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北京大学学报（医学版） ›› 2026, Vol. 58 ›› Issue (3): 592-599. doi: 10.19723/j.issn.1671-167X.2026.03.020

• 论著 • 上一篇    下一篇

环境温度个体暴露与慢性阻塞性肺疾病患者睡眠期间血氧饱和度的关联

左蒙1, 张文楼1, 陈柏锜1, 赵晨2, 陈亚红3, 何建辉4, 郭新彪1, 邓芙蓉1,*()   

  1. 1. 北京大学公共卫生学院劳动卫生与环境卫生学系，北京 100191
    2. 海淀区花园路社区卫生服务中心, 北京 100088
    3. 北京大学第三医院呼吸与危重症医学科，北京 100191
    4. 中国香港中文大学赛马会公共卫生及基层医疗医院，中国香港 999077
  • 收稿日期:2026-02-25 出版日期:2026-06-18 发布日期:2026-04-24
  • 通讯作者: 邓芙蓉
  • 基金资助:
    国家自然科学基金(22376005); 国家自然科学基金(22076006); 首都卫生发展科研专项(2020-2Z-40917)

Association between ambient personal temperature exposure and oxygen saturation during sleep in patients with chronic obstructive pulmonary disease

Meng ZUO1, Wenlou ZHANG1, Baiqi CHEN1, Chen ZHAO2, Yahong CHEN3, Jianhui HE4, Xinbiao GUO1, Furong DENG1,*()   

  1. 1. Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
    2. Community Health Service Center, Huayuan Road, Haidian District, Beijing 100088, China
    3. Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
    4. School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR 999077, China
  • Received:2026-02-25 Online:2026-06-18 Published:2026-04-24
  • Contact: Furong DENG
  • Supported by:
    the National Natural Science Foundation of China(22376005); the National Natural Science Foundation of China(22076006); the Capital Health Development Research Project(2020-2Z-40917)

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摘要：

目的: 探讨慢性阻塞性肺疾病(简称慢阻肺)患者温度个体暴露与其睡眠期间血氧饱和度的关联及其潜在的易感因素，以期为采取有效措施保障易感人群健康提供科学依据。方法: 采用前瞻性定组研究设计，于2021年3月至2023年9月对北京市96例稳定期慢阻肺患者进行了202晚(20:00~08:00)的睡眠期间血氧饱和度(oxygen saturation, SpO2)动态实时监测，同步监测温度的个体暴露水平，并同时监测环境湿度和其他主要空气污染物。根据既往临床研究，将SpO2 < 90%定义为氧去饱和，以评估睡眠期间低氧事件的发生风险。采用线性混合效应模型和广义线性混合效应模型分别分析温度个体暴露与睡眠期间SpO2变化及氧去饱和风险的关联，并构建交互作用模型评估易感因素。结果: 研究期间，慢阻肺患者平均个体温度暴露为(27.5±2.6) ℃，温度范围为16.5~40.0 ℃。温度个体短期暴露与慢阻肺患者睡眠期间SpO2下降和氧去饱和风险增加有关。温度暴露在滞后0~30 min时效应最强，温度每升高1个四分位数间距(interquartile range, IQR，6.0 ℃)，SpO2下降0.24%(95%CI：-0.28%，-0.20%)，氧去饱和的比值比(odds ratio，OR)为1.26 (95%CI：1.12，1.42)。此外，研究还发现，与暴露于低湿度水平的慢阻肺患者相比，暴露于中、高湿度水平的患者更容易受到温度暴露的影响。与慢性阻塞性肺疾病全球倡议(global initiative for chronic obstructive lung disease，GOLD)Ⅰ~Ⅱ级患者相比，个体温度暴露对GOLD Ⅲ~Ⅳ级患者睡眠期间SpO2的影响更强(交互项P＜0.05)。结论: 在16.5~40.0 ℃的温度范围内，温度个体暴露增加与慢阻肺患者睡眠期间SpO2下降和氧去饱和风险增加有关，温湿度之间存在显著的协同放大作用，高温高湿条件下患者更容易受到温度的影响，且肺功能较差的患者受温度的影响更为明显。

