大气污染与脑出血急性发作关系的病例交叉研究

目的 探讨大气污染与脑出血急性发作的关系.方法 应用时间分层病例交叉设计,分析杭州市2002-2004年气溶胶光学厚度(AOD)、可吸入颗粒物(PM10)、二氧化硫(SO2)和二氧化氮(NO2)与脑出血急性发作的关系.结果 在调整了气象因素后,不同时间段大气污染对脑出血急性发作的滞后期及OR值均不同.AOD每增加1个单位,上半年(滞后2 d)OR=1.727(95%CI:1.103～2.703),春季(滞后2 d)OR=2.412(95%CI:1.230～4.733),其他时间段OR值无统计学意义(P>0.05);SO2每增加10μg/m3,全年(滞后2d)OR=1.119(95%CI:1.019～1.229),上半年(滞后2d)OR=1.230(95%CI:1.092～1.386),春季(滞后2 d)OR=1.254(95%CI:1.076～1.460),其他时间段OR值无统计学意义(P>0.05);NO2每增加10μg/m3,上半年(滞后2 d)OR=0.841(95%CI:0.734～0.964).其他时间段OR值无统计学意义(P>0.05);PM10各时间段OR值均无统计学意义(P>0.05).结论 杭州市大气污染对脑出血急性发作存在影响,尤其是上半年和春季.

A case-crossover study on the relationship between air pollution and acute onset of cerebral hemorrhage in Hangzhou city

Objective To explore the relationship bet-ween air pollution and acute onset of cerebral hemorrhage in Hangzhou.Methods Time-stratified case-crossover study was used to analyze the effect of aerosol optical depth(AOD),PM10,SO2 and NO2 on the acute onset of cerebral hemorrhage.Conditional logistic regression was used to estimate the odds ratios(Ors) and their 95% confidence intervals(Cis) in relation to an increase of one unit of AOD and 10 μg/m3 of air pollutants.Results After adjusted temperature and relative humidity,the Ors of acute onset of cerebral hemorrhage by a unit increase in AOD at a 2 day-lag were 1.727(95%CI:1.103-2.703)in first half year and 2.412 (95%CI:1.230-4.733) at a 2 day-lag in spring.For a 10 μg/m3 increase in SO2,the Ors were 1.119(95% CI:1.019-1.229),1.230(95%CI:1.092-1.386),1.254(95%CI:1.076-1.460) in the whole year(2 day-lag),in first half year(2 day-lag) and in spring(2 day-lag),respectively.NO2 exposure in first half year(2 day-lag) was associated with cerebral hemorrhage,with OR as 0.841(95% CI:0.734-0.964).However,there were no statistical significances for AOD,SO2,NO2 in the rest time-periods(P>0.05).Additionally,no association was found between PM10 and the acute onset of cerebral hemorrhage in any time-periods(P>0.05).Conclusion Our data showed that there was association between air pollution and the acute onset of cerebral hemorrhage,especially in spring and in the first half of the year.