兰州市气温和相对湿度对慢性阻塞性肺疾病患者门诊就诊人次的影响及其交互效应

doi:10.19723/j.issn.1671-167X.2020.02.019

北京大学学报（医学版） ›› 2020, Vol. 52 ›› Issue (2): 308-316. doi: 10.19723/j.issn.1671-167X.2020.02.019

兰州市气温和相对湿度对慢性阻塞性肺疾病患者门诊就诊人次的影响及其交互效应

包海荣¹,刘晓菊¹,谭恩丽¹,舒娟¹,董继元^2,^△(),李盛³

^1. 兰州大学第一医院老年呼吸科, 兰州 730000
^2. 兰州大学公共卫生学院劳动卫生与环境卫生学研究所, 兰州 730000
^3. 兰州市疾病预防控制中心, 兰州 730000

收稿日期:2019-08-06 出版日期:2020-04-18 发布日期:2020-04-18
通讯作者: 董继元 E-mail:yuiopdongjiyuan@163.com
基金资助:
甘肃省自然科学基金(18JR3RA354);兰州市科技计划项目(2018-3-74);兰州市城关区科技计划项目(2018-7-10);兰州市城关区科技计划项目(2018-7-13)

Effects of temperature and relative humidity on the number of outpatients with chronic obstructive pulmonary disease and their interaction effect in Lanzhou, China

Hai-rong BAO¹,Xiao-ju LIU¹,En-li TAN¹,Juan SHU¹,Ji-yuan DONG^2,^△(),Sheng LI³

^1. Department of Gerontal Respiratory Medicine, The First Hospital of Lanzhou University, Lanzhou 730000, China
^2. Institute of Occupational and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, China
^3. Lanzhou Center for Disease Prevention and Control, Lanzhou 730030, China

Received:2019-08-06 Online:2020-04-18 Published:2020-04-18
Contact: Ji-yuan DONG E-mail:yuiopdongjiyuan@163.com
Supported by:
Supports by the Natural Science Foundation of Gansu Province(18JR3RA354);Science and Technology Plan Projects of Lanzhou(2018-3-74);Science and Technology Project of Chengguan District, Lanzhou(2018-7-10);Science and Technology Project of Chengguan District, Lanzhou(2018-7-13)

摘要/Abstract

摘要：

目的解日均气温,日均相对湿度与慢性阻塞性肺疾病患者门诊就诊人次的关系,以及日均气温,日均相对湿度的影响是否存在滞后效应.方法: 采用泊松广义线性回归模型结合分布滞后非线性模型分析 2013年1月至2017年12月兰州市日均气温,日均相对湿度及其交互作用对慢性阻塞性肺疾病患者门诊就诊人次的影响.结果: 日均气温与慢性阻塞性肺疾病的门诊就诊人次呈非线性关系,-12 ℃~-8 ℃时门诊就诊人次随着日均气温的下降而逐渐增加,气温每下降1℃,慢性阻塞性肺疾病门诊就诊人次增加11.60%.日均相对湿度对慢性阻塞性肺疾病的门诊就诊人次也呈非线性影响,日均相对湿度在15%~28%范围时,门诊就诊人次随着相对湿度的降低而逐渐增加,相对湿度每下降1%,慢性阻塞性肺疾病门诊就诊人次增加37.05%.气温与相对湿度对慢性阻塞性肺疾病的影响存在交互作用,即不同相对湿度条件下,气温作用有所差异,当日均相对湿度≤50%,日均气温≤11 ℃时,气温的效应最明显,气温每下降1 ℃,慢性阻塞性肺疾病日门诊就诊人次全人群增加12.68%,男性5.62%,女性7.56%,<65岁人群5.24%,≥65岁人群14.74%.当日均相对湿度>50%,日均气温≤11 ℃时,气温每下降1 ℃,慢性阻塞性肺疾病日门诊就诊人次全人群增加9.00%,<65岁人群7.11%,≥65岁人群10.93%.当日均相对湿度>50%,日均气温>11 ℃时和日均相对湿度≤50%,日均气温>11 ℃时,气温对慢性阻塞性肺疾病日门诊就诊人次无影响.结论: 日均气温与日均相对湿度有一定的交互作用,低温干燥(相对湿度≤50%,气温≤11 ℃时)环境和低温高湿(相对湿度>50%,气温≤11 ℃时)环境均可增加慢性阻塞性肺疾病患者门诊就诊风险.

