文章摘要
张云权,宇传华,鲍俊哲.平均气温、寒潮和热浪对湖北省居民脑卒中死亡的影响[J].中华流行病学杂志,2017,38(4):508-513
平均气温、寒潮和热浪对湖北省居民脑卒中死亡的影响
Impact of daily mean temperature, cold spells, and heat waves on stroke mortality a multivariable Meta-analysis from 12 counties of Hubei province, China
投稿时间:2016-08-27  
DOI:10.3760/cma.j.issn.0254-6450.2017.04.019
中文关键词: 脑卒中;气温;死亡率;分布滞后非线性模型;多元Meta分析
英文关键词: Stroke;Temperature;Mortality;Distributed lag nonlinear model;Multivariate Meta-analysis
基金项目:国家自然科学基金(81273179);国家自然科学基金委员会国际合作与交流(71661167007);中央高校基本科研业务费专项资金(2015305020201)
作者单位E-mail
张云权 430071 武汉大学公共卫生学院流行病与卫生统计学系  
宇传华 430071 武汉大学公共卫生学院流行病与卫生统计学系
430072 武汉大学全球健康研究中心 
yuchua@whu.edu.cn 
鲍俊哲 430071 武汉大学公共卫生学院流行病与卫生统计学系  
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中文摘要:
      目的 分析平均气温、寒潮和热浪对湖北省12个区(县)居民脑卒中死亡的影响。方法 收集湖北省12个区(县)2009年1月1日至2012年12月31日脑卒中死亡监测资料和同期气象数据,应用分布滞后非线性模型(DLNM)评估各区(县)日均温度、寒潮和热浪与脑卒中死亡之间的关系,利用多元Meta分析合并12个区(县)的温度-脑卒中死亡的暴露-反应关系及寒潮和热浪对脑卒中死亡影响的滞后反应关系。结果 2009-2012年共观察670.2万人,纳入的脑卒中死亡人数为42 739例,各区(县)脑卒中日均死亡2.7(0.5~6.0)例,年均气温为16.6(14.7~17.4)℃。DLNM分析显示,日均气温与脑卒中死亡间呈反“J”形关系。寒潮对脑卒中死亡的影响存在2~3 d滞后,持续近10 d;热浪的效应则发生急促,持续时间较短。12个区(县)寒潮日滞后3~14 d,脑卒中累积死亡风险为0.968~1.523,合并风险RR=1.180(95%CI:1.043~1.336);热浪日滞后0~2 d,脑卒中累积死亡风险为0.675~2.066,合并风险RR=1.114(95%CI:1.012~1.227)。结论 日均气温与湖北省居民脑卒中死亡呈反“J”形关系,寒潮和热浪均明显增加脑卒中死亡风险,但其死亡效应的滞后模式存在一定差异。
英文摘要:
      Objective To assess the acute effects of daily mean temperature, cold spells, and heat waves on stroke mortality in 12 counties across Hubei province, China. Methods Data related to daily mortality from stroke and meteorology in 12 counties across Hubei province during 2009-2012, were gathered. Distributed lag nonlinear model (DLNM) was first used, to estimate the county-specific associations between daily mean temperature, cold spells, heat waves and stroke mortality. Multivariate Meta-analysis was then applied to pool the community-specific relationships between temperature and stroke mortality (exposure-response relationship) as well as both cold-and-heat-associated risks on mortality at different lag days (lag-response relationship). Results During 2009-2012, a total population of 6.7 million was included in this study with 42 739 persons died of stroke. An average of 2.7 (from 0.5 to 6.0) stroke deaths occurred daily in each county, with annual average mean temperature as 16.6 ℃ (from 14.7 ℃ to 17.4 ℃) during the study period. An inverse J-shaped association between temperature and stroke mortality was observed at the provincial level. Pooled mortality effect of cold spells showed a 2-3-day delay and lasted about 10 days, while effect of heat waves appeared acute but attenuated within a few days. The mortality risks on cold-spell days ranged from 0.968 to 1.523 in 12 counties at lag 3-14, with pooled effect as 1.180 (95%CI:1.043-1.336). The pooled mortality risk (ranged from 0.675 to 2.066) on heat-wave days at lag 0-2 was 1.114 (95%CI:1.012-1.227). Conclusions An inverse J-shaped association between temperature and stroke mortality was observed in Hubei province, China. Both cold spells and heat waves were associated with increased stroke mortality, while different lag patterns were observed in the mortality effects of heat waves and cold spells.
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