[1]邢璐宇陈欣孙洁.天津市细颗粒物短期暴露对慢性心力衰竭患者心力衰竭加重再入院的影响及易感人群的探索[J].心血管病学进展,2022,(9):846-851.[doi:10.16806/j.cnki.issn.1004-3934.2022.09.018]
　XING Luyu,CHEN Xin,SUN Jie.Effect?f?hort-Term?xposure?o?M2.5?n?ianjin?n?eadmission?f?atients?ith?hronic Heart?ailure?nd Exploration?f?usceptible?opulation[J].Advances in Cardiovascular Diseases,2022,(9):846-851.[doi:10.16806/j.cnki.issn.1004-3934.2022.09.018]
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天津市细颗粒物短期暴露对慢性心力衰竭患者心力衰竭加重再入院的影响及易感人群的探索()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2022年9期
页码:
846-851
栏目:
出版日期:
2022-09-25

文章信息/Info

Title:
Effect?f?hort-Term?xposure?o?M2.5?n?ianjin?n?eadmission?f?atients?ith?hronic Heart?ailure?nd Exploration?f?usceptible?opulation
作者:
邢璐宇1陈欣2孙洁1
（1.天津医科大学一中心临床学院，天津 300110；2.天津市第一中心医院心脏科，天津 300110）
Author(s):
XING Luyu 1; CHEN Xin 2; SUN Jie 1
(1.The First Central Clinical College of Tianjin Medical University,Tianjin 300110,China; 2.Cardiology Department,Tianjin First Central Hospital,Tianjin 300110,China)
关键词:
细颗粒物; 心力衰竭; 易感人群
Keywords:
Particulate matter 2.5; Heart failure; Susceptible population
DOI:
10.16806/j.cnki.issn.1004-3934.2022.09.018
摘要:
目的 分析天津市大气污染物细颗粒物（PM2.5）短期暴露对慢性心力衰竭（心衰）患者心衰加重再入院的影响以及是否存在易感人群。方法 收集2018年1月1日—2020年12月31日天津市第一中心医院心脏科每日因心衰入院患者的病历资料，根据纳入和排除标准确定研究对象；收集同期天津市区污染物及气象数据，采用时间分层的病例交叉研究方法比较不同滞后天数(lag0～7)下，天津市PM2.5短期暴露对慢性心衰患者心衰加重再入院的影响以及易感人群特征。结果 研究共纳入1 167例次慢性心衰患者。单污染物模型中，在控制气象混杂因素的情况下，PM2.5短期暴露可导致慢性心衰患者因心衰加重再入院的风险增加，大气PM2.5浓度每升高10μg/m3，慢性心衰加重的再入院风险在lag0、lag2、lag3、lag4、lag5均增加(P＜0.05)，其中最佳滞后期为lag0（OR＝1.029 8,95% CI 1.004 6～1.055 6) 。在多污染物模型中，PM2.5＋可吸入颗粒物（PM10）、PM2.5＋一氧化碳并未增加患者心衰加重再入院的风险。在控制混杂因素的情况下，当PM2.5浓度每升高10μg/m3，年龄≥65岁、既往合并高血压、肺部感染、心衰病因为血管性心脏病的患者更易发生心衰加重再入院。结论 PM 2.5短期暴露会增加慢性心衰患者心衰加重再入院风险，老年人、既往合并高血压、肺部感染以及心衰病因为血管性心脏病的患者更易感。
Abstract:
Objective To?nalyze?he?ffect?f?hort-term?xposure?f?air?ollutant PM2.5 in?ianjin?n?he?eadmission?f?atients?ith?hronic?eart?ailure and?hether?here?s??usceptible?opulation. Methods From?anuary?2018?o?ecember?2020,the?edical?ecords?f?atients?dmitted?o?ospital?or?eart?ailure?n?ardiology Department,Tianjin?irst?entral?ospital were?ollected,and?he?ubjects?ere?etermined?ccording?o?he?nclusion and?xclusion?riteria. At?he?ame?ime,the?ollutants?nd?eteorological?ata?f?ianjin?ere?ollected,and?he?ffects?f?hort-term?xposure?f?M2.5 on?he?eadmission?f?atients?ith?hronic?eart?ailure?nd?he?haracteristics?f?usceptible?opulation?ere?ompared?nder?ifferent?ag?ays by time-stratified case-control study(lag0～7). Results A?otal?f?167?ases?ith?hronic?eart?ailure?ere?ncluded?n?he?tudy.?n the single pollutant model,under the control of meteorological confounding factors,short-term exposure to PM2.5 can increase the risk of readmission of chronic heart failure patients due to worsening heart failure. Every 10μg/m3 increase in atmospheric PM2.5 concentration,the readmission risk of chronic heart failure exacerbation increased in lag0, lag2, Lag3, lag4 and lag5(P＜0.05),and the best lag period was lag0（OR＝1.029 8,95% CI 1.004 6～1.055 6). In?he?ulti-pollutant?odel,PM2.5＋PM10 and?M2.5＋CO?id?ot?ncrease?he?isk?f?eart?ailure?ggravating?eadmission. When the PM2.5 concentration increased by 10μG/m3,patients≥65 years old,with previous hypertension,pulmonary infection,and heart failure due to vascular heart disease are more likely to suffer from worsening heart failure and be readmitted in the case of controlling the confounding factors. Conclusion Short-term?xposure?o?M2.5?ncreases?he?isk?f?eadmission?n?atients?ith?hronic?eart?ailure. The elderly,patients with previous hypertension,pulmonary infection and heart failure due to vascular heart disease are more susceptible.

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备注/Memo

备注/Memo:
收稿日期：2022-04-14
基金项目：天津市气象局科研项目（202003zdxm02）
更新日期/Last Update: 2022-10-24