本文選題：空氣污染 + 顆粒物　； 參考：《華中科技大學(xué)》2013年碩士論文

【摘要】：目的：在固定群組中分析可吸入顆粒物（PM_(10)）和細(xì)顆粒物（PM_(2.5)）與心率變異性（HRV）的關(guān)系，以及顆粒物和Framingham風(fēng)險評分（FRS）對HRV的交互作用。在大樣本的社區(qū)居民中研究尿中羥基多環(huán)芳烴（OH-PAHs）對HRV的影響以及FRS與HRV的關(guān)系，并進一步探討OH-PAHs和FRS對HRV可能存在的聯(lián)合作用。 方法：固定群組研究中選取了82名珠海和70名武漢社區(qū)居民志愿者作為研究對象，采用PM_(10)和PM_(2.5)的個體采樣器以及動態(tài)心電圖儀Holter監(jiān)測24小時顆粒物濃度和HRV，F(xiàn)RS的計算基于年齡、性別、低密度脂蛋白或總膽固醇、高密度脂蛋白、血壓、吸煙和糖尿病七個心血管危險因素。大樣本的社區(qū)居民研究中從武漢兩個社區(qū)共選取了1978名20-74歲、居住年限超過5年的社區(qū)居民作為研究對象。采用Holter測定短時HRV，氣象色譜-質(zhì)譜聯(lián)用儀檢測尿中OH-PAHs的水平。 結(jié)果：固定群組研究中發(fā)現(xiàn)，隨著PM_(10)的增加，武漢居民的TP（P_(trend)=0.005）和LF（P_(trend)=0.041）顯著降低，PM_(10)和FRS對TP和LF有交互作用（P_(interaction)=0.013和P_(interaction)=0.021），但在珠海居民中未發(fā)現(xiàn)類似的結(jié)果。另外，在武漢居民低FRS組中，暴露于高水平PM_(10)的居民其HRV顯著低于暴露于低水平PM_(10)的居民（P=0.023和P=0.004），而在高FRS組中未發(fā)現(xiàn)HRV存在這種差別。在總?cè)巳旱难芯康玫搅伺c武漢類似的結(jié)果。大樣本社區(qū)居民研究中，，尿中四類OH-PAHs和尿中總羥基多環(huán)芳烴（ΣOH-PAHs）之間的相關(guān)具有顯著性，相關(guān)系數(shù)為0.41-0.84。隨著ΣOH-PAHs的增加，LF顯著降低（P_(trend)=0.008）。萘代謝產(chǎn)物（ΣOHNa）與SDNN存在負(fù)向的劑量反應(yīng)關(guān)系（P_(trend)=0.013）。增加的芴代謝產(chǎn)物（ΣOHFlu）與降低的SDNN和LF均存在顯著的劑量反應(yīng)關(guān)系（P_(trend)=0.031和P_(trend)=0.005）。同時，隨著FRS的增加，HRV各指標(biāo)均顯著降低（P_(trend)0.001），而且ΣOHNa和ΣOHFlu分別與FRS對SDNN具有聯(lián)合作用（P_(trend)=0.016和P_(trend)=0.030），ΣOH-PAHs和ΣOHFlu分別與FRS對LF存在聯(lián)合作用（P_(trend)=0.006和P_(trend)=0.005）。 結(jié)論：增加的PM_(10)與降低的HRV存在顯著的劑量反應(yīng)關(guān)系，PM_(10)和FRS對HRV存在交互作用，未發(fā)現(xiàn)PM_(2.5)與HRV有顯著的劑量反應(yīng)關(guān)系。尿中OH-PAHs和FRS均可獨立地引起HRV的改變，而且，OH-PAHs和FRS對HRV的降低有聯(lián)合作用。
[Abstract]:Objective: to analyze the relationship between inhalable particulate matter (PM_ (10)) and fine particulate matter (PM_ (2.5)) and heart rate variability (HRV) in fixed groups, as well as the interaction of particulate matter and Framingham risk score (FRS) on HRV. In the community residents of large samples, the effects of hydroxyl polycyclic aromatic hydrocarbons (OH-PAHs) on HRV and the relationship between FRS and HRV were studied in the community residents of large samples. To further explore the possible joint effects of OH-PAHs and FRS on HRV.
Methods: 82 Zhuhai and 70 Wuhan community residents were selected as subjects in the study. The concentration of particulate matter and HRV were monitored by the individual sampler of PM_ (10) and PM_ (2.5) and the dynamic electrocardiograph (Holter). The calculation of FRS was based on age, sex, low density lipoprotein or total cholesterol, high density lipoprotein. Seven cardiovascular risk factors of blood pressure, smoking and diabetes. A total of 1978 community residents in two communities in Wuhan were selected from two communities in Wuhan. The community residents who lived for more than 5 years were used as the research subjects. The short-term HRV was measured by Holter, and the level of urine in urine was detected by the meteorological chromatography-mass spectrometry.
Results: with the increase of PM_ (10), the TP (P_ (trend) =0.005) and LF (P_ (trend) =0.041) of Wuhan residents decreased significantly. PM_ (10) and FRS were interacted with TP and trend, but no similar results were found among residents in Zhuhai. Residents exposed to high level PM_ (10) were significantly lower than those exposed to low level PM_ (10) (P=0.023 and P=0.004), while the difference in HRV was not found in the high FRS group. The study in the total population was similar to that in Wuhan. In large sample community residents, four types of OH-PAHs and urinary polyhydroxy polycyclic aromatic hydrocarbons (sigma OH-PAHs) in urine were found in the large sample community. The correlation between 0.41-0.84. and LF decreased significantly (P_ (trend) =0.008) with the increase of sigma OH-PAHs. The negative dose-response relationship between naphthalene metabolite (sigma OHNa) and SDNN (P_ (trend) =0.013). The increased fluorene metabolites (sigma OHFlu) were both significantly dose-dependent. 1 and P_ (trend) =0.005). At the same time, with the increase of FRS, each index of HRV is significantly reduced (P_ (trend) 0.001), and the sigma OHNa and the sigma OHFlu are respectively combined with FRS for SDNN.
Conclusion: there is a significant dose response relationship between the increased PM_ (10) and the reduced HRV. PM_ (10) and FRS have interaction with HRV. There is no significant dose response relationship between PM_ (2.5) and HRV. Both OH-PAHs and FRS in urine can independently cause the change of HRV. Moreover, OH-PAHs and FRS have a joint effect on the reduction of HRV.

