CAJ | 학술논문

目的：了解天津市大气污染物对居民心脑血管疾病死亡的急性影响，探索早期预警方法，为心脑血管疾病的预防控制提供依据。 　　方法：采用天津市疾病预防控制中心收集的居民全死因监测数据，气象资料和大气污染物资料来源于天津市气象局和天津市环境监测中心。采用时间序列的泊松回归GAM进行天津市每日大气污染物与居民心脑血管疾病死亡危险度分析，同时控制气象因素、长期趋势、星期几效应以及人口数等混杂因素的影响，进行单污染物和多污染物分析。 　　结果：单因素GAM分析显示大气中SO2、NO2、PM10效应在当日达到最大，风险RR值分别增加1.13%[95%CI （0.76~1.51）%]、0.78%[95%CI（0.41~1.15）%]和0.61%[95%CI（0.51~0.71）%]；SO2、NO2、PM10日均浓度每升高10μg/m3，0~5日后心脑血管疾病死亡的风险RR值分别增加0.70%[95%CI（0.47~0.94）]%，0.51%[95%CI （0.27~0.74）%]和0.16%[95%CI（0.06~0.27）%]；多因素分析显示，SO2、NO2、PM10日均浓度每增加10μg/m3，心脑血管疾病死亡的风险RR值分别增加0.77%[95%CI（0.58~0.97）%]，0.41%[95%CI（0.05~0.78）%]和0.38%[95%CI （0.12~0.64）%]。 　　结论：天津市大气污染物能增加人群心脑血管疾病死亡风险，可能对心脑血管疾病急性发作起到诱导作用，有必要开展大气污染物治理，建立预警系统，合理分配卫生资源，降低心脑血管疾病死亡危害。
목적：료해천진시대기오염물대거민심뇌혈관질병사망적급성영향，탐색조기예경방법，위심뇌혈관질병적예방공제제공의거。 　　방법：채용천진시질병예방공제중심수집적거민전사인감측수거，기상자료화대기오염물자료래원우천진시기상국화천진시배경감측중심。채용시간서렬적박송회귀GAM진행천진시매일대기오염물여거민심뇌혈관질병사망위험도분석，동시공제기상인소、장기추세、성기궤효응이급인구수등혼잡인소적영향，진행단오염물화다오염물분석。 　　결과：단인소GAM분석현시대기중SO2、NO2、PM10효응재당일체도최대，풍험RR치분별증가1.13%[95%CI （0.76~1.51）%]、0.78%[95%CI（0.41~1.15）%]화0.61%[95%CI（0.51~0.71）%]；SO2、NO2、PM10일균농도매승고10μg/m3，0~5일후심뇌혈관질병사망적풍험RR치분별증가0.70%[95%CI（0.47~0.94）]%，0.51%[95%CI （0.27~0.74）%]화0.16%[95%CI（0.06~0.27）%]；다인소분석현시，SO2、NO2、PM10일균농도매증가10μg/m3，심뇌혈관질병사망적풍험RR치분별증가0.77%[95%CI（0.58~0.97）%]，0.41%[95%CI（0.05~0.78）%]화0.38%[95%CI （0.12~0.64）%]。 　　결론：천진시대기오염물능증가인군심뇌혈관질병사망풍험，가능대심뇌혈관질병급성발작기도유도작용，유필요개전대기오염물치리，건립예경계통，합리분배위생자원，강저심뇌혈관질병사망위해。
Objective: To explore the acute effect of air pollution on mortality for patients with cardio cerebral vascular disease and to provide the basis for disease prevention and control. Methods: The Mortality for patients with cardio cerebral vascular disease from 2001-01 to 2009-12 was from Tianjin Centers for Disease Control and Prevention, the meteorological and air pollution data were from Tianjin meteorological bureau and Tianjin environmental monitoring station respectively. The Single and multiple generalized additive model (GAM) extended poisson regression analysis was performed to calculate the relationship between air pollution and cardio-cerebral vascular disease mortality by controlling the time trends, weather, the day of week and air population. Results: Results: Single GAM analysis indicated that when the effect of SO2, NO2 and PM10 in the air reached the maximum in the day, the RR values for the mortality in patients with cardio-cerebral vascular disease increased 1.13%[95%CI (0.76-1.51)%], 0.78% [95%CI ( 0.41-1.15)%] and 0.61% [95%CI ( 0.51-0.71)%] respectively; when the average concentration of SO2, NO2 and PM10 increasing 10μg/m3 per day, after 0-5 days, the RR values for the mortality elevated 0.70% [95%CI (0.47-0.94)%], 0.51% [95%CI (0.27-0.74)%] and 0.16% [95%CI (0.06-0.27)%] respectively. Multiple GAM analysis presented that when SO2, NO2 and PM10 increasing 10 μg/m3 per day, the RR values for the mortality elevated 0.77% [95%CI (0.58-0.97)%], 0.41% [95%CI (0.05-0.78) %] and 0.38% [95%CI (0.12-0.64%)%] respectively. Conclusion: The air pollution could increase the mortality risk in patients with cardio-cerebral vascular disease, it is necessary to establish the prevention system in order to decrease the mortality risk in those patients.