关键词: 慢性阻塞性肺疾病, 血氧饱和度, 温度, 个体暴露

Abstract:

Objective: To assess the association between personal temperature exposure and oxygen saturation (SpO2) during sleep in chronic obstructive pulmonary disease (COPD) patients, to analyze potential susceptibility factors and to provide a scientific basis for the adoption of effective measures to safeguard the health of susceptible populations. Methods: In this prospective panel study, 96 stable COPD patients were recruited. From March 2021 to September 2023 in Beijing, all participants completed 202 nights (from 20:00 to 08:00) of dynamic real-time SpO2 monitoring during sleep, simultaneously monitoring personal exposure level to temperature, alongside environmental humidity and other key air pollutant data. Based on previous clinical studies, SpO2 < 90% was defined as desaturation to assess the risk of hypoxic events occurring during sleep. Linear mixed-effects models and generalized linear mixed-effects models were used to analyze the association between personal temperature exposure and SpO2 during sleep, as well as the risk of oxygen desaturation. Interaction models were constructed to evaluate susceptibility factors. Results: During the study, the average personal temperature exposure was (27.5± 2.6) ℃, with a temperature range from 16.5 ℃ to 40.0 ℃. Short-term exposure to personal temperature was associated with a decline in SpO2 and an increased risk of oxygen desaturation during sleep in the COPD patients. The effect of temperature exposure was strongest at lag 0-30 min, with a 0.24% (95%CI: -0.28%, -0.20%) decrease in SpO2, and with an odds ratio (OR) of oxygen desaturation was 1.26 (95% CI: 1.12, 1.42) for each interquartile range (IQR, 6.0 ℃) increase in temperature. Besides, the patients exposed to medium and high humidity levels were more likely to be affected by temperature exposure compared with the patients exposed to low humidity levels. Personal temperature exposure had a stronger effect on SpO2 during sleep in the patients with global initiative for chronic obstructive lung disease (GOLD) Ⅲ-Ⅳ compared with the patients with GOLD Ⅰ-Ⅱ (Pinteraction < 0.05). Conclusion: From 16.5 ℃ to 40.0 ℃, personal temperature exposure is associated with SpO2 decline during sleep in COPD patients. There was a significant synergistic amplification between temperature and humidity, patients were more susceptible to damage under high temperature and high humidity conditions. Moreover, patients with poorer lung function are more significantly affected by temperature.

Key words: Chronic obstructive pulmonary disease, Oxygen saturation, Temperature, Personal exposure

中图分类号: 

  • R122.2

表1

研究对象的基本信息、暴露及健康指标的描述性分析"

Variable Value
Gender
  Male, n(%) 85 (88.5)
  Female, n(%) 11 (11.5)
Age/years, $\bar x \pm s$ 69.0±6.3
BMI/(kg/m2), $\bar x \pm s$ 24.0±3.3
Smoking status, n(%)
  Never 19 (19.8)
  Former 48 (50.0)
  Current 29 (30.2)
GOLD stage, n(%)
  Ⅰ 13 (13.5)
  Ⅱ 50 (52.1)
  Ⅲ 27 (28.1)
  Ⅳ 6 (6.3)
Lung function, $\bar x \pm s$
  FEV1/L 1.6±0.6
  FEV1%pred/% 58.4±17.8
  FVC/L 2.8±0.8
  FVC%pred/% 75.5±17.0
  FEV1/FVC 0.57±0.09
Temperature/℃, $\bar x \pm s$ 27.5±2.6
Humidity/%, $\bar x \pm s$ 21.1±7.1
Sleep SpO2/%, $\bar x \pm s$ 94.1±2.6
Air pollutants，$\bar x \pm s$
  PM2.5/(μg/L) 21.0±18.6
  PM10/(μg/L) 23.0±15.3
  NO2/(μg/L) 15.5±6.6
  O3/(μg/L) 29.5±17.3
  SO2/(μg/L) 0.9±0.4
  CO/(mg/L) 0.5±0.3

