本文關(guān)鍵詞： 大氣污染物 COPD 時間序列分析 廣義相加模型 PM_(2.5)　出處：《河北醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:了解張家口市2013-2015年大氣污染基本情況,定量評價張家口市大氣污染物(PM_(2.5)、PM10、CO、SO_2、NO_2、O_3)對人群COPD發(fā)病情況及入院人數(shù)的影響。方法:1對張家口市2013.1.1-2015.12.31期間大氣污染物測量數(shù)據(jù)(PM_(2.5)、PM10、CO、SO_2、NO_2、O_3)以及氣象數(shù)據(jù)(主要包括日均氣溫以及相對濕度)進行搜集。2對張家口市某醫(yī)院2013.1.1-2015.12.31期間人群COPD入院人數(shù)信息進行搜集。3通過基于時間序列Poisson分布的廣義可加模型對獲得的資料數(shù)據(jù)(張家口市大氣污染和人群COPD入院人數(shù))展開回歸分析,通過平滑樣條函數(shù)清除各種潛在的混雜因素,比如溫度和長期趨勢等,基于AIC最小原則,對模型應(yīng)用變量及其立方平滑樣條函數(shù)的自由度進行最終明確。結(jié)果:1在2013-2015年期間,張家口市的大氣污染物中PM_(2.5)的年均濃度依次是35.54±22.34μg/m~3、34.9±39.08μg/m~3、34.04±20.45μg/m~3,PM10的年均濃度分別為86.57±53.49μg/m~3、77.47±70.28μg/m~3、77.66±52.12μg/m~3,CO的年均濃度分別為0.77±0.33mg/m~3、1.07±0.59mg/m~3、0.8±0.47mg/m~3,NO_2年均濃度分別為27.89±11.64μg/m~3、28.61±14.64μg/m~3、26.4±14.12μg/m~3,SO_2年均濃度分別為38.71±27.03μg/m~3、53.1±38.55μg/m~3、31.38±20.93μg/m~3,O_3年均濃度分別為109.1±46.33μg/m~3、84.12±37.09μg/m~3、97.15±44.84μg/m~3;2在滯后效應(yīng)單污染模型中,在對多種氣象因素及長期趨勢所產(chǎn)生的影響進行有效管控后,在滯后0天(lag0)時,PM_(2.5)每增加10μg/m~3,患者群體每天COPD入院率增加1.7%(95%CI:0.6%~2.8%);PM10每升高10μg/m~3,人群每日COPD入院率增加1%(95%CI:0.5%~1.5%);co每升高10μg/m~3,人群每日copd入院率增加0.14%(95%ci:0.07%~0.21%);no2每升高10μg/m~3,人群每日copd入院率增加6.4%(95%ci:3.7%~9.2%);so2每升高10μg/m~3,人群每日copd入院率增加2.6%(95%ci:1.4%~3.9%);在滯后5天(lag5)時,o3每升高10μg/m~3,人群每日copd入院率增加1.2%(95%ci:0.2%~2.2%)。3在累積效應(yīng)單污染物模型中,在對多種氣象因素及長期趨勢所產(chǎn)生的影響進行有效管控后,在滯后7天(avg7)時,pm2.5每增加10μg/m~3,患者群體每天copd入院率增加2.3%(95%ci:0.6%~4.1%);pm10每升高10μg/m~3,人群每日copd入院率增加1.9%(95%ci:1%~2.7%);co每升高10μg/m~3,人群每日copd入院率增加0.2%(95%ci:0.1%~0.3%);no2每升高10μg/m~3,人群每日copd入院率增加10.2%(95%ci:5.9%~14.7%);so2每增加10μg/m~3,患者群體每天因copd入院的患者數(shù)量風險就會提高4.6%(95%ci:2.7%~6.6%)。在滯后5天(avg5)時,o3每增加10μg/m~3,患者群體每天因copd入院的患者數(shù)量風險就會提高0.8%(95%ci:-0.6%~2.2%),不過不具備統(tǒng)計學價值。4滯后效應(yīng)雙污染模型中,僅發(fā)現(xiàn)pm2.5在控制了o3的影響時對copd每日入院人數(shù)的影響具有統(tǒng)計學意義(p0.05),人群copd每日入院率相應(yīng)增加1.7%(95%ci:0.6%~2.9%)。發(fā)現(xiàn)pm10在控制了pm2.5、so2、o3的影響時對copd每天入院人數(shù)所產(chǎn)生的影響具有統(tǒng)計學價值(p0.05),在不受pm2.5影響的情況下,pm10每增加10μg/m~3,患者群體copd每日入院率增加1.02%(95%ci:0.03%~2.01%)。在不受so2影響的情況下,pm10每增加10μg/m~3,因copd每天入院的患者數(shù)量風險就會提高1%(95%ci:0.5%~1.5%)。在不受o3影響的情況下,pm10每增加10μg/m~3,因copd每天入院的患者數(shù)量風險就會提高0.06%(95%ci:0%~1.3%)。5累積效應(yīng)雙污染模型中,僅發(fā)現(xiàn)pm2.5在控制了o3的影響時對copd每日入院人數(shù)的影響具有統(tǒng)計學意義(p0.05),人群copd每日入院率相應(yīng)增加2.3%(95%ci:0.6%~4.1%)。發(fā)現(xiàn)pm10在控制了pm2.5、so2、o3的影響時對copd每天入院人數(shù)所產(chǎn)生的影響具有統(tǒng)計學價值(p0.05)。在不受pm2.5影響的情況下,pm10每增加10μg/m~3,患者群體copd每日入院率增加2.8%(95%ci:1.1%~4.6%)。在不受so2影響的情況下,PM10每增加10μg/m~3,因COPD每天入院的患者數(shù)量風險就會提高1.9%(95%CI:1%~2.8%)。在不受O_3影響的情況下,PM10每增加10μg/m~3,因COPD每天入院的患者數(shù)量風險就會提高1.3%(95%CI:0.2%~2.4%)。結(jié)論:1 2013-2015年張家口市PM_(2.5)、PM10年均濃度均接近或高于國家年均濃度二級標準,污染水平不算太高;而CO、SO_2、NO_2和O_3皆達到了國家年均濃度二級標準,其污染性較小。