何芬芬, 董意麟, 吕恒, 肖莉萍, 施恒远, 许娟, 朋文佳, 贾贤杰. 山东省平邑县日均气温对心脑血管疾病每日死亡影响的时间序列研究[J]. 蚌埠医学院学报, 2023, 48(5): 646-651. DOI: 10.13898/j.cnki.issn.1000-2200.2023.05.022
    引用本文: 何芬芬, 董意麟, 吕恒, 肖莉萍, 施恒远, 许娟, 朋文佳, 贾贤杰. 山东省平邑县日均气温对心脑血管疾病每日死亡影响的时间序列研究[J]. 蚌埠医学院学报, 2023, 48(5): 646-651. DOI: 10.13898/j.cnki.issn.1000-2200.2023.05.022
    HE Fen-fen, DOND Yi-lin, LÜ Heng, XIAO Li-ping, SHI Heng-yuan, XU Juan, PENG Wen-jia, JIA Xian-jie. Effect of the doily mean temperature on the death of cardiovascular and cerebrovascular diseases in Pingyi, Shandong Province: a time-series study[J]. Journal of Bengbu Medical College, 2023, 48(5): 646-651. DOI: 10.13898/j.cnki.issn.1000-2200.2023.05.022
    Citation: HE Fen-fen, DOND Yi-lin, LÜ Heng, XIAO Li-ping, SHI Heng-yuan, XU Juan, PENG Wen-jia, JIA Xian-jie. Effect of the doily mean temperature on the death of cardiovascular and cerebrovascular diseases in Pingyi, Shandong Province: a time-series study[J]. Journal of Bengbu Medical College, 2023, 48(5): 646-651. DOI: 10.13898/j.cnki.issn.1000-2200.2023.05.022

    山东省平邑县日均气温对心脑血管疾病每日死亡影响的时间序列研究

    Effect of the doily mean temperature on the death of cardiovascular and cerebrovascular diseases in Pingyi, Shandong Province: a time-series study

    • 摘要:
      目的探讨山东省平邑县日均气温对心脑血管疾病每日死亡的影响。
      方法收集2015-2019年该地区心脑血管疾病每日死亡资料和同期气象数据,运用泊松线性回归结合分布滞后非线性模型,在控制季节性、长期趋势和其他气象指标等混杂因素后研究日均气温对每日心脑血管疾病总死亡的滞后与累积影响,同时依据死因和基本人口学特征(性别、年龄、住址)进行分层,以确定易感亚群。
      结果平邑县日均气温与心脑血管总死亡的暴露-响应曲线为倒“J”形,极端气温使心脑血管总死亡风险升高。极端低温具有明显延迟效应,从滞后第2天延续至第10天,效应最强出现在第5天(RR=1.089,95%CI: 1.041~1.140),而极端高温主要是短期即时效应,在当天最强(RR=1.236,95%CI: 1.154~1.324)后下降持续至滞后第4天。极端低温的累积影响在滞后0~21 d最强(RR=2.565,95%CI: 1.300~5.061),极端高温的累积效应在滞后0~7 d达到最大(RR=1.775,95%CI: 1.409~2.237),冷效应累积影响强于热效应。在亚组中,心血管病与女性对冷热更敏感, < 65岁年龄组与城市居民参照各自组别对极端低温更敏感,而≥65岁与农村人群对极端高温更敏感。
      结论极端低温与极端高温均是心脑血管死亡的危险因素,且前者的累积影响更强,持续时间更久。患有心血管病、女性要尤为注意极端温度的影响,65岁以下人群和城市居民需尽量避免寒冷的危害,65岁及以上和农村人群要警惕炎热的不利影响。

       

      Abstract:
      ObjectiveTo explore the impact of daily mean temperature on the daily death of residents with cardiovascular and cerebrovascular diseases (CVD and CBD) in Pingyi County, Shandong Province.
      MethodsThe daily death data of CVD and CBD and meteorological data of the same period from 2015 to 2019 in this region were collected.The Poisson linear regression combined with distributed lag nonlinear model was used to study the lag and cumulative impact of daily mean temperature on total death of CVD and CAD after controlling the confounding factors of seasonality, long-term trends and other meteorological indicators.The susceptible subgroups were identified by stratification based on cause of death and basic demographic characteristics(sex, age and address).
      ResultsThe expose-response curve of daily mean temperature and total CVD and CBD death in Pingyi County was inverted "J" shape, and the extreme temperature increased the risk of total CVD and CBD death.The extreme low temperature had a significant delay effect, which lasted from the second day to the tenth day, and the strongest effect appeared on the fifth day(RR=1.089, 95%CI: 1.041-1.140).However, the extreme high temperature was mainly a short-term immediate effect, which decreased after the maximum on that day (RR=1.236, 95%CI: 1.154-1.324) and lasted until the fourth day behind.The cumulative effect of extreme low temperature was the strongest at 0-21 d(RR=2.565, 95%CI: 1.300-5.061), the cumulative effect of extreme high temperature reached the maximum at 0-7 d(RR=1.775, 95%CI: 1.409-2.237), and the cumulative effect of cold effect was stronger than that of heat effect.In subgroups, the cardiovascular disease and women were more sensitive to cold and heat, people aged less than 65 years old and urban residents were more sensitive to extreme cold for their respective groups, and people aged 65 or older and in rural areas were more sensitive to extreme heat.
      ConclusionsThe extremely low temperature and extremely high temperature are the risk factors of CVD and CBD death, and the cumulative effect of the former is stronger and lasts longer.People with cardiovascular and women need to be particularly aware of the effects of extreme temperatures, while people aged less than 65 years old and urban residents should avoid the harmful effect of cold, and those aged 65 or older and rural areas can strengthen the prevention of heat.

       

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