王欣, 张星光, 高成花, 方鑫. 中国大气PM2.5短期暴露对心血管疾病死亡率影响的meta分析[J]. 环境与职业医学, 2021, 38(1): 17-22. DOI: 10.13213/j.cnki.jeom.2021.20384
引用本文: 王欣, 张星光, 高成花, 方鑫. 中国大气PM2.5短期暴露对心血管疾病死亡率影响的meta分析[J]. 环境与职业医学, 2021, 38(1): 17-22. DOI: 10.13213/j.cnki.jeom.2021.20384
WANG Xin, ZHANG Xingguang, GAO Chenghua, FANG Xin. Effect of short-term atmospheric PM2.5 exposure on cardiovascular mortality in China: A meta-analysis[J]. Journal of Environmental and Occupational Medicine, 2021, 38(1): 17-22. DOI: 10.13213/j.cnki.jeom.2021.20384
Citation: WANG Xin, ZHANG Xingguang, GAO Chenghua, FANG Xin. Effect of short-term atmospheric PM2.5 exposure on cardiovascular mortality in China: A meta-analysis[J]. Journal of Environmental and Occupational Medicine, 2021, 38(1): 17-22. DOI: 10.13213/j.cnki.jeom.2021.20384

中国大气PM2.5短期暴露对心血管疾病死亡率影响的meta分析

Effect of short-term atmospheric PM2.5 exposure on cardiovascular mortality in China: A meta-analysis

  • 摘要: 背景

    细颗粒物(PM2.5)作为大气颗粒物中的主要污染成分,与心血管疾病的发生发展密切相关。

    目的

    探讨中国大气PM2.5浓度对心血管疾病死亡率影响的短期效应。

    方法

    以"PM2.5(fine particlate matter)""大气颗粒物(ambient particulate matters)" "心血管系统疾病(cardiovascular disease)"及"死亡(mortality)"为关键词,检索万方、维普、中国知网、PubMed数据库,纳入2000年1月1日-2020年4月22日期间研究中国大气PM2.5浓度与心血管系统疾病死亡率关系的文献。以PM2.5质量浓度每增加10 μg·m-3人群心血管系统疾病死亡率增加的百分比(ER值)为效应指标,短期效应定义为 < 7 d的效应。采用Stata15.0软件进行meta分析。

    结果

    共检索到581篇文献,最终符合纳入条件的文献18篇。采用随机效应模型对纳入的文献进行合并,发现PM2.5质量浓度每增加10 μg·m-3,心血管疾病死亡率增加0.51%(95%CI:0.37%~0.65%),I2=80.2%。亚组分析依据PM2.5年平均浓度分组后,PM2.5质量浓度≥ 75 μg·m-3组异质性明显降低,不同研究方法、效应类型分组的异质性结果及敏感性检验结果均无明显改变。Egger's检验P < 0.05,存在发表偏倚。

    结论

    PM2.5质量浓度升高可能会增加人群心血管系统疾病死亡率。

     

    Abstract: Background

    Fine particulate matter (PM2.5), the main pollution component of atmospheric particulate matters, is closely related to the occurrence and development of cardiovascular disease.

    Objective

    This study is designed to investigate the short-term effect of atmospheric PM2.5 concentration on cardiovascular mortality in China.

    Methods

    The databases of Wanfang, VIP, China National Knowledge Infrastructure, and PubMed were searched for the literature reporting a relationship between PM2.5 concentration and cardiovascular disease mortality in China since January 1, 2000-April 22, 2020 using fine particulate matter, ambient particulate matters, cardiovascular disease, and mortality as key words in either Chinese or English. The percentage of cardiovascular disease mortality (ER) with each increase of 10 μg·m-3 PM2.5 was used as the effect index. A short-term effect was defined as < 7 d continuous exposure to any index pollutant. Stata 15.0 software was used for meta-analysIs.

    Results

    A total of 581 articles were retrieved, and 18 articles were finally included according to inclusion and exclusion criteria. The random effect model showed that for every 10 μg·m-3 increase in PM2.5, the mortality rate of cardiovascular disease increased by 0.51% (95% CI:0.37%-0.65%), I2=80.2%. After subgrouping PM2.5 annual average concentrations, the heterogeneity of the concentration ≥ 75 μg·m-3 group decreased significantly, and the heterogeneity results of the subgroups of different methods and lag effects and the sensitivity test results were found no significantly change. Egger's test results indicated publication bias (P < 0.05).

    Conclusion

    Higher PM2.5 concentrations may increase the mortality of cardiovascular disease.

     

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