关键词: 气温, 相对湿度, 交互作用, 慢性阻塞性肺疾病

Abstract:

Objective: To understand the relationships of daily average temperature and relative humi-dity with outpatient visit frequency of patients with chronic obstructive pulmonary disease, and whether temperature and relative humidity have a lag effect.Methods: The effects of daily average temperature, relative humidity, and their interaction in Lanzhou between January 2013 and December 2017 on the outpatient visit frequency of chronic obstructive pulmonary disease patients were analyzed using Poisson generalized linear regression model combined with distributed lag non-linear model.Results: There was a non-linear relationship between the daily average temperature and the outpatient visit frequency of chronic obstructive pulmonary disease patients. Between -12 ℃ and -8 ℃, the outpatient visit frequency increased gradually with the decrease of the daily average temperature, and the outpatient visit frequency of chronic obstructive pulmonary disease patients increased by 11.60% per 1 ℃ of temperature drop. The daily average relative humidity also presented a non-linear effect on the outpatient visit frequency chronic obstructive pulmonary disease patients. When the daily average relative humidity was in the range of 15%-28%, the outpatient visit frequency increased gradually with the decrease of relative humidity, and the outpatient visit frequency of COPD patients increased by 37.05% for every 1% decrease of relative humidity. A synergistic effect was found between air temperature and relative humidity on chronic obstructive pulmonary disease, that is, under different relative humidity, the effect of air temperature was different. When the daily average relative humidity ≤ 50% and the daily average temperature≤11 ℃, the effect of air temperature was the most obvious. For every 1 ℃ drop in temperature, the daily out-patient visit frequency of the whole population increased by 12.68% (5.62% in males and 7.56% in females; 5.24% in population < 65 years and 14.74% in population ≥ 65 years). When the daily average relative humidity > 50% and the daily average temperature ≤ 11 ℃, the daily outpatient visit frequency of the whole population increased by 9.00% for every 1 ℃ drop in temperature (< 65 years, 7.11%; ≥65 years, 10.93%). When the daily average temperature > 11 ℃, the temperature had no effect on the daily outpatient visit frequency of chronic obstructive pulmonary disease patients under different relative humidity.Conclusion: The presence of a certain extent of interaction is observed between daily average temperature and relative humidity. Low-temperature and dry environment (relative humidity ≤50%, temperature ≤11 ℃) as well as low-temperature and high-humidity environment (relative humidity > 50%, temperature ≤11 ℃) can both increase the risk of outpatient visit in chro-nic obstructive pulmonary disease patients.

Key words: Temperature, Relative humidity, Interaction, Chronic obstructive pulmonary disease

中图分类号:

R122.7

包海荣,刘晓菊,谭恩丽,舒娟,董继元,李盛. 兰州市气温和相对湿度对慢性阻塞性肺疾病患者门诊就诊人次的影响及其交互效应[J]. 北京大学学报（医学版）, 2020, 52(2): 308-316.

Hai-rong BAO,Xiao-ju LIU,En-li TAN,Juan SHU,Ji-yuan DONG,Sheng LI. Effects of temperature and relative humidity on the number of outpatients with chronic obstructive pulmonary disease and their interaction effect in Lanzhou, China[J]. Journal of Peking University (Health Sciences), 2020, 52(2): 308-316.

