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    扬州市大气NO2与脑卒中急性发病的时间序列研究

    A time series analysis of atmospheric nitrogen dioxide and acute onset of stroke in Yangzhou, China

      摘要
    • 摘要:
      目的 分析扬州市大气NO2暴露对脑卒中急性发病的影响，为脑卒中防治宣传政策的制定及疾病预防提供科学依据。
      方法 基于江苏省慢性病管理信息平台收集扬州市2020年1月1日—2022年12月31日脑卒中急性发病数据，同时从扬州市生态环境局和扬州市气象局获取大气污染数据(PM2.5、PM10、SO2、NO2、CO、O3)和气象数据(日均气温、相对湿度)，采用时间序列分析方法研究NO2对脑卒中发病的影响。
      结果 2020—2022年扬州市的NO2日均浓度M为25.1 μg/m3。单污染物模型中，NO2浓度(lag02 d)每升高10 μg/m3，居民脑卒中发病风险增加1.91%(95%CI：0.50%~3.32%)；双污染物模型中，在控制其他污染物的混杂影响后，NO2与脑卒中急性发作之间的正相关联仍然稳定。亚组分析显示，NO2对不同性别、不同文化程度人群脑卒中发病风险均有统计学意义，其中，对女性、小学及以下文化程度人群影响更大。NO2浓度(lag02 d)每升高10 μg/m3，女性的发病风险增加2.20%(95%CI：0.47%~3.93%)，小学及以下文化程度人群脑卒中发病风险增加5.84%(95%CI：2.31%~9.38%)。NO2对≥65岁人群脑卒中发病风险的影响有统计学意义，NO2每升高10 μg/m3，≥65岁居民脑卒中发病风险增加2.34%(95%CI：0.83%~3.85%)。NO2对脑梗死发病风险的影响有统计学意义，NO2每升高10 μg/m3，脑梗死发病风险增加2.31%(95%CI：0.76%~3.86%)。
      结论 扬州市NO2可能会增加脑卒中急性发病的风险，尤其是脑梗死。女性、≥65岁、小学及以下文化水平人群对NO2浓度上升导致的脑卒中急性发作更易感。

       

      Abstract:
      Objective To investigate the influence of atmospheric nitrogen dioxide (NO2) exposure on the acute onset of stroke in Yangzhou, China, and to provide a scientific basis for formulating propaganda policies for the prevention and treatment of stroke and strengthening disease prevention.
      Methods The Chronic Disease Management Information Platform of Jiangsu Province was used to collect the data on the acute onset of stroke in Yangzhou City from January 1, 2020 to December 31, 2022, and meanwhile, air pollution data (PM2.5, PM10, SO2, NO2, CO, O3) and meteorological data (mean daily temperature and relative humidity) were obtained from Yangzhou Ecological Environment Bureau and Yangzhou Meteorological Bureau, respectively. A time series analysis was performed to investigate the influence of NO2 on the onset of stroke.
      Results The median of daily concentration of NO2 was 25.1 μg/m3 in Yangzhou in 2020—2022. In the single-pollutant model, the risk of stroke among residents was increased by 1.91% (95% confidence interval CI: 0.50%-3.32%) for every 10 μg/m3 increase in NO2 concentration (lag02 d), and in the dual-pollutant model, the positive association between NO2 and the acute onset of stroke remained stable after control of the confounding effects of other pollutants. The subgroup analysis showed that NO2 had statistically significant effects on stroke risk in people with different gender and education levels, among which the effect was more significant in female and people with primary school education or below. For every 10 μg/m3 increase in NO2 concentration (lag02 d), the risk of stroke was increased by 2.20% (95%CI: 0.47%-3.93%) in female, and the risk of stroke was increased by 5.84% (95%CI: 2.31%-9.38%) in people with primary school education or below. NO2 had a statistically significant effect on stroke risk in patients ≥65 years old. For every 10 μg/m3 increase in NO2, the risk of stroke in patients ≥65 years old increased by 2.34% (95%CI: 0.83%-3.85%). The effect of NO2 on the risk of cerebral infarction was statistically significant, and the risk of cerebral infarction increased by 2.31% for every 10 μg/m3 increase in NO2 (95%CI: 0.76%-3.86%).
      Conclusion NO2 in Yangzhou may increase the risk of acute stroke, especially cerebral infarction. Female, people ≥65 years of age, and people with primary school education and below are more susceptible to acute stroke caused by increased NO2 levels.

       

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