图1

温度个体暴露与患者睡眠期间SpO2(A)和氧去饱和风险(B)的关联"

图2

温度个体暴露与患者睡眠期间SpO2(A)和氧去饱和风险(B)的暴露反应关系"

图3

温度个体暴露与不同肺功能状态患者睡眠期间SpO2(A)和氧去饱和风险(B)的关联"

图4

不同湿度水平下温度个体暴露与患者睡眠期间SpO2(A)和氧去饱和风险(B)的关联"

表2

温度个体暴露与睡眠期间SpO2和氧去饱和风险关联的敏感性分析"

Model Value change in SpO2(95%CI)/% P OR of oxygen desaturation (95%CI) P
Main model -0.26 (-0.29，-0.22) < 0.001 1.34 (1.20，1.49) < 0.001
Adjust model
+PM10 -0.21 (-0.24，-0.16) < 0.001 1.23 (1.11，1.37) < 0.001
+NO2 -0.23 (-0.27，-0.19) < 0.001 1.30 (1.16，1.45) < 0.001
+O3 -0.21 (-0.21，-0.25) < 0.001 1.25 (1.12，1.39) < 0.001
+SO2 -0.26 (-0.30，-0.22) < 0.001 1.23 (1.10，1.37) < 0.001
+CO -0.18 (-0.22，-0.14) < 0.001 1.18 (1.05，1.32) < 0.001
1
Thompson R , Lawrance EL , Roberts LF , et al. Ambient temperature and mental health: A systematic review and meta-analysis[J]. Lancet Planet Health, 2023, 7 (7): e580- e589.

doi: 10.1016/S2542-5196(23)00104-3
2
Liu J , Varghese BM , Hansen A , et al. Heat exposure and cardiovascular health outcomes: A systematic review and meta-analysis[J]. Lancet Planet Health, 2022, 6 (6): e484- e495.

doi: 10.1016/S2542-5196(22)00117-6
3
Chen R , Yin P , Wang L , et al. Association between ambient temperature and mortality risk and burden: Time series study in 272 main Chinese cities[J]. BMJ, 2018, 363, k4306.
4
Wu Q , Yang M , Wu K , et al. Abnormal ambient temperature change increases the risk of out-of-hospital cardiac arrest: A systematic review and meta-analysis of exposure types, risk, and vulnerable populations[J]. Sci Total Environ, 2023, 861, 160554.

doi: 10.1016/j.scitotenv.2022.160554
5
Tran HM , Tsai FJ , Lee KY , et al. Extreme temperature increases the risk of COPD morbimortality: A systematic review and meta-analysis[J]. Sci Total Environ, 2025, 958, 178087.

doi: 10.1016/j.scitotenv.2024.178087
6
Wang C , Xu J , Yang L , et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health[CPH] study): A national cross-sectional study[J]. Lancet, 2018, 391 (10131): 1706- 1717.

doi: 10.1016/S0140-6736(18)30841-9
7
Zhang Y , Liu X , Kong D , et al. Effects of ambient temperature on acute exacerbations of chronic obstructive pulmonary disease: Results from a time-series analysis of 143 318 hospitalizations[J]. Int J Chron Obstruct Pulmon Dis, 2020, 15, 213- 223.

doi: 10.2147/COPD.S224198
8
Rau A , Tarr GAM , Baldomero AK , et al. Heat and cold wave-related mortality risk among United States veterans with chronic obstructive pulmonary disease: A case-crossover study[J]. Environ Health Perspect, 2024, 132 (2): 27004.

