【摘要】：目的:研究北京市顆粒物污染對(duì)慢性阻塞性肺疾病急性加重(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)的影響,并分析顆粒物污染對(duì)不同特征人群的影響差異。方法:從國(guó)家衛(wèi)生與計(jì)劃生育委員會(huì)醫(yī)療管理服務(wù)指導(dǎo)中心獲取北京市2014年至2015年三甲醫(yī)院AECOPD患者的住院資料,從中國(guó)空氣質(zhì)量監(jiān)測(cè)平臺(tái)獲取同期大氣污染資料,從中國(guó)氣象局獲取同期氣象資料。采用廣義相加Poisson回歸模型,在控制長(zhǎng)期趨勢(shì)、周效應(yīng)、節(jié)假日效應(yīng)、氣象條件等混雜因素后,評(píng)估PM_(2.5)、PM_(10)對(duì)AECOPD住院人次的影響。根據(jù)患者不同特征(性別、年齡)進(jìn)行亞組分析,確定顆粒物污染的高危人群。結(jié)果:納入15家醫(yī)院,共7 884例住院患者,男女比例2.3∶1,65~79歲患者最多(45.5%)、≥80歲(37.1%)次之、65歲(17.4%)最少。PM_(2.5)、PM_(10)日均濃度分別為(77.1±66.6)μg/m~3、(111.9±75.8)μg/m~3,兩者均在移動(dòng)平均滯后4 d時(shí)對(duì)AECOPD的影響最大,即PM_(2.5)日均濃度每增加10μg/m~3,AECOPD住院人次增加0.53%(95%CI:0.01%~1.06%,P=0.0478),PM_(10)日均濃度每增加10μg/m~3,AECOPD住院人次增加0.53%(95%CI:0.07%~1.00%,P=0.025 0)。亞組分析結(jié)果顯示,PM_(2.5)、PM_(10)日均濃度每增加10μg/m~3,女性患者住院人次分別增加1.13%(95%CI:0.19%~2.07%,P=0.018 3)、1.06%(95%CI:0.22%~1.91%,P=0.013 6);≥80歲患者住院人次分別增加1.25%(95%CI:0.40%~2.11%,P=0.004 0)、1.18%(95%CI:0.42%~1.95%,P=0.002 4);而男性、65歲、65~79歲患者中,PM_(2.5)、PM_(10)與AECOPD的關(guān)聯(lián)無(wú)統(tǒng)計(jì)學(xué)意義。由此可見(jiàn),女性、≥80歲患者對(duì)顆粒物污染更敏感。結(jié)論:顆粒物污染會(huì)增加AECOPD住院風(fēng)險(xiǎn),且女性、年老者風(fēng)險(xiǎn)更高。
[Abstract]:Aim: to study the effect of particulate pollution on acute exacerbation of chronic obstructive pulmonary disease (acute exacerbation of chronic obstructive pulmonary disease,AECOPD) in Beijing, and to analyze the effect of particulate pollution on different characteristic population. Methods: the hospitalization data of AECOPD patients in the third Class A Hospital of Beijing from 2014 to 2015 were obtained from the Medical Management Service guidance Center of the National Health and Family Planning Commission, and the air pollution data of the same period were obtained from the China Air quality Monitoring platform. Obtain meteorological data for the same period from the China Meteorological Administration. A generalized additive Poisson regression model was used to evaluate the effects of PM_ (2.5) and PM_ (10) on AECOPD hospitalizations after controlling the long-term trend, week effect, holiday effect and meteorological conditions. Subgroup analysis was carried out according to different characteristics of patients (sex and age) to determine the high risk population for particulate pollution. Results: a total of 7 884 inpatients were included in 15 hospitals. The male / female ratio of 2.3: 1 to 65% was the highest (45. 5%), followed by 鈮，

本文編號(hào)：2335640