沈阳市1992—2000年间日平均气温与居民循环系统疾病日均死亡率的关系

目的定量评价沈阳市日平均气温短期变化与城市居民循环系统疾病日均死亡率的关系。方法运用半参数一般递加模型,在控制长期趋势、湿度、气压、工作日和季节等混杂因素的基础上,分析了沈阳市1992年1月1日—2000年12月31日平均气温与居民日循环系统疾病死亡的关系。结果沈阳市全人群循环系统疾病死亡率最低点的气温（最适日均气温）为23.4℃,其中男性最适气温为23.6℃,女性为23.2℃。日平均气温与循环系统疾病死亡率成“V”字型关系,气温变化与循环系统疾病中的心血管疾病死亡率关系较显著,而与脑血管疾病死亡率关系不明显。超过23.4℃后,气温每上升1℃,全人群循环系统日均死亡率增加0.027 5/10万;气温低于23.4℃时,气温每下降1℃,全人群日均死亡率增加0.0062/10万。65岁以上人群对气温变化敏感,特别是对于高温（气温超过26.6℃）,每增加1℃,日均死亡率增加1.1909/10万。65岁以下人群对于气温变化不敏感,无论气温高于或低于最适气温1℃,死亡率改变量均〈0.001 1/10万。男性和女性对于气温变化的敏感程度近似。结论气温变化与城市居民循环系统疾病死亡率变化间的“V”字型关联提示,非极温状态下的气温远离最适气温的变化也可能增加人群循环系统疾病死亡率,而气温靠近最适气温的变化则可能减少人群循环系统疾病死亡率。

A Study on the Association between Ambient Daily Average Temperature and Daily Mortality of Circulatory System Diseases in Shenyang City,1992-2000

Objective To assess the association between air pollution and daily mortality of circulatory system diseases.Methods All death records of the deceased who lived in urban area of Shenyang and died from circulatory system disease during Jan 1,1992 to Dec 31,2000 were collected.We used the semi-parametric generalized additive model to study the relationship between short-term daily average temperature and daily mortality of circulatory system diseases after controlling the confounding factors of long-term trends,humidity,air pressure,work days and season,etc.Results The optimal temperature for all people was 23.4℃.And it was 23.6℃ for male and 23.2℃ for female.A significant graphically ＇V＇ shape relationship between mortality caused by circulatory diseases and ambient temperature was found.The relationship between the temperature changes and the mortality caused by cardiovascular diseases was significant,but not significant with cerebrovascular diseases.The mortality caused by cardiovascular diseases increased 0.0275/100 000 while the temperature increasing each 1℃ above 23.4℃,and increased 0.0062/100 000 while temperature decreasing each 1℃ below 23.4℃.People over 65 years old were the most sensitive population for temperature changing,their mortality caused by cardiovascular diseases increased 1.1909/100 000 when the temperature increasing each 1℃ from 26.6℃.But people under 65 years old were not sensitive to temperature changing,their mortality caused by cardiovascular diseases was all less than 0.0011/100 000 no matter the temperature was higher or lower 1℃ from the optimal temperature.There was no significant difference of the effect of temperature changing on mortality caused by cardiovascular between male and female.Conclusion The ＂V＂ shape relationship between mortality caused by cardiovascular diseases and ambient temperature clues us on that temperature left from the optimal temperature could increase the death rate caused by cardiovascular diseases and temperature closed to the