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大气颗粒物暴露与人体心血管疾病急性效应关系研究的系统评价
作者:常旭红1 2  张钰1 2  吴建茹1 2  王蓓1 2  唐萌1 3 
单位:1. 环境医学工程教育部重点实验室,东南大学公共卫生学院,江苏 南京 210009;
2. 东南大学公共卫生学院 流行病与 卫生统计学系,江苏 南京 210009;
3. 江苏省生物材料与器件重点实验室 东南大学,江苏 南京 210009
关键词:颗粒物 超细颗粒物 心血管疾病 时间序列研究 急性效应 
分类号:R122.7
出版年·卷·期(页码):2012·31·第一期(1-8)
摘要:

目的:回顾总结不同粒径颗粒物对心血管疾病急性有害效应的影响并进行系统评价。方法:选择心血管疾病、颗粒物、时间序列研究等相关检索词,检索PubMed、Web of science、CNKI等数据库,同时手工检索相关杂志和参考文献,对检索文章按颗粒物的空气动力学粒径分为4类:PM10、PM2.5~10、PM2.5、超细颗粒物(UFP);然后对每种粒径的颗粒物根据效应变量(RR或RD)及结局(入院或死亡)进行分类,将符合标准并能够进行Meta分析的文献采用Stata 10.0软件进行定量合成。纳入文献之间的异质性检验采用卡方检验(α=0.10),若检验提示同质性,采用固定效应模型计算合并值和95%CI;若检验提示存在异质性,则使用随机效应模型计算合并值和95%CI。对不符合Meta分析的文献进行定性的系统评价;同时对潜在的发表偏倚进行Begg's秩相关检验分析。结果:对纳入的51篇文献分类整理,将文章中的结果进行合并计算,得出颗粒物与心血管疾病的总效应关系,入院率结果显示:PM10 RD 0.7%(0.1%,1.3%),PM2.5~10 RD 0.3%(0.01%,0.7%),PM2.5 RD 0.9%(0.7%,1.1%);死亡率结果显示:PM10 RR 1.02(1.01,1.03),RD 0.51%(0.36%,0.65%);PM2.5~10 RR 1.024(1.010,1.038),RD 0.3%(0.01%,0.6%);PM2.5 RR 1.013(1.002,1.025),RD 0.86%(0.47%,1.24%)。UFP对人群心血管影响的研究较少,共纳入9篇文献,均提示UFP与心血管疾病有关。结论:颗粒物是人群心血管疾病的危险因素且与其粒径有关,纳米级物质研究成为热点,有关资料目前相对匮乏,将是以后研究重点所在。

Objective: To systematic review the association between atmospheric particulates and cardiovascular disease in acute adverse effects. Methods: Cardiovascular disease, particulate matter, time series and other related search terms were retrieved in PubMed, Web of science, CNKI and other databases. Other related magazines and references were reviewed manually. According to the aerodynamic diameter of particles, the retrieved articles were divided into four categories: PM10, PM2.5-10, PM2.5, ultrafine particles (UFP),then classified by RR or RD and outcome (hospitalization or death). Meta-analysis of the literature was completed by quantitative synthesis using Stata 10.0 software. Chi-square test was used for heterogeneity test (α=0.10), if the result showed homogeneity, we used fixed effects model to combine value and 95% CI, otherwise, random effects model was used to calculate the combined value and 95% CI. Begg's rank correlation test was conducted to analyze the potential publication bias. Results: The 51 selected references were sorted to calculate the total effect of cardiovascular and particulate matter. Hospital admission rates results showed: PM10 RD 0.7%(0.1%,1.3%),PM2.5~10 RD 0.3%(0.01%,0.7%),PM2.5 RD 0.9%(0.7%,1.1%);mortality results showed: PM10 RR 1.02(1.01,1.03),RD 0.51%(0.36%,0.65%),PM2.5~10 RR 1.024(1.010,1.038), RD 0.3%(0.01%,0.6%),PM2.5 RR 1.013(1.002,1.025),RD 0.86%(0.47%,1.24%). There was little research about UFP on cardiovascular effects, nine papers were collected, all inferred that nano-particles were correlated with cardiovascular disease. Conclusions: Particulate matter is the risk factor of cardiovascular disease and related to aerodynamic diameter of particles, more and more researches will focus on the nano-materials.

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