基于广义线性混合模型分析可吸入颗粒物对儿童肺功能的影响

目的采用广义线性混合模型,探讨可吸入颗粒物(PM)对儿童肺功能的影响。方法 2005-2006年,采用多阶段随机抽样的方法,招募6~8岁儿童1 000名,采用问卷调查的形式,收集人口和社会经济学特征、生活方式和病史的信息,并每年进行1次体检,直至研究对象年满17岁;采用肺功能测定仪检测每名儿童的1秒用力呼气量(FEV1)、用力肺活量(FVC)和峰值呼气流量(PEF),每名受试者进行3次肺功能测试,取平均值。采用广义线性混合模型探讨PM对儿童肺功能的影响。结果截至2017年,共有912名研究对象完成随访,随访率91.2%。广义线性混合模型分析表明,PM2.5每增加5μg/m^3,FVC下降1.26%,FEV1下降1.51%,FEF下降1.39%。PM10每增加5μg/m^3,FVC下降1.35%,FEV1下降1.63%,FEF下降1.43%。亚组分析表明,在暴露于二手烟的儿童中,可吸入颗粒物对肺功能影响更加显著(P值均<0.001)。结论 PM浓度与儿童肺功能指标呈负相关,PM浓度增加可导致儿童肺功能降低。

Effects of particulate matter on lung function in children based on generalized linear mixed model

Objective To investigate the effects of particulate matters(PM)on lung function in children based on generalized linear mixed model.Methods The multi-stage random sampling method was used to recruit 1 000 children aged 6 to 8 years from 2005 to 2006.Self-administrated questionnaire was used to collect each individual’s information on the demographic and socioeconomic characteristics,lifestyle,and medical history.All participants underwent physical examination annually until they were 17 years old.The forced expiratory volume in 1 sec(FEV1),forced vital capacity(FVC)and peak expiratory flow(PEF)were measured by pulmonary function tester.Each participant took three pulmonary function tests,and the average value was used for analysis.The generalized linear mixed model was adopted to investigate the effects of PM on lung function in Children.Results By 2017,a total of 912 participants completed the follow-up study,with a follow-up rate of91.2%.Generalized linear mixed model analysis showed that every 5μg/m^3 increment of PM2.5 was associated with 1.26%decline of FVC,1.51% decline of FEV1,and 1.39% decline of FEF.Every 5μg/m^3 increment in PM10 was associated with1.35% decline of FVC,1.63% decline of FEV1,and 1.43% decline of FEF.Subgroup analysis suggested that children exposed to second smoking were more sensitive to effect of PM on lung function(all P<0.001).Conclusion The PM concentration is negatively correlated with children′s lung function indexes,and increased PM concentration may lead to decreased lung function in children.