图/表 7

图1

图2

表1

表2

图3

表3

图4

参考文献 30

[1]	曾运红, 郭兰萍, 张羽 , 等. 慢性阻塞性肺疾病发病性院与气候因素的关系[J]. 广东医学, 2003,24(11):1230-1231.
[2]	阴俊, 谈建国, 竺丽明 , 等. 不同地区慢性阻塞性肺病与气象因子相关性分析[J]. 气象科技, 2007,35(6):841-844.
[3]	李耀宁, 陶立新, 张子曰 , 等. 慢性阻塞性肺病与气象因素相关性分析[J]. 气象与环境学报, 2010,26(6):13-17
[4]	陈新, 刘特, 王树越 , 等. 日平均气温对医院慢性阻塞性肺疾病急性加重患者住院人次的影响[J]. 吉林大学学报(医学版), 2015,41(2):389-392
[5]	Liang WM, Liu WP, Kuo HW . Diurnal temperature range and emergency room admissions for chronic obstructive pulmonary disease in Taiwan[J]. Int J Biometeorol, 2009,53(1):17-23.
[6]	Donaldson GC, Golderoing JJ, Wedzicha JA . Influence of season on exacerbation characteristics in patients with COPD[J]. Chest, 2012,141(1):94-100.
[7]	Ferrari U, Exner T, Wanka ER , et al. Influence of air pressure, humidity, solar radiation, temperature, and wind speed on ambulatory visits due to chronic obstructive pulmonary disease in Bava-ria, Germany[J]. Int J Biometeorol, 2012,56(1):137-143.
[8]	Jenkings CR, Celli B, Aanerson JA , et al. Seasonality and determinants of moderate and severe COPD exacerbations in the TORCH study[J]. Eur Respir J, 2012,39(1):38-45.
[9]	Tseng CM ,Chen YT,Ou SM, et al.The effect of cold temperature on increased exacerbation of chronic obstructive pulmonary disease: a nationwide study.[J]. PLoS One, 2013,8(3):1-7.
[10]	Almagrop P, Hernandez C, Martinex-Camblor P , et al. Seasonality, ambient temperatures and hospitalizations for acute exacerbation of COPD: A population-based study in a metropolitan area[J]. Int J Chron Obstruct Pulmon Dis, 2015,10(1):899-908.
[11]	Hansel NN, Mccormack MC, Kim V . The Effects of Air Pollution and Temperature on COPD[J]. COPD, 2016,13(3):372-379.
[12]	Mccormack MC, Paulin LM, Gummerson CE , et al. Colder temperature is associated with increased COPD morbidity[J]. Eur Respir J, 2017,49(6):1-7.
[13]	景文超, 马玉霞 . 兰州市呼吸道疾病与气象要素关系分析[C]// 第28届中国气象学会年会: S14气候环境变化与人体健. 厦门: 中国气象学会, 2011: 1-15.
[14]	李银娟, 方秋红 . 住院慢性阻塞性肺疾病急性加重期患者季候分布特点调查及气象影响因素分析[J]. 中国全科医学, 2015(14):1695-1699
[15]	周先锋, 于思雨, 阮晓楠 , 等. 气象因素对慢性阻塞性肺疾病患者门诊就诊人次的影响[J]. 环境与职业医学, 2015,32(8):711-716
[16]	王敏珍, 郑山, 王式功 , 等. 气温与湿度的交互作用对呼吸系统疾病的影响[J]. 中国环境科学, 2016,36(2):581-588
[17]	付桂琴, 刘华悦, 贾俊妹 . 石家庄地区气温对慢性阻塞性肺病住院人次的影响[J]. 气象与环境学报, 2017,33(2):102-106
[18]	杨慧慧 . 合肥市2010-2012 年温度和湿度对儿童手足口病的影响及其交互效应[D]. 合肥: 安徽医科大学, 2016
[19]	赵雨馨 . 长春市气温变化和天气环流型对慢性阻塞性肺病的影响研究[D]. 兰州: 兰州大学, 2018
[20]	Gasparrini A, Armstrong B, Kenward MG . Distributed lag non linear models[J]. Stat Med, 2010,29(21):2224-2234.
[21]	Gasparrini A . Distributed lag linear and non-linear models in R: the package dlnm[J]. J Stat Softw, 2011,43(8):1-20.
[22]	Gasparrini A, Armstrong B, Kenward MG . Reducing and meta-analyzing estimates from distributed lag non-linear models[J]. BMC Med Res Methodol, 2013,13(1):1.
[23]	Gasparrini A . Modeling exposure-lag-response associations with distributed lag non-linear models[J]. Stat Med, 2014,33(5):881-899.
[24]	Mukaka M . Statistics Corner: A guide to appropriate use of correlation coefficient in medical research[J]. J Med Asso Malawi, 2012,24(3):69-71.
[25]	郭亮, 王烨菁, 贾晓东 , 等. 气温对上海市某中心城区医院急诊内科就诊量的影响[J]. 环境与职业医学, 2017,34(4):321-325.
[26]	王金玉, 李盛, 李普 , 等. 2014-201年兰州市气温与死亡人次关系的时间序列研究[J]. 环境与职业医学, 2018,35(12):1076-1082
[27]	韦性富, 郑山, 翁俊 , 等. 甘肃省金昌市气温变化对高血压门急诊就诊人次影响的时间序列分析[J]. 环境与职业医学, 2019,36(5):452-458.
[28]	Ye XF . The effects of hot and cold temperatures on emergency hospital admissions in Brisbane, Australia[D]. Australia: Queensland University of Technology, 2013.
[29]	李骊 . 广州市大气污染,气象与逐日人群死亡数的关系研究[D]. 广州: 南方医科大学, 2015.
[30]	甘肃省体育局. 2014年甘肃省国民体质监测报告[M]. 兰州: 甘肃人民出版社, 2017: 80-100.

