日最高气温与医院心脑血管疾病急诊人次关系的病例交叉研究

目的 探讨北京市某区日最高气温与某医院心脑血管疾病急诊人次(ICD10:100～199)的关系,研究日最高气温对心脑血管疾病的影响.方法 收集2004-2006年北京市海淀区某三级甲等医院急诊科心脑血管疾病资料及相关的气象资料和大气污染物资料,采用季节分层的病例交叉设计分析不同季节日最高气温变化对心脑血管疾病的影响.结果 多气象因素模型结果显示,春、夏季日最高气温每升高1℃,心脑血管疾病急诊人次分别增加17.3%(OR=1.173,95%CI:1.149～1.197)和4.2%(OR:1.042,95%CI:1.011～1.074);而秋季13最高气温每升高1℃,心脑血管疾病急诊人次反而下降25%(OR:0.750,95%CI:0.727～0.773),关联有统计学意义(P<0.05);冬季日最高气温每升高1℃,心脑血管疾病急诊人次下降2.1%(OR=0.979,95%CI:0.956-1.004),但关联无统计学意义(P>0.05).结论 春、夏季日最高气温升高可以导致心脑血管疾病急诊增加.提示春季和夏季,日最高气温的增加可能是心脑血管疾病发病的一个危险性因素;而秋季和冬季,日最高气温的增加反而作为一种保护性因素,能够减少心脑血管疾病的发生.

Abstract：

Objective To explore the association between the daily maximum temperature and hospital emergency visits for cardiovascular and cerebrovascular diseases (ICD-10:100～199) in different seasons in Beijing, China Methods The data of the daily hospital emergency visits for cardiovascular and cerebrovascular diseases (ICD-10: 100～199) from a Level-3A hospital in Haidian district in Beijing during 2004-2006 and the corresponding meteorological, air pollution data were collected. The seasonal-stratified case-crossover design and Logistic multiple regression model was used for the data analysis. Results After adjusting the influence of relative humidity, wind speed and atmospheric pressure, for It increase in daily maximum temperature, the corresponding increase in the hospital emergency visits of the diseases was 17.3%(OR=1.173,95%CI: 1.149～1.197) and 4.2% (OR=1.042,95%CI: 1.011～1.074) in spring and summer of the years, respectively (P<0.05); contrarily, those decreased by 25% in autumn(OR =0.750,95% CI: 0.727～0.773); no significant association was seen in winter (P>0.05). Conclusion The increase of daily maximum temperature may be a risk factor for daily hospital emergency visits for cardiovascular and cerebrovascular diseases in spring and summer, however, it may be a preventive factor in autumn. The effects of air temperature on health should not be the same in seasons.

Association of Maximum Temperature between Daily Hospital Emergency Visits for Cardiovascular and Cerebrovascular Diseases:a Case-Crossover Study

Objective To explore the association between the daily maximum temperature and hospital emergency visits for cardiovascular and cerebrovascular diseases (ICD-10:100～199) in different seasons in Beijing, China Methods The data of the daily hospital emergency visits for cardiovascular and cerebrovascular diseases (ICD-10: 100～199) from a Level-3A hospital in Haidian district in Beijing during 2004-2006 and the corresponding meteorological, air pollution data were collected. The seasonal-stratified case-crossover design and Logistic multiple regression model was used for the data analysis. Results After adjusting the influence of relative humidity, wind speed and atmospheric pressure, for It increase in daily maximum temperature, the corresponding increase in the hospital emergency visits of the diseases was 17.3%(OR=1.173,95%CI: 1.149～1.197) and 4.2% (OR=1.042,95%CI: 1.011～1.074) in spring and summer of the years, respectively (P<0.05); contrarily, those decreased by 25% in autumn(OR =0.750,95% CI: 0.727～0.773); no significant association was seen in winter (P>0.05). Conclusion The increase of daily maximum temperature may be a risk factor for daily hospital emergency visits for cardiovascular and cerebrovascular diseases in spring and summer, however, it may be a preventive factor in autumn. The effects of air temperature on health should not be the same in seasons.