2本研究發(fā)現(xiàn),滯后效應(yīng)中張家口市大氣污染物PM_(2.5)、PM10、CO、SO_2、NO_2、O_3與COPD入院人數(shù)之間有統(tǒng)計學關(guān)聯(lián),且PM_(2.5)、PM10、CO、SO_2、NO_2對COPD入院的最大滯后效應(yīng)出現(xiàn)在當日(lag0),而O_3的最大滯后效應(yīng)出現(xiàn)在滯后第5天(lag5)。得出結(jié)論:PM_(2.5)、PM10、CO、SO_2、NO_2對COPD入院人數(shù)有一定的影響。3本研究發(fā)現(xiàn),累積效應(yīng)中張家口市大氣污染物PM_(2.5)、PM10、CO、SO_2、NO_2與COPD入院人數(shù)之間有統(tǒng)計學關(guān)聯(lián),未發(fā)現(xiàn)O_3與COPD入院人數(shù)之間有統(tǒng)計學關(guān)聯(lián),且PM_(2.5)、PM10、CO、SO_2、NO_2對COPD入院的最大滯后效應(yīng)出現(xiàn)在累積滯后第7天時(avg7)。得出結(jié)論:PM_(2.5)、PM10、CO、SO_2、NO_2對COPD入院人數(shù)有一定的影響。
[Abstract]:Objective: to understand the air pollution in Zhangjiakou city for 2013-2015 years the basic situation of atmospheric pollutants quantitative evaluation of Zhangjiakou city (PM_ (2.5), PM10, CO, SO_2, NO_2, O_3) influence on the population of COPD incidence and hospitalization. Methods: 1 2013.1.1-2015.12.31 in Zhangjiakou city during the air pollutant measurement data (PM_ (2.5), PM10 CO, SO_2, NO_2, O_3), and the meteorological data (including the average air temperature and relative humidity) were collected for.2 in a hospital of Zhangjiakou city during 2013.1.1-2015.12.31 crowd COPD admission information collected by.3 generalized additive model of data obtained from the Poisson distribution based on time series (Zhangjiakou City air pollution and the population of COPD hospital the number of expansion) regression analysis, by smoothing spline function to remove potential confounding factors, such as temperature and long-term trends, based on the principle of minimum AIC, the application of variable model and The cubic smoothing spline function of degree of freedom was finally clear. Results: 1 in a period of 2013-2015 years, air pollution in the city of Zhangjiakou, PM_ (2.5) the annual average concentration was 35.54 + 22.34 g/m~3,34.9 + 39.08 g/m~3,34.04 + 20.45 g/m~3, PM10 concentration was 86.57 + 53.49 g/m~3,77.47 + 70.28 g/m~3,77.66 + 52.12 g/m~3, annual average concentration of CO was 0.77 + 0.33mg/m~3,1.07 + 0.59mg/m~3,0.8 + 0.47mg/m~3, NO_2 annual average concentration was 27.89 + 11.64 g/m~3,28.61 + 14.64 g/m~3,26.4 + 14.12 g/m~3, annual average concentration of SO_2 was 38.71 + 27.03 g/m~3,53.1 + 38.55 g/m~3,31.38 + 20.93 g/m~3, O_3 annual average concentration was 109.1. 