doi: 10.1289/EHP13176
9
Mekhuri S , Quach S , Barakat C , et al. A cross-sectional survey on the effects of ambient temperature and humidity on health outcomes in individuals with chronic respiratory disease[J]. Rev Can De La Ther Respir, 2023, 59, 256- 269.
10
Shi C , Zhu J , Wu Q , et al. Effects of ambient temperature and humidity on COPD mortality in Ganzhou city, China[J]. Int J Biometeorol, 2024, 68 (9): 1789- 1798.

doi: 10.1007/s00484-024-02705-6
11
Kent BD , Mitchell PD , McNicholas WT . Hypoxemia in patients with COPD: Cause, effects, and disease progression[J]. Int J Chron Obstruct Pulmon Dis, 2011, 6, 199- 208.
12
Kendzerska T , Leung RS , Aaron SD , et al. Cardiovascular outcomes and all-cause mortality in patients with obstructive sleep apnea and chronic obstructive pulmonary disease (overlap syndrome)[J]. Ann Am Thorac Soc, 2019, 16 (1): 71- 81.

doi: 10.1513/AnnalsATS.201802-136OC
13
Qiu H , Xia X , Man CL , et al. Real-time monitoring of the effects of personal temperature exposure on the blood oxygen saturation level in elderly people with and without chronic obstructive pulmonary disease: A panel study in Hong Kong[J]. Environ Sci Technol, 2020, 54 (11): 6869- 6877.

doi: 10.1021/acs.est.0c01799
14
Goldberg MS , Giannetti N , Burnett RT , et al. A panel study in congestive heart failure to estimate the short-term effects from personal factors and environmental conditions on oxygen saturation and pulse rate[J]. Occup Environ Med, 2008, 65 (10): 659- 666.

doi: 10.1136/oem.2007.034934
15
Li A , Zhang Q , Yao Y , et al. Higher ambient temperatures may worsen obstructive sleep apnea: A nationwide smartwatch-based analysis of 6.2 million person-days[J]. Sci Bull, 2024, 69 (13): 2114- 2121.

doi: 10.1016/j.scib.2024.05.016
16
Nøhr N , Jepsen R , Jørsboe H , et al. Physiological responses to heat exposure in a general population cohort in Denmark: The Lolland-Falster Health Study[J]. Eur J Public Health, 2024, 34 (5): 1008- 1014.

doi: 10.1093/eurpub/ckae121
17
朱蕾, 刘又宁, 钮善福. 临床呼吸生理学[M]. 北京: 人民卫生出版社, 2008: 331- 337.
18
He BT , Lu G , Xiao SC , et al. Coexistence of OSA may compensate for sleep related reduction in neural respiratory drive in patients with COPD[J]. Thorax, 2017, 72 (3): 256- 262.

doi: 10.1136/thoraxjnl-2016-208467
19
Zhao R , Xue J , Zhang X , et al. Comparison of ring pulse oximetry using reflective photoplethysmography and PSG in the detection of OSA in Chinese adults: A pilot study[J]. Nat Sci Sleep, 2022, 14, 1427- 1436.

doi: 10.2147/NSS.S367400
20
Mu Z , Chen PL , Geng FH , et al. Synergistic effects of temperature and humidity on the symptoms of COPD patients[J]. Int J Biometeorol, 2017, 61 (11): 1919- 1925.

doi: 10.1007/s00484-017-1379-0
21
Han A , Deng S , Yu J , et al. Asthma triggered by extreme tempe-ratures: From epidemiological evidence to biological plausibility[J]. Environ Res, 2023, 216 (Pt 2): 114489.
22
Liu C , Yavar Z , Sun Q . Cardiovascular response to thermoregulatory challenges[J]. Am J Physiol Heart Circ Physiol, 2015, 309 (11): H1793- H1812.

doi: 10.1152/ajpheart.00199.2015
23
Schlader ZJ , Rivas E , Soller BR , et al. Tissue oxygen saturation during hyperthermic progressive central hypovolemia[J]. Am J Physiol Regul Integr Comp Physiol, 2014, 307 (6): R731- R736.

doi: 10.1152/ajpregu.00190.2014
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ISSN 1671-167X
CN 11-4691/R
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