首页|大气CO短期暴露对心力衰竭住院风险的影响

大气CO短期暴露对心力衰竭住院风险的影响

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目的 探讨中国62个城市中大气CO短期暴露对心力衰竭住院的影响.方法 基于China-PEACE心力衰竭回顾研究,纳入2015年1月1日至2015年12月31日62个城市的心力衰竭住院患者,同时获取62个城市每日CO暴露浓度和气象监测数据等资料.采用广义相加模型和贝叶斯层次模型分析大气CO浓度与心力衰竭住院风险的关系,根据年龄、地区和季节对患者进行亚组分析.结果 本研究共纳入了 117 364名心力衰竭患者,在2015年1月1日至12月31日,日均大气CO暴露浓度为1.07 mg/m3.CO浓度每升高1 mg/m3,暴露当天心力衰竭住院的OR值为1.041(95％CI:1.015～1.068).在住院前0～1 d,CO移动平均暴露水平与心力衰竭住院风险的关联有统计学意义(OR=1.032,95％CI:1.001～1.064).亚组分析结果显示,不同季节、不同年龄的亚组人群中,大气CO暴露水平升高均与心力衰竭住院风险的关联有统计学意义.在北方地区CO暴露水平升高可以增加心力衰竭住院风险,而在南方地区,住院日前1 d和前2d对应的CO暴露水平与心力衰竭住院风险的统计学关联相反[OR值分别为1.102(95％C/:1.054～1.153),0.949(95％CI:0.907～0.995)].结论 大气CO短期暴露水平升高可导致心力衰竭住院风险升高.
Association between short-term exposure to atmospheric carbon monoxide and hospitalizations for heart failure
Objective To understand the effect of short-term exposure to atmospheric CO on hospitalization for heart failure among 62 cities in China.Methods Based on the China PEACE retrospective study on heart failure,hospitalized patients with heart failure in 62 cities from January 1,2015 to December 31,2015 were included.In addition,daily CO concentration and meteorological monitoring data were collected.Generalized additive model and Bayesian hierarchical model were employed to assess the association between daily exposure concentration of atmospheric CO and the risk of hospitalization for heart failure,and further stratified analysis by age,geographical region and seasons was conducted.Results A total of 117 364 heart failure patients were included in this study.From January 1,2015 to December 31,2015,the daily average atmospheric CO exposure concentration was 1.07 mg/m3.For each 1 mg/m3 increase in CO concentration,the OR value of hospitalization for heart failure on lag day 0 was 1.041(95％C/:1.015-1.068).At lag 0-1 day,the association between the moving average exposure level of CO and the risk of hospitalization for heart failure was statistically significant[OR=1.032(95％CI:1.001-1.064)].In different subgroups of age and seasons,there were statistically significant associations between the short-term exposure level of atmospheric CO and hospitalization risk of heart failure.Higher exposure level of CO also increased the risk of hospitalization for heart failure in the north.However,in the south,the OR values of hospitalization for heart failure on lag day 0 and lag day 1 were 1.102(95％C/:1.054-1.153)and 0.949(95％CI:0.907-0.995),respectively.Conclusion The present study indicates that the increase in short-term exposure level of atmospheric CO may increase risk of hospitalization for heart failure.

Carbon monoxideHeart failureHospitalizationGeneralized additive modelBayesian hierarchical model

温熙麟、石瑀、李镒冲、符紫薇、陈伯望、吴库生、李静

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汕头大学公共卫生学院,广东汕头 515041

中国医学科学院阜外医院深圳医院

中国医学科学院阜外医院

汕头大学医学院预防医学教研室

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CO 心力衰竭 住院 广义相加模型 贝叶斯层次模型

广东省基础与应用基础研究基金深圳市医疗卫生三名工程深圳市战略性新兴产业发展专项资金("创新链+产业链"融合专项)中国医学科学院阜外医院深圳医院青年英才培育基金

2019A1515111003SZSM201811096ZDYBH201900000007YS-2019-008

2024

10.16241/j.cnki.1001-5914.2024.04.002

环境与健康杂志
中华预防医学会,天津市疾病预防控制中心

环境与健康杂志

CSTPCD
影响因子：0.658
ISSN：1001-5914
年,卷(期)：2024.41(4)
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