46.33 g/m~3,84.12 + 37.09 g/m~3,97.15 + 44.84 g/m~3; 2 in the lag effect of single pollution model, effectively control the impact on the long-term trend and various meteorological factors, at lag 0 Day (lag0), PM_ (2.5) for each additional 10 g/m~3 patients, COPD group daily admission rate increased by 1.7% (95%CI:0.6%~2.8%); PM10 increased 10 g/m~3, 1% COPD daily admission rate increased (95%CI:0.5%~1.5%); CO increased 10 g/m~3, 0.14% COPD daily admission rate increased (95%ci:0.07%~0.21%); NO2 increased 10 g/m~3, 6.4% COPD daily admission rate increased (95%ci:3.7%~9.2%); SO2 increased 10 g/m~3, 2.6% COPD daily admission rate increased (95%ci:1.4%~3.9%); the lag of 5 days (lag5), O3 increased by 10 g/m~3, 1.2% COPD daily admission rate increased (95%ci:0.2%~2.2%) in.3 the cumulative effect of single pollutant model, effectively control the impact on the long-term trend and various meteorological factors, the lag of 7 days (avg7), each additional PM2.5 10 g/m~3, COPD group of patients daily admission rate increased by 2.3% (95%ci:0.6%~4.1%); PM10 increased 10 g/m~3, population COPD daily admission rate increased by 1.9% (95%ci:1%~2.7%); CO increased 10 g/m~3, 0.2% COPD daily admission rate increased (95%ci:0.1%~0.3%); NO2 increased 10 g/m~3, 10.2% COPD daily admission rate increased (95%ci:5.9%~14.7%); SO2 increased 10 g/m~3, group of patients every day because the number of patients with COPD hospitalized will risk 4.6% (95%ci:2.7%~6.6%). The lag of 5 days (avg5), O3 increased by 10 per mu g/m~3, groups of patients every day because the number of patients with COPD hospitalized risk will be increased by 0.8% (95%ci:-0.6%~2.2%), but does not have the effect of double pollution model lag value of.4 was found only in PM2.5, the effect of control effect on O3 COPD daily hospitalization was statistically significant (P0.05), group COPD daily admission rate increased 1.7% (95%ci:0.6%~2.9%). PM10 was found in the control of the PM2.5, SO2, COPD impact on the daily hospitalization O3 the influence of With statistical value (P0.05), was not affected by PM2.5 under the condition of PM10 for each additional 10 g/m~3 patients, group COPD daily admission rate increased by 1.02% (95%ci:0.03%~2.01%). In the case of not affected by SO2, each PM10 increase 10 g/m~3, because the number of patients with risk will be increased by 1% COPD every day of admission (95%ci:0.5%~1.5%). In the case of not affected by O3, each PM10 increase 10 g/m~3, because the number of patients with risk will be increased by 0.06% COPD per day of admission (95%ci:0%~1.3%.5) the cumulative effect of double pollution model, only found PM2.5 in effect control of O3 effect on COPD daily hospitalization was statistically significant (P0.05). The crowd COPD daily admission rate increased 2.3% (95%ci:0.6%~4.1%). PM10 was found in the control of the PM2.5, SO2, has significant influence on the COPD value of every admission number O3 (P0.05). The effect is not affected by PM2.5 in case of PM10 姣忓鍔，

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