【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R114

【參考文獻】

相關(guān)期刊論文 前8條

1 李濟超;張曉敏;萬才珍;孫暉;張望珍;潘亞芬;王玉;;焦化作業(yè)工人代謝綜合征與脂肪肝流行病學(xué)研究[J];公共衛(wèi)生與預(yù)防醫(yī)學(xué);2006年02期

2 秦俊法,潘偉清,華棟,李增禧;微量元素與心血管疾病 Ⅱ.微量元素在心血管病中的可能作用及機制[J];廣東微量元素科學(xué);2002年12期

3 朱柏祥;李麗穎;刑永華;趙毅;;心率變異性對心力衰竭病人預(yù)后的預(yù)測[J];航空航天醫(yī)藥;2009年12期

4 譚皓;李濟超;楊曉波;白云;隆宗煈;楊杪;袁晶;鄔堂春;;焦?fàn)t作業(yè)與代謝綜合征的相關(guān)性研究[J];環(huán)境與職業(yè)醫(yī)學(xué);2006年02期

5 田鳳鉎;鄭金平;孫建婭;郭亮;梁華山;鄔堂春;;焦?fàn)t作業(yè)工人高血壓患病率及其危險因素分析[J];山西醫(yī)科大學(xué)學(xué)報;2008年06期

6 陳艷仙;林明裕;;慢性充血性心力衰竭者的心率變異性分析[J];實用心電學(xué)雜志;2009年06期

7 吳稚華;陳序;;冠心病心絞痛及急性心肌梗塞患者的心率變異性特征[J];西部醫(yī)學(xué);2008年03期

8 段斌;;心率變異性與冠心病心電圖心肌缺血的改變[J];中國醫(yī)藥導(dǎo)報;2010年16期

本文編號：1826468