重庆市极端温度对心脑血管病死亡影响的时间规律分析

李永红; 罗书全; 和晋渝; 程义斌; 姚孝元; 孙波; 王艳; 金银龙

doi:10.13421/j.cnki.hjwsxzz.2018.06.001

重庆市极端温度对心脑血管病死亡影响的时间规律分析

Time-Regular Pattern Analysis on Effect of Extreme Temperature to the Death of Cerebrovascular and Cardiovascular Diseases in Chongqing

摘要

摘要:
目的探讨"火炉城市"重庆市极端温度与心脑血管疾病死亡之间的关系及其时间规律。
方法收集重庆市2011-2013年心脑血管疾病死亡数据及气象、环保等数据，控制空气污染、时间长期和短期趋势等混杂因素，采用分布滞后非线性模型（DLNM）分析极端温度对心脑血管疾病死亡影响的滞后效应和累积效应。
结果对于脑血管病死亡，高温的影响在当天最大（RR=1.66，95%CI：1.19~2.33）、持续2 d；低温的影响滞后4 d、持续12 d，最大RR值出现在第6天（lag 6）为1.22（95%CI：1.06~1.41）。对于缺血性心脏病死亡，高温的影响在当天最大（RR=1.88，95%CI：1.12~3.15）、持续7 d；低温的影响滞后1 d、持续27 d，其最大RR值出现在第2天（lag 2）为2.05（95%CI：1.32~3.20）。极端高温（34℃）对脑血管病和缺血性心脏病死亡的累积风险分别为2.08（95%CI：1.49~2.90）和2.63（95%CI：1.27~5.42），极端低温（2℃）对两者的累积效应分别为4.61（95%CI：1.85~11.5）和120（95%CI：3.72~463）。
结论极端高温和低温对两种疾病死亡的滞后效应不同；极端低温的累积效应高于极端高温，尤其是对缺血性心脏病死亡的影响。

Abstract:
Objectives To examine the association between extremely cold and hot temperature with mortality of cerebrovascular and cardiovascular diseases and their time-patterns in one of the unbearably hot city Chongqing in China.
Methods The data of cerebrovascular and cardiovascular mortality, meteorology and air pollution in 2011-2013 in Chongqing were collected. A distributed lag non-linear model (DLNM) was used to investigate the lag effect and the cumulative effect of extremely cold and hot temperature on mortality for lag (0~30) days, considering with air pollutants and short-term and long-term time trends as possible confounding factors.
Results The effect of extremely high temperature on the mortality of cerebrovascular diseases lasted for two days (lag 0-1) with a peak RR (1.66, 95%CI:1.19~2.33) at the day (lag 0); the effect of cold delayed by four days and lasted for twelve days (lag 4~15), with the highest risk (RR=1.22, 95%CI:1.06~1.41) at the sixth day (lag 6). The effect of extremely high temperature on the mortality of cardiovascular diseases lasted for seven days with a peak RR (1.88, 95%CI:1.12~3.15) at the day (lag 0); the effect of extremely low temperature delayed by one day and lasted for twenty-seven days, with the highest risk (RR=2.05, 95%CI:1.32~3.20)at the second day (lag 2). The cumulative relative risk of extremely high temperature (34℃) on the mortality of cerebrovascular and cardiovascular diseases were 2.08 (95%CI:1.49~2.90) and 2.63 (95%CI:1.27~5.42), respectively; the cumulative relative risk of extremely low temperature (2℃) on the mortality of cerebrovascular and cardiovascular diseases were 4.61 (95%CI:1.85~11.5) and 120 (95%CI:3.72~463), respectively.
Conclusions Both extremely cold and hot temperature increased the mortality of cerebrovascular and cardiovascular diseases with different patterns in Chongqing. The cumulative effect of extremely low temperature was higher than that of extremely high temperature on the mortality of cerebrovascular and cardiovascular diseases, especially on cardiovascular diseases.

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