大气可吸入颗粒物与心脑血管疾病急诊关系的病例交叉研究

目的 探讨北京市大气可吸入颗粒物污染(PM10)对心腩血管疾病急诊的影响.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和北京市环境监测中心大气污染物数据,应用时间分层的病例交叉设计研究方法进行数据分析.结果 无滞后单向同顾性1:4配对病例交叉研究的效应值(OR值)最大,在控制所选PM10当日气温、相对湿度影响的情况下,PM10浓度每提高10μg/m3与心脑血管疾病急诊(ICD-10:I00-I99)、冠心病急诊(ICD-10:120-125)、心律失常急诊(ICD-10:147-149)、心衰急诊(ICD-10:150)和脑血管疾病急诊(ICD-10:160-169)的OR值分别为1.006(95%CI:1.003～1.008)、1.003(95%CI:0.996～1.010)、1.005(95%CI:0.997～1.013)、1.019(95%CI:1.005～1.033)、1.003(95%CI:0.998～1.007),其中PM10与总心脑血管疾病急诊和心衰急诊的关联有统计学意义(P<0.05).结论 大气PM10污染物浓度升高可导致总心脑血管疾病急诊和心衰急诊增加.

Association between the concentration of particulate matters and the hospital emergency room visits for circulatory diseases: a case-crossover study

Objective To explore the association between the concentration of particulate matters with an aerodynamic diameter of <10 μm ( PM10 ) and the hospital emergency room visits for circulatory diseases ( International Classification of Diseases, tenth vision ICD-10 : 100-199) in Beijing, China. Methods We collected data for daily hospital emergency room visits of circulatory diseases ( ICD-10:I00-I99 ) from Peking University Third Hospital and from the ambient air PM10 through the Beijing Municipal Environmental Monitoring Center. A time-stratified case-crossover design was used to evaluate associations between circulatory disease health outcomes and PM10.Results The no-lagged unidirectional case-crossover design with 1:4 matched pairs had the highest odds ratios (ORs) between PM10 and the hospital emergency room visits for circulatory diseases. After adjusting the temperature and the relative humidity, a 10μg/m3 increased in the PM10 were found associated with the emergency room visits on value of ORs of 1.006(95% CI:1.003-1.008) for the total circulatory diseases ( ICD-10:I00-I99), 1.003 (95% CI:0.996-1.010) for coronary heart disease ( ICD-10:I20-I25 ), 1.005 ( 95 % CI:0.997-1.013 ) for cardiac arrhythmia ( ICE)-10:I47-I49), 1.019 (95 % CI:1.005-1.033 ) for heart failure disease ( ICD-10:I50 ),and 1.003 ( 95 % CI : 0.998-1.007 ) for cerebrovascular diseases ( ICD-10:I60-I69 ), respectively. Conclusion These findings suggested that elevated levels of ambient PM10 were positively associated with hospital emergency room visits for the total number of circulatory diseases and heart failure disease.