Particulate Matter and Hospital Admissions for Stroke in Beijing, China: Modification Effects by Ambient Temperature.
Particulate Matter and Hospital Admissions for Stroke in Beijing, China: Modification Effects by Ambient Temperature.
复制标题
中国北京的颗粒物和中风入院情况：环境温度的改变效应
DOI：
10.1161/jaha.116.003437
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发表时间：
2016-07-13
影响因子：
5.4
通讯作者：
Guo X
中科院分区：
文献类型：
--
作者：
Huang F;Luo Y;Guo Y;Tao L;Xu Q;Wang C;Wang A;Li X;Guo J;Yan A;Guo X
颗粒物质（PM）对脑卒中的影响可能因颗粒大小、脑卒中亚型、患者特征和温度而异。我们研究了2013-2014年中国北京不同亚组卒中入院与PM的关系。方法和结果采用时间分层病例交叉设计来评估不同粒径PM与缺血性和出血性卒中住院率之间的关系。按年龄、性别和温度进行分层分析。在研究期间，总共有147624例中风入院。在全期分析中，PM2.5和PM10在入院当天与缺血性卒中入院率呈正相关，在第2天和第3天与缺血性卒中呈负相关。在温暖天气（bb0 - 13.5°C），当天PM2.5 （82.0 μg/m3）、PM2.5 - 10 （36.6 μg/m3）和PM10 （93.5 μg/m3）每增加1 IQR，缺血性卒中入院的比值比分别为2.071 （95% CI 1.959-2.190）、1.470 （95% CI 1.391-1.554）和1.590 （95% CI 1.493-1.694）。出血性卒中的相应值分别为1.941 （95% CI 1.658-2.273）、1.590 （95% CI 1.366-1.851）和1.527 （95% CI 1.278-1.826）。在其他滞后结构中也观察到正相关，且高于寒冷天气（≤13.5°C）。本研究表明，PM2.5、PM2.5 - 10和PM10与卒中入院的关系在不同温度水平下存在差异。短期暴露于PM2.5、PM2.5 - 10和PM10与温暖天气（>13.5°C）缺血性和出血性中风住院率呈正相关。
Background The impact of particulate matter (PM) on stroke may vary by particle size, stroke subtype, and patient characteristics and temperature. We examined the association of stroke admissions with PM in different subgroups in Beijing, China, during 2013–2014. Methods and Results A time‐stratified case‐crossover design was used to assess the relation between PM of different particle sizes and hospital admissions for ischemic and hemorrhagic stroke. Stratified analyses were performed by age, sex, and temperature. In total, there were 147 624 stroke admissions during the study period. In the whole‐period analysis, both PM2.5 and PM10 were positively associated with ischemic stroke admissions on the day of hospital admission and negatively associated with ischemic stroke at lag2 and lag3 day. In warm days (>13.5°C), the odds ratios of ischemic stroke admissions were 2.071 (95% CI 1.959–2.190), 1.470 (95% CI 1.391–1.554), and 1.590 (95% CI 1.493–1.694) per IQR increase in the same‐day PM2.5 (82.0 μg/m3), PM2.5–10 (36.6 μg/m3), and PM10 (93.5 μg/m3), respectively. For hemorrhagic stroke, the corresponding values were 1.941 (95% CI 1.658–2.273), 1.590 (95% CI 1.366–1.851), and 1.527 (95% CI 1.278–1.826). The positive associations were also observed in the other lag structures and were higher than in cold days (≤13.5°C). Conclusions This study suggests that the associations of PM2.5, PM2.5–10, and PM10 with stroke admissions differed across levels of temperature. Short‐term exposure to PM2.5, PM2.5–10, and PM10 was positively associated with hospital admissions for ischemic and hemorrhagic stroke on warm days (>13.5°C).