南京市大气NO<sub>2</sub>对缺血性心脏疾病患者死亡的影响分析-东南大学学报医学版

南京市大气NO₂对缺血性心脏疾病患者死亡的影响分析

单位：1. 南京市疾病预防控制中心环境卫生科, 江苏南京 210003;
2. 国家卫生健康委计划生育药具不良反应监测中心/江苏省卫生健康发展研究中心流行病学研究部, 江苏南京 210036

分类号：R122; R541

出版年·卷·期（页码）：2023·42·第六期（885-889）

摘要：

目的:探讨大气二氧化氮(NO₂)对居民缺血性心脏疾病死亡的影响。方法:收集南京市大气主要污染物的日均质量浓度、日平均温度和人群每日缺血性心脏疾病死亡人数等。采用广义相加模型,分析大气NO₂与人群每日缺血性心脏疾病死亡人数的关系、滞后效应及影响。结果:2013—2020年南京市大气NO₂的日均质量浓度为44.11 μg·m^-3。期间共记录35 961条缺血性心脏疾病死亡病例,平均每天12例,其中年龄>65岁死亡数为31 455例(占87.47%)。大气NO₂质量浓度每增加10 μg·m^-3时,全人群缺血性心脏疾病死亡的风险升高2.29%(95%CI:1.48%~3.10%),其中女性风险明显高于男性(P＜0.05);＞65岁人群风险显著高于≤65岁人群(P＜0.05)。结论:南京市大气NO₂污染仍须进一步监测及治理,大气NO₂污染可能增加人群缺血性心脏疾病死亡的风险,尤其对女性和＞65岁老年人群的影响更为明显。

Objective: To investigate the effect of atmospheric nitrogen dioxide(NO₂) on ischemic heart disease mortality. Methods: The daily average concentrations of major atmospheric pollutants, daily average temperature and daily ischemic heart disease deaths in Nanjing were collected.The generalized additive model was used to analyze the relationship between NO₂ and daily ischemic heart disease mortality, the lag effect and related influencing factors. Results: The daily average concentration of atmospheric NO₂ in Nanjing from 2013 to 2020 was 44.11 μg·m^-3.A total of 35 961 deaths from ischemic heart disease were recorded during the study period, with an average of 12 cases per day. Among them, 31 455 cases(87.47%) died of age over 65 years old.For every 10 μg·m^-3 increase in atmospheric NO₂ concentration, the risk of ischemic heart disease death in the whole population increased by 2.29%(95%CI:1.48%-3.10%). The risk of ischemic heart disease death in women was significantly higher than that in men(P<0.05), and the risk of ischemic heart disease death in people over 65 years old was significantly higher than that in people ≤65 years old(P<0.05). Conclusion: The atmospheric NO₂ pollution in Nanjing still needs further monitoring and control.Atmospheric NO₂ pollution may increase the risk of ischemic heart disease death inNanjing, especially for women and the elderly over 65 years old.

参考文献：

[1] ROTH G A,MENSAH G A,JOHNSON C O,et al.Globalburden of cardiovascular diseases and risk factors,1990-2019:update from the GBD 2019 study[J].J Am Coll Cardiol,2020,76(25):2982-3021.
[2] Institute for Health Metrics and Evaluation,University of Washington.GBD 2019[EB/OL].(2020-10-15)[2023-02-01].https://vizhub.healthdata.org/gbd-compare/.
[3] Health Effects Institute,Institute for Health Metrics and Evaluation.State of global air 2020:a special report on global exposure to air pollution and its health impacts[R].Boston,MA:Health Effects Institute,2020.
[4] 符建华,周方召.中国省域空气质量测度及影响因素分析[J].城市问题,2020(5):20-27.
[5] COLLABORATORS G B D R F.Global burden of 87 risk factors in 204 countries and territories,1990-2019:a systematic analysis for the global burden of disease study 2019[J].Lancet,2020,396(10258):1223-1249.
[6] 贾云飞,陈春静,唐彦钊,等.南京市大气臭氧与人群循环系统疾病死亡的时间序列分析[J].环境与健康杂志,2020,37(1):42-46.
[7] 樊琳,顾清,曾强.广义相加模型在大气污染流行病学研究中的应用进展[J].环境与职业医学,2019,36(7):676-681.
[8] 班婕,李湉湉.北京市不同度量方式下臭氧短期暴露人群急性健康效应研究[J].环境与健康杂志,2016,33(4):287-291.
[9] 周少磊,刘波.2017—2019年北京市通州区PM_2.5浓度污染特征及与支气管哮喘门诊量的关系研究[J].河南预防医学杂志,2022,33(9):657-661.
[10] 杜冰倩,任志强,夏云,等.宁波市气象因素与空气污染对死亡影响的交互作用研究[J].现代预防医学,2022,49(16):2886-2892.
[11] 张莉君,东春阳,许慧慧,等.上海市大气污染与某综合医院儿科呼吸系统疾病门诊人次的关系[J].环境与职业医学,2020,37(8):741-746.
[12] 陈瑞,孙建云,魏巧珍,等.2014—2020年兰州市大气污染物特征及变化趋势分析[J].卫生研究,2021,50(5):769-774.
[13] 张敏,陆艳,姚玉刚,等.大气气态污染物与苏南某市居民心脏病日死亡数关系的研究[J].东南大学学报(医学版),2016,35(2):211-214.
[14] 蔡东杰,杨军,黄琳,等.广州市大气NO₂污染对暴露人群不同疾病死亡的影响[J].中国环境科学,2022,42(8):3950-3956.
[15] SZYSZKOWICZ M.Air pollution and emergency department visits for ischemic heart disease in Montreal,Canada[J].Int J Occup Med Environ Health,2007,20(2):167-173.
[16] BECKERMAN B S,JERRETT M,FINKELSTEIN M,et al.The association between chronic exposure to traffic-related air pollution and ischemic heart disease[J].J Toxicol Environ Health A,2012,75(7):402-411.
[17] STIEB D M,ZHENG C,SALAMA D,et al.Systematic review and meta-analysis of case-crossover and time-series studies of short term outdoor nitrogen dioxide exposure and ischemic heart disease morbidity[J].Environ Health,2020,19(1):47.
[18] STIEB D M,BERJAWI R,EMODE M,et al.Systematic review and meta-analysis of cohort studies of long term outdoor nitrogen dioxide exposure and mortality[J].PLoS One,2021,16(2):e0246451.

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