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed

Items	Total	Male	Female	<65 years	≥65 years
Lag 0 d	1.003(0.999,1.007)	1.005(1.001,1.010)	1.002(0.996,1.008)	1.004(0.999,1.008)	1.003(0.995,1.010)
Lag 0-1 d	1.007(1.001,1.014)	1.011(1.001,1.020)	1.004(0.994,1.014)	1.007(0.999,1.015)	1.006(0.993,1.020)
Lag 0-2 d	1.010(1.002,1.019)	1.016(1.004,1.028)	1.006(0.993,1.02)	1.011(1.001,1.021)	1.012(0.994,1.030)
Lag 0-3 d	1.015(1.004,1.025)	1.021(1.008,1.035)	1.009(0.994,1.024)	1.014(1.002,1.025)	1.018(0.998,1.039)
Lag 0-4 d	1.019(1.008,1.029)	1.026(1.012,1.041)	1.011(0.996,1.041)	1.017(1.005,1.029)	1.026(1.006,1.048)
Lag 0-5 d	1.023(1.013,1.034)	1.032(1.018,1.046)	1.014(0.999,1.030)	1.019(1.007,1.031)	1.036(1.015,1.057)
Lag 0-6 d	1.028(1.018,1.038)	1.037(1.024,1.051)	1.017(1.002,1.033)	1.021(1.010,1.033)	1.047(1.027,1.068)
Lag 0-7 d	1.033(1.023,1.044)	1.043(1.028,1.057)	1.021(1.005,1.037)	1.023(1.011,1.036)	1.060(1.038,1.081)

Items	Total	Male	Female	<65 years	≥65 years
Lag 0 d	0.999(0.990,1.002)	0.999(0.996,1.002)	1.001(0.997,1.004)	1.001(0.998,1.003)	0.999(0.995,1.003)
Lag 0-1 d	0.999(0.995,1.003)	0.997(0.992,1.003)	1.002(0.995,1.008)	1.001(0.996, 1.006)	0.998(0.991,1.006)
Lag 0-2 d	0.999(0.992,1.007)	0.996(0.987,1.007)	1.004(0.992,1.016)	1.003(0.994, 1.013)	0.997(0.983,1.010)
Lag 0-3 d	1.001(0.991,1.011)	0.997(0.984,1.010)	1.007(0.991,1.023)	1.007(0.994,1.019)	0.996(0.978,1.013)
Lag 0-4 d	1.004(0.992,1.016)	0.999(0.983,1.015)	1.011(0.993,1.015)	1.011(0.996,1.026)	0.995(0.974,1.016)
Lag 0-5 d	1.010(0.996,1.024)	1.005(0.987,1.023)	1.018(0.997,1.040)	1.020(1.003,1.037)	0.994(0.971,1.018)
Lag 0-6 d	1.019(1.003,1.035)	1.014(0.993,1.035)	1.027(1.003,1.052)	1.031(1.012,1.051)	0.994(0.967,1.021)
Lag 0-7 d	1.023(1.006,1.040)	1.018(0.996,1.040)	1.031(1.005,1.057)	1.036(1.015,1.057)	0.994(0.966,1.023)

