摘要
目的定量分析夏季日温差对呼吸系统疾病门诊就诊量的影响。方法收集浙江省苍南县第三人民医院2010~2013年夏季(7~9月)呼吸系统疾病门诊就诊数据和同期气象日数据,采用广义相加模型,探讨滞后效应和累积效应,分析日温差对呼吸系统疾病就诊量的暴露-反应关系,并进行人群亚组分析。结果研究期间,苍南县日温差的变化范围为1.4℃~11.3℃,苍南县第三人民医院呼吸系统疾病门诊病例27 770例。日温差升高可导致门诊呼吸系统疾病就诊量增加。在滞后4 d出现最大单独效应,在累积13 d出现最大累积效应,RR值分别为1.033(95%CI:1.022~1.045)、1.349(95%CI:1.318~1.381)。累积效应对儿童组(<15岁)的影响较大。结论在苍南县,夏季日温差增大可能导致呼吸系统疾病发病风险增加,并存在滞后性,应特别注意儿童呼吸系统疾病的发作,及时采取积极的应对措施以减少呼吸系统疾病的发生。
Objective To quantitatively analyze the influence of the diurnal temperature range（ DTR） on outpatient visit of respiratory diseases in summer. Methods The outpatient visit data were collected from the electronic medical record（ EMR） of respiratory diseases in the Third Peoples Hospital of Cangnan County,Zhejiang Province,China between July to September in 2010-2013. The daily meteorological data at the same period were collected. Generalized additive model（ GAM） was used to explore the exposure-response relationship between DTR and risk of respiratory diseases,lag effects,cumulative lag effects,and impacts on different populations. Results A total of 27 770 cases of outpatients with respiratory diseases were collected and the DTR varied from 1. 4 ℃ to 11. 3 ℃. Increasing DTR significantly increased the number of outpatient with respiratory diseases with the maximum lag effect at lag 4 days and cumulative lag 13 days. The RRs for outpatient visit were 1. 033（ 95%CI： 1. 022-1. 045） and 1. 349（ 95%CI： 1. 318-1. 381）at lag 4 days and cumulative 13 days,respectively. Children（ 〈15 years old） were more likely to be affected. Conclusion In Cangnan County,the increasing DTR in summer may significantly increase the incidence of respiratory diseases and lag effects exists. Special attention should be paid to the onset of childhood respiratory disease,and more positive measures should be taken to minimize the effect of DTR.
作者
魏然
张安然
李佳蔚
胡文琦
薛莉
林君芬
马伟
WEI Ran;ZHANG Anran;LI Jiawei;HU Wenqi;XUE Li;LIN Junfen;MA Wei(Department of Epidemiology,School of Public Health,Shandong University,Jinan 250012,Shandong,China;Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 310051,Zhejiang,China;Shandong University Climate Change and Health Center,Jinan 250012,Shandong,China)
出处
《山东大学学报（医学版）》
CAS
北大核心
2018年第8期107-113,共7页
Journal of Shandong University:Health Sciences
基金
国家重大科学研究计划(973计划)(2012CB955500-955502)
关键词
日温差
呼吸系统疾病
门诊量
广义相加模型
气象因素
Diurnal temperature range
Respiratory disease
Outpatient visit
Generalized additive model
Meteoro-logical factor
