Analysis of the influence of meteorological factors on the number of patients with pulmonary heart disease in Liangzhou district of Gansu Province
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摘要:
目的 探讨甘肃省凉州区气象因素对肺心病门诊人数的影响效应。 方法 搜集甘肃省凉州区2014-2016年日气象数据(气温、气压、降水量以及日照时数等)和每日肺心病门诊就医人数，采用分布滞后非线性模型(distributed lag nonlinear model，DLNM)分析气象因子对肺心病门诊就医人数的影响关系及滞后效应。 结果 2014-2016年凉州区肺心病门诊人数合计20 462例，平均日门诊人数为18.67例，肺心病日门诊人数与气温和日照时数均呈正相关，与气压、相对湿度和降水量呈负相关，其中日均气温对肺心病门诊人数影响最大(r=0.133，P < 0.001)。在日平均温度最高，滞后16 d时，相对危险度(relative risk，RR)最高(1.26，95%CI：1.13~1.40)，气温每升高1℃，肺心病门诊人数将增加1.26(95%CI：1.13~1.40)。极端低温(-18℃)时不存在发病危险，在极端高温(29℃)，滞后0~15 d时对肺心病门诊人数的相对危险度达到最大。 结论 气象因子是影响凉州区肺心病门诊人数的重要因素，肺心病的患病风险会因为气温变化而增加，且影响效应会再当天立即发生。高温效应维持时间较短，相对危险度高，而低温对门诊人数的相对危险度则相对较低，并且滞后时间长。 Abstract:Objective To investigate the effect of meteorological factors on the number of outpatients with pulmonary heart disease in Liangzhou district of Gansu province. Methods We collected the daily meteorological data (temperature, air pressure, precipitation, sunshine hours, etc.) of Liangzhou district of Gansu province and the number of daily outpatients with the pulmonary heart disease from 2014 to 2016, and used the distribution lag model to analyze the impact relationship and hysteresis effect of the meteorological factors on the number of outpatients to pulmonary heart disease clinics. Results The total number of outpatients with pulmonary heart disease was 20 462 in Liangzhou district from 2014 to 2016, and the average number of outpatients per day was 18.67. The number of outpatients with pulmonary heart disease per day was positively correlated with temperature and sunshine hours, and negatively correlated with air pressure, relative humidity and precipitation. Among them, the average daily temperature had the most significant effect on the number of outpatients with pulmonary heart disease (r=0.133, P < 0.001). At the highest daily average temperature, lagging 16 days, the relative risk coefficient (RR value) was the highest (1.26, 95% CI: 1.13-1.40). For every 1℃ increase in temperature, the number of outpatients with pulmonary heart disease increased by 1.26 (95% CI: 1.13-1.40). There was no risk of morbidity at an extreme low temperature (-18℃), and the relative risk of the number of the pulmonary heart disease outpatients was the greatest at lag 0-15 at an extreme high temperatures (29℃). Conclusion Meteorological factor is an important factor affecting the number of outpatients with pulmonary heart disease in Liangzhou district. The risk of pulmonary heart disease will increase due to temperature changes, and the impact will occur immediately on the same day. The high temperature effect is short-lived and the relative risk is high, while the relative risk of low temperature to the number of outpatients is relatively low and the lag time is long. -
图 2 2014-2016肺心病门诊人数序列图
Figure 2. Series of the number of patients with pulmonary heart disease from 2014 to 2016
图 3 肺心病日门诊人数与气象因子之间的暴露-反应关系曲线
Figure 3. Exposure-response curve between the number of outpatients on day of pulmonary heart disease and meteorological factors
图 4 日均气温在不同滞后日与肺心病风险关联三维图
Figure 4. Three-dimensional map of daily average temperature associated with pulmonary heart disease risk on different lag days
图 5 特殊滞后时间和温度值的相对风险图
Figure 5. Relative risk plot for specific lag time and temperature values
表 1 肺心病门诊人数分布
Table 1. Time distribution of the number of patients with pulmonary heart disease
季节 年份 合计 2014 2015 2016 春 1 085 2 155 2 263 5 503 夏 851 1 885 2 384 5 120 秋 1 091 2 452 2 513 6 056 冬 651 1 128 2 004 3 783 合计 3 678 7 620 9 164 20 462 
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表 2 凉州区各气象因素的统计性描述
Table 2. Statistical description of various meteorological factors in Liangzhou district
指标 均值 方差 中间值 P25 P75 最小值 最大值 平均气温(℃) 10.03 10.69 11.8 0.7 19.3 -18.1 29.6 日最高气温(℃) 16.69 10.95 18.4 7.6 2.1 -12.3 37.9 日最低气温(℃) 4.35 10.35 5.7 -4.3 13.3 -23.5 24.3 平均气压(hpa) 846.76 5.43 846.4 843.0 850.2 831.3 865.9 最低气压(hpa) 843.98 5.51 843.6 840.1 847.6 829.5 862.5 最高气压(hpa) 849.47 5.81 849.1 845.2 853.4 833.8 869.7 日照时数(0.1 h) 80.33 34.39 86.0 68.0 103.0 0.0 140.0 平均湿度(1%) 45.36 17.28 43.0 33.0 56.0 12.0 98.0 最小湿度(1%) 23.23 14.21 20.0 13.0 30.0 2.0 88.0 降水量(0.1 mm) 5.50 21.24 0.0 0.0 0.0 0.0 278.0
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表 3 肺心病门诊人数与气象因素的相关分析
Table 3. Correlation analysis between the number of outpatients with pulmonary heart disease and meteorological factors
指标 平均气温 日最高气温 日最低气温 平均气压 日最高气压 肺心病门诊人数 0.133 0.129 0.132 -0.032 -0.033 指标 日最低气压 日照时数 平均相对湿度 最小相对湿度 降水量 肺心病门诊人数 -0.040 0.058 -0.003 -0.011 -0.110
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