Relative humidity stratification	Temperature stratification	Group	Change /%	95%CI/%
Relative humidity ≤50 ℃	Temperature≤11 ℃	Total	12.68	5.30, 20.57
		Male	5.62	0.40, 1.42
		Female	7.56	1.27, 14.24
		<65 years	5.24	-2.63, 13.75
		≥65 years	14.74	6.76, 23.32
	Temperature >11 ℃	Total	3.33	-1.97, 8.92
		Male	9.95	-0.89, 21.97
		Female	11.86	-0.21, 24.88
		<65 years	4.12	-4.06, 12.99
		≥65 years	5.93	-3.33, 16.07
Relative humidity >50%	Temperature ≤11 ℃	Total	9.00	3.57, 14.73
		Male	2.16	-1.88, 6.37
		Female	3.97	-0.66, 8.82
		<65 years	7.11	1.40, 16.36
		≥65 years	10.93	5.05, 17.14
	Temperature >11 ℃	Total	10.29	-3.97, 16.99
		Male	-2.05	-6.77, 7.16
		Female	-1.79	-7.67, 4.45
		<65 years	5.88	-2.75, 6.73
		≥65 years	11.85	-5.04, 19.11

兰州市气温和相对湿度对慢性阻塞性肺疾病患者门诊就诊人次的影响及其交互效应

Effects of temperature and relative humidity on the number of outpatients with chronic obstructive pulmonary disease and their interaction effect in Lanzhou, China

RICH HTML

PDF (PC)

摘要/Abstract

引用本文

使用本文

图/表 7

参考文献 30

相关文章 8

Metrics

本文评价

推荐阅读 0

[1]	周庆欣,杨晴晴,石舒原,李沛,孙凤. 健康体检人群血尿酸与气流阻塞的相关性[J]. 北京大学学报（医学版）, 2024, 56(4): 693-699.
[2]	王子恺,莫佳丽,张蒙,廖纪萍. 2013—2020年北京市慢性阻塞性肺疾病急性加重女性住院患者的流行病学和住院费用分析[J]. 北京大学学报（医学版）, 2023, 55(6): 1074-1081.
[3]	杨若彤,王梦莹,李春男,于欢,王小文,吴俊慧,王斯悦,王伽婷,陈大方,吴涛,胡永华. 缺血性脑卒中全基因组关联研究提示阳性基因位点与睡眠行为的交互作用[J]. 北京大学学报（医学版）, 2022, 54(3): 412-420.
[4]	陈曦,王斯悦,薛恩慈,王雪珩,彭和香,范梦,王梦莹,武轶群,秦雪英,李劲,吴涛,朱洪平,李静,周治波,陈大方,胡永华. 基于核心家系全外显子组测序数据探索新生突变与非综合征型唇腭裂的关联[J]. 北京大学学报（医学版）, 2022, 54(3): 387-393.
[5]	朱小玲,李文静,王宪娥,宋文莉,徐莉,张立,冯向辉,路瑞芳,释栋,孟焕新. 细胞色素B-245α链及胆固醇酯转运蛋白基因多态性与广泛型侵袭性牙周炎易感性的关系[J]. 北京大学学报（医学版）, 2022, 54(1): 18-22.
[6]	谢江,李菲. 睡眠重叠综合征与糖尿病发病率的横断面调查研究[J]. 北京大学学报（医学版）, 2019, 51(2): 252-255.
[7]	袁园，王苹，吴雅慧，叶晓茜，黄尚志，石冰，王科，王竹青，刘冬静，王子凡，. 中国人群细胞黏附相关基因多态性与非综合征型唇腭裂的关联研究[J]. 北京大学学报(医学版), 2016, 48(3): 403-408.
[8]	胡永华. 基于群体的复杂性疾病的病因研究[J]. 北京大学学报（医学版）, 2007, 39(2): 113-115.