大连市空气污染与急性脑梗死患者发病的相关性
Association between air pollution and acute ischemic stroke occurrence of patients in Dalian
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摘要:
目的 探讨大连市急性脑梗死患者发病与空气污染的相关性。
方法 回顾收集大连市3家三级甲等医院2015年1月1日-12月31日收治的3 578例急性脑梗死患者的住院病历资料，同时收集大连市同期空气污染资料。采用Spearman相关分析评估发病当日PM2.5、PM10、NO2、SO2、CO、O3浓度与急性脑梗死患者发病的相关性。采用1：1配对的病例交叉研究设计，分析发病前0~3日PM2.5浓度与急性脑梗死患者发病的相关性。
结果 急性脑梗死患者的发病数与PM2.5、PM10、NO2、SO2、CO、O3均呈正相关，相关系数分别为0.209、0.122、0.237、0.381、0.272、0.377（均P < 0.05）。大动脉粥样硬化型、心源性栓塞型、小动脉闭塞型脑梗死患者发病数均与各空气污染指标呈正相关（均P < 0.05）。PM2.5、PM10、NO2、SO2与小动脉闭塞型相关性最高，相关系数分别为0.284、0.235、0.280、0.685（均P < 0.05）；CO与心源性栓塞型相关性最高，相关系数为0.210（P < 0.05）；O3与大动脉粥样硬化型的相关系数最高，相关系数为0.684（P < 0.05）。滞后效应分析中PM2.5每升高10 μg/m3时，滞后0日（当天）急性脑梗死患者发病的OR（95%CI）最高，为1.098（1.034~1.166）（P < 0.05）。
结论 大连市急性脑梗死患者的发病与空气污染物的浓度呈正相关，其中PM2.5对急性脑梗死患者的发病无明显滞后效应。
Abstract:Objective To evaluate the association between acute ischemic stroke (AIS) occurrence of patients and air pollution in Dalian.
Methods Our study collected hospital records of 3 578 AIS patients from three tertiary Grade A hospitals in Dalian from January 1 to December 31, 2015 and obtained air pollution data of the same period. Spearman correlation analysis was used to evaluate the associations of PM2.5, PM10, NO2, SO2, CO, and O3 concentration on the same day with the AIS recorded. The 1:1 matched case-crossover study design was applied to determine the risk of AIS in relation to the PM2.5 concentraions of previous three days.
Results The incidence of AIS was positively associated with PM2.5, PM10, NO2, SO2, CO, and O3, and the coefficients of correlation (r) were 0.209, 0.122, 0.237, 0.381, 0.272, and 0.377, respectively (Ps < 0.05). Strokes due to large artery atherosclerosis, cardiac embolism, and small artery occlusion were positively associated with all the studied air pollutants (P < 0.05). To be specific, strokes due to small artery occlusion had higher correlation coefficients with PM2.5 (r=0.284), PM10 (r=0.235), NO2 (r=0.280), and SO2 (r=0.685) (Ps < 0.05); strokes due to cardiac embolism had a higher correlation coefficient with CO (r=0.210) (P < 0.05); strokes due to large artery atherosclerosis had a higher correlation coefficient with O3 (r=0.684) (P < 0.05). Each 10 μg/m3 increase in PM2.5 was most associated with AIS at lag 0 day (current day) (OR=1.098, 95%CI:1.034-1.166) (P < 0.05).
Conclusion The concentrations of air pollutants are positively associated with reported AIS occurrence of patients in Dalian, and PM2.5 has no significant lag effect on the AIS occurrence.
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