the period from March 1st to May 31st in 2004, the association between the concentrations of PM10 and daily outpatient visits for cardiovascular diseases was investigated when dust and sand events occurred frequently. The semi-parametric generalized additive Poisson regressions model (GAM) was used to analyze the associations between PM10, NO2, SO2 and daily cardiovascular outpatient number relative risks by controlling the long time trends, season, meteorological variables, and calendar effect. [Results] (1) PM10 was significantly associated with increased outpatient visits from a lag of 2 days total cardiovascular diseases in the male and female patients, while PM10 was significantly related to