气温变化与心脑血管疾病急诊关系的病例交叉研究

目的 探讨北京市日平均气温与心脑血管疾病急诊(ICD-10:I00～I99)的关系,研究气温变化对心脑血管疾病的影响.方法 收集北京大学第三医院急诊科心脑血管疾病急诊资料、北京市气象资料和北京市大气污染物数据,应用时间分层的病例交叉设计研究方法分析春季(3-5月)、夏季(6-8月)、秋季(9-11月)、冬季(12-2月)日平均气温与心脑血管疾病急诊的关系.结果 在控制二氧化硫(SO2)、二氧化氮(NO2)及大气可吸入颗粒物(PM10)影响的情况下,春季、夏季、秋季、冬季当日平均气温对心脑血管疾病急诊的影响最大,平均气温每升高1℃与心脑血管疾病急诊的OR值分别为1.282(95%CI:1.250 ～1.315)、1.027(95% CI:1.001～1.055)、0.661(95% CI:0.637～0.687)、0.960(95%CI:0.937～0.984),关联有统计学意义(P<0.05).当同时调整相对湿度、风速、大气压强的影响时,春季、夏季、秋季、冬季平均气温与心脑血管疾病急诊的OR值分别为1.423(95%CI:1.377～1.471)、1.082(95%CI:1.041～1.124)、0.633(95%CI:0.607～0.660)、0.971(95%CI:0.944～1.000).关联有统计学意义(P<0.05).结论 春季、夏季日平均气温升高可以导致心脑血管疾病急诊人次增加,说明春夏季气温升高对心脑血管疾病患者是危险因素,应注意防暑;秋季、冬季气温升高可以导致心脑血管疾病急诊减少,说明秋冬季气温升高对心脑血管疾病患者是保护性因素,应注意保暖.

Association between ambient temperature and hospital emergency room visits for cardiovascular diseases:a case-crossover study

Objective To explore the association between ambient average temperature and hospital emergency room visits for cardiovascular diseases(International Classification of Diseases,Tenth Vision ICD-10:I00-I99) in Beijing,China.Methods Data was collected on daily hospital emergency room visits for cardiovascular diseases from Peking University Third Hospital,including meteorological data(daily average temperature,relative humidity,wind speed,and atmospheric pressure) from the China Meteorological Data Sharing Service System,and on air pollution from the Beijing Municipal Environmental Monitoring Center.Time-stratified case-crossover design was used to analyze data on 4 seasolls.Results After adjusting data on air pollution,1 degree(℃) increase of ambient average temperature would associate with the emergency room visits of odds ratio(Ors)as 1.282(95%CI:1.250-1.315).1.027(95%CI:1.001-1.055),0.661(95%CI:0.637-0.687),and 0.960 (95%CI:0.937-0.984) in spring,summer,autumn,and winter respectively.After controlling the influence of relative humidity,wind speed,and atmospheric pressure,1℃ increase in the ambient average temperature would be associated with the emergency room visits on Ors value as 1.423 (95%CI:1.377-1.471).1.082(95%CI:1.041-1.124),0.633(95%CI:0.607-0.660)and 0.971(95%CI:0.944-1.000) in spring,summer,auttmm,and winter respectively.Conclusion These data on outcomes suggested that the elevated level of ambient temperature would increase the hospital emergeney room visits for cardiovascular diseases in spring and summer while the elevated level of ambient temperature would decrease the hospital emergency room visits for the cardiovascular diseases in autumn and winter,suggesting that patients with cardiovascular diseases should pay attention to the climate change.