2014-2016年铜陵地区昼夜温差对精神分裂症影响的时间序列研究

目的 探讨昼夜温差与精神分裂症每日入院人数之间的关系。方法 收集铜陵市2014-2016三年间的精神分裂症每日入院资料及同期气象、污染物数据，联合应用泊松广义线性回归和分布滞后非线性模型（distributed lag non-linear model，DLNM），控制相对湿度、污染物、季节性、星期几效应和长期趋势，分析昼夜温差对精神分裂症每日入院的影响。结果 本地区昼夜温差达到10.2℃（P₇₅）时，会增加精神分裂症的入院数（RR=1.058，95%CI:1.030~1.088，P=0.026），且风险会随昼夜温差的持续增加而不断升高，此效应在暴露当天即出现，危险效应一直持续到第15天。经性别、年龄以及职业分层后的结果显示，男性和年龄在20~岁的人群更容易受到昼夜温差的影响。在较大的昼夜温差时，农民入院的风险高于其他职业群体。结论 高昼夜温差能增加精神分裂症入院，并存在0~15 d的滞后效应。因此在昼夜温差较大时采取适当的干预措施降低风险意义重大。

A time-series study on the influence of diurnal temperature range on schizophrenia in Tongling City 2014-2016

Objective To explore the relationship between diurnal temperature range (DTR) and daily admission number of schizophrenia. Methods The data of daily admission of schizophrenia and meteorological and pollutant data in the same period of 2014-2016 in Tongling City were collected. The poisson generalized linear regression and the distributed lag nonlinear model (DLNM) were used in combination to control the relative humidity, pollutants, seasonal and long-term trends and other factors, analysis of DTR on schizophrenia daily admission. Results When the DTR reached 10.2℃ (P₇₅), the number of admissions to schizophrenia increased (RR=1.058, 95% CI:1.030-1.088,P=0.026), and the risk increased continuously with the increase of DTR the day of exposure appears and would last until the 15th day. Results of gender, age and occupational stratification showed that males and those aged 20-39 were more susceptible to DTR. At larger DTR, farmers were at higher risk of admission than other occupational groups. Conclusions A large DTR can increase the admission of schizophrenia, and there is a lag of 0-15 days. Therefore, it is of great significance to take appropriate interventions to control the risk brought by the temperature drop when the DTR is large.