本文選題：急性支氣管炎　切入點：時間序列　出處：《安徽醫(yī)科大學》2017年碩士論文

【摘要】：目的:1.了解合肥市兒童急性支氣管炎的流行特征;2.采用時間序列分析方法,探討溫度變化與兒童急性支氣管炎的關系,并且明確相應的易感人群,為開展有效的兒童急性支氣管炎的預防工作提供科學合理的依據。方法:1.從安徽省兒童醫(yī)院搜集2010~2013年的每日合肥地區(qū)兒童急性支氣管炎的就診發(fā)病資料,包括患者姓名,性別,年齡,發(fā)病時間,居住地址等。合肥市氣象局提供了合肥市轄區(qū)內自2010年至2013年的每日詳細氣象數據資料,包括日最高溫度,日平均溫度,日最低溫度,和相對濕度等;2.通過建立急性支氣管炎和氣象變量的時間序列,利用R軟件中分布滯后非線性模型(DLNM)來探索溫度,晝夜溫差(一天內最高溫度與最低溫度的差值)對急性支氣管炎的影響以及是否存在滯后效應;3.將兒童急性支氣管炎發(fā)病資料分別按性別和年齡分為:男性與女性組、0-4歲組和5-14歲組,進一步分析易感人群。結果:1.研究顯示,2010-2013年兒童急性支氣管炎的發(fā)病資料存在一定的季節(jié)性,冬季高發(fā)。2.在研究期間,兒童急性支氣管炎的總發(fā)病數為14055人,平均每日兒童急性支氣管炎患者的就診量為51.9(范圍:0~115)。從性別分組上看,男性兒童患者明顯多于女性兒童患者,比例為2.4:1(9918:4137)。平均溫度、最高溫度和最低溫度的均值分別為3.9℃(范圍:-2.8℃~15.3℃),8.2℃(范圍:-1.1℃~22.3℃)和0.4℃(范圍-8.0℃~11.0℃);相對濕度的平均值為69.5%(范圍:22.0%~100%)。3.溫度與兒童急性支氣管炎發(fā)病率之間存在著非線性關系,其影響是急性的,滯后時間較短。平均溫度的降低能夠顯著增加兒童急性支氣管炎的發(fā)病風險。平均溫度每降低1℃時,滯后效應的最大值在滯后0天,其相對危險度為1.016(95%CI:1.003~1.076)。女性和0-4歲兒童更容易受到溫度的影響。4.晝夜溫差能夠增加兒童急性支氣管炎的發(fā)病風險。晝夜溫差每增加1℃時,滯后效應的最大值在滯后第三天,其相對危險度為1.010(95%CI:1.005~1.016)。女性和0-4歲兒童比其他兒童更容易受到晝夜溫差的影響。結論:1.合肥市兒童急性支氣管炎的發(fā)病高峰期是冬季。2.平均溫度的降低能夠增加兒童急性支氣管炎的發(fā)病風險,其中女性和0-4歲兒童更容易受到低溫的影響。3.隨著晝夜溫差的增大,兒童急性支氣管炎發(fā)病風險也隨之增加,女性和0-4歲兒童對晝夜溫差的變化更加易感。
[Abstract]:Purpose 1.To understand the epidemic characteristics of acute bronchitis in children in Hefei.The relationship between temperature change and acute bronchitis in children was studied by using time series analysis method, and the corresponding susceptible population was identified, which provided a scientific and reasonable basis for the effective prevention of acute bronchitis in children.Method 1: 1.The data of acute bronchitis of children in Hefei from 2010 to 2013 were collected from Anhui Children's Hospital, including patient name, sex, age, onset time, residence address and so on.Hefei Meteorological Bureau provided daily detailed meteorological data from 2010 to 2013, including daily maximum temperature, daily average temperature, daily minimum temperature, and relative humidity.By establishing the time series of acute bronchitis and meteorological variables and using the distributed lag nonlinear model (DLNM) in R software to explore the temperature,The effect of diurnal temperature difference (the difference between the highest and lowest temperatures in a day) on acute bronchitis and whether there is a lag effect.The data of acute bronchitis in children were divided into male and female groups according to sex and age: male and female groups aged 0-4 and 5-14 years old.The result is 1: 1.The study showed that the incidence of acute bronchitis in children from 2010 to 2013 was seasonal, with a high incidence of. 2. 2 in winter.During the study period, the total incidence of acute bronchitis in children was 14055, and the average daily attendance of children with acute bronchitis was 51.9 (range: 0115).In terms of gender groups, male children have more children than women, with a ratio of 2.4: 1 9918: 4137.There is a nonlinear relationship between temperature and the incidence of acute bronchitis in children.A decrease in mean temperature can significantly increase the risk of acute bronchitis in children.When the average temperature decreases by 1 鈩，

本文編號：1716729