CAJ | 학술논문

目的了解中国昆明、长沙、广州和珠海四城市温度在不同滞后日对心脑血管疾病(ICD-10:I00 ～ I99)死亡的影响.方法收集四城市心脑血管疾病死亡与气象资料、大气污染物数据,利用分布滞后非线性模型研究不同城市温度与死亡关系,分析低温、中间温度、高温在不同滞后期对心脑血管疾病死亡的累积效应,并用一般线性阈值模型评估温度对死亡的累积冷热效应.结果四城市温度与死亡关系呈非线性,四城市居民最小死亡风险对应温度分别为长沙22.0℃、昆明20.0℃、广州26.0℃、珠海25.5℃；在研究滞后期间内低温所致最大累积死亡风险值(95％CI)四城市分别为1.858(1.089～ 3.170)、1.537(1.306 ～ 1.809)、2.121(1.771 ～ 2.540)和1.934(1.469 ～ 2.548),高温分别为1.100(0.816 ～1.483)、1.061 (0.956～ 1.177)、1.134(1.047 ～ 1.230)和1.259(1.104 ～ 1.436).温度当天热效应大于冷效应,但随着滞后日增加,热效应迅速下降,而冷效应急剧上升,并持续至3～4周.结论温度与心脑血管疾病死亡呈非线性关系.低温和高温均可增加心脑血管疾病的死亡风险,以低温的影响更显著.冷效应持续时间长,热效应短暂急促.
목적 료해중국곤명、장사、엄주화주해사성시온도재불동체후일대심뇌혈관질병(ICD-10:I00 ～ I99)사망적영향.방법 수집사성시심뇌혈관질병사망여기상자료、대기오염물수거,이용분포체후비선성모형연구불동성시온도여사망관계,분석저온、중간온도、고온재불동체후기대심뇌혈관질병사망적루적효응,병용일반선성역치모형평고온도대사망적루적랭열효응.결과 사성시온도여사망관계정비선성,사성시거민최소사망풍험대응온도분별위장사22.0℃、곤명20.0℃、엄주26.0℃、주해25.5℃；재연구체후기간내저온소치최대루적사망풍험치(95％CI)사성시분별위1.858(1.089～ 3.170)、1.537(1.306 ～ 1.809)、2.121(1.771 ～ 2.540)화1.934(1.469 ～ 2.548),고온분별위1.100(0.816 ～1.483)、1.061 (0.956～ 1.177)、1.134(1.047 ～ 1.230)화1.259(1.104 ～ 1.436).온도당천열효응대우랭효응,단수착체후일증가,열효응신속하강,이랭효응급극상승,병지속지3～4주.결론 온도여심뇌혈관질병사망정비선성관계.저온화고온균가증가심뇌혈관질병적사망풍험,이저온적영향경현저.랭효응지속시간장,열효응단잠급촉.
Objective To estimate the effects of temperature on cardiovascular disease (CVD) deaths in 4 cities-Kunming,Changsha,Guangzhou and Zhuhai,from southern part of China.Methods Daily CVD deaths,meteorological and air pollution data were used to explore the association between temperature and mortality.Distributed lag non-linear model was fitted for each city to access the delayed and cumulative effects of low,median and high temperature on CVD deaths.Cold and hot effects of temperature on CVD deaths were then accessed,based on the linear threshold model.Results The city-specific exposure-response functions appeared to be non-linear.Temperatures that associated with the lowest mortality for Changsha,Kunming,Guangzhou and Zhuhai were 22.0 ℃,20.0 ℃,26.0 ℃,and 25.5 ℃.The greatest cumulative RRs (95％CI) for CVD deaths of low temperature during the delayed period of the study in the 4 cities were 1.858 (1.089-3.170),1.537 (1.306-1.809),2.121 (1.771-2.540) and 1.934 (1.469-2.548),while 1.100 (0.816-1.483),1.061 (0.956-1.177),1.134 (1.047-1.230) and 1.259 (1.104-1.436) for high temperatures in Changsha,Kunming,Guangzhou and Zhuhai respectively.The hot effect was greater than the cold effect on the current days.The hot effect was restricted to the first week,whereas the cold effect increased over the lag days,and then last for 3-4 weeks.Conclusion The city-specific exposure-response functions appeared to be non-linear.Both high and cold temperatures were associated with increased CVD deaths,but the impact of low temperature was more notable.Cold effect was delayed by several days but last for a longer period than the hot effect did.