热浪与居民急性心肌梗死死亡关系的病例交叉研究

张金良; 刘玲; 柴发合

Abstract

张金良,刘玲,柴发合.热浪与居民急性心肌梗死死亡关系的病例交叉研究[J].Chinese journal of Epidemiology,2012,33(7):710-716

热浪与居民急性心肌梗死死亡关系的病例交叉研究

A case-crossover study on the association between heat waves and daily deaths caused by acute myocardial infarction

Received:December 28, 2011

DOI：

KeyWord: 热浪急性心肌梗死病例交叉方法

English Key Word: Heat wave Acute myocardial infarction Case-crossover study

FundProject:

Author Name	Affiliation	E-mail
ZHANG Jin-liang	State Key Laboratory of Environmental Criteria and Risk Assessment and Environmental Standards Institute, Chinese Research Academy of Environmental Sciences(CRAES), Beijing 100012, China	zhangjl@craes.org.cn
LIU Ling	State Key Laboratory of Environmental Criteria and Risk Assessment and Environmental Standards Institute, Chinese Research Academy of Environmental Sciences(CRAES), Beijing 100012, China
CHAI Fa-he	State Key Laboratory of Environmental Criteria and Risk Assessment and Environmental Standards Institute, Chinese Research Academy of Environmental Sciences(CRAES), Beijing 100012, China

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Abstract:

目的探讨热浪对北京市居民每日急性心肌梗死(AMI)死亡人数的影响.方法采用病例交叉方法,分析1999年1月1日至2000年6月30日热浪对北京市居民每日AMI死亡人数的影响,比较对不同性别和年龄居民的影响程度.分别选择死亡发生前后第7天作为对称双向对照,以OR值及其对应的危险期反映热浪过程对居民AMI死亡人数影响的大小、滞后天数及持续时间.结果研究期间共发生5次热浪.第1次持续9d,最高气温38.8℃,平均湿度46.7％,AMI死亡OR=1.437(95％CI:1.066～1.937)；第2次热浪持续3d,最高气温36.8℃,平均湿度61.0％,AMI死亡OR=1.846(95％C/:0.671～5.076)；第3次热浪持续7d,最高气温41.5℃,平均湿度58.5％,AMI死亡OR=2.427(95％CI:1.825～3.229);第4次持续3d,最高气温39.6℃,平均湿度31.9％,AMI死亡OR=2.857(95％CI:1.088～ 7.506)；第5次热浪持续4d,最高气温37.4℃,平均湿度42.0％,AMI死亡OR=1.500(95％CI:O.632 ～ 3.560).第1次热浪对男女性死于AMI影响的OR值分别为1.153(95％CI:0.756～1.758)和1.818(95％CI:1.185～ 2.790),对＜65岁年龄组居民影响的OR值为1.200 (95％CI:0.669～ 2.153),而对≥65岁组影响的OR值为1.534 (95％CI:1.083～2.173).第3次热浪对男女性影响的OR值分别为2.392( 95％CI:1.649～ 3.470)和2.514(95％CI:1.613 ～ 3.919),对＜65岁和≥65岁年龄组居民影响的O值分别为2.000(95％CI:1.149～ 3.482)和2.623(95％CI:1.880～3.660).结论 (1)热浪对居民AMI死亡有影响,且存在滞后效应,滞后期一般为0～2d；(2)热浪开始当天日最高气温较前一日升温的幅度越大,居民AMI死亡风险越大；(3)热浪期间女性死于AMI的风险高于男性；(4)≥65岁年龄组居民热浪期间死于AMI的风险高于＜65岁组；(5)高年龄组女性对热浪的影响更为敏感.

English Abstract:

Objective To explore the effects of heat wave on daily deaths caused by acute myocardial infarction (AMI) in Beijing.Methods A case-crossover design was used to study the impact of 5 heat waves on the daily number of AMI deaths from Jan.1,1999 to Jun.30,2000.The effect of heat wave on death in different gender or age groups was also compared.The 7th day before and after death occurred was chosen as its own bi-directional self-control.The OR value and its corresponding risk period was used to reflect the impact of heat wave on daily number of AMI deaths,lag days and duration.Results There were five heat waves during the study period.The first heat wave sustained 9 days and the maximum temperature was 38.8 ℃ with average humidity as 46.7％.The OR value for the AMI death was 1.437 (95％CI:1.066-1.937).The second heat wave lasted 3 days,with the maximum temperature of 36.8 ℃ and average humidity of 61.0％.The OR value for the AM1 death was 1.846 (95％ CI:0.671-5.076).The third heat wave continued 7 days,with the maximum temperature of 41.5 ℃ with average humidity of 58.5％.The OR value for the daily death counts caused by AMI was 2.427 (95％ CI:1.825-3.229).The fourth lasted for 3 days,with the maximum temperature of 39.6 ℃ and average humidity as 3 1.9％.The OR value for the AMI deaths was 2.857 (95％ CI:1.088-7.506).The fifth heat wave lasted for 4 days,with the maximum temperature as 37.4 ℃,and average humidity as 42.0％ during this period.The OR value for daily death counts caused by AMI was 1.500(95％CI:0.632-3.560).The OR value of the first heat wave for daily death counts of men and women caused by AMI were 1.153 (95％CI:0.756-1.758 ) and 1.818 (95％CI:1.185-2.790) respectively.The OR value for daily death counts of under 65 age was 1.200 (95％ CI:0.669-2.153),with the OR value for the older than 64 age group was 1.534 (95％ CI:1.083-2.173).The OR value for daily death counts of older than 64 age women was 1.818 (95％CI:1.109-2.981 ).The OR values of the third heat wave for daily death counts of men and women caused by AMI were 2.392 (95％CI:1.649-3.470) and 2.514 (95％CI:1.613-3.919) respectively.The OR value for daily death counts of under 65 age group was 2.000 (95％CI:1.149-3.482 ) and the OR value for the older than 64 age group was 2.623 (95％CI:1.880-3.660).The OR value for daily death counts of older than 64 age group women was 2.800 (95％CI:1.676-4.678).Conclusion (1) Significant increase for daily death counts of AMI in Beijing was noticed during the heat wave and usually causing hysteretic effect.The lag phase was 0-2 days in general.(2)The increase of maximum temperature was greater at the beginning day when the heat wave occurred in the previous day,with shorter lag time and greater risk of AMI death.(3)The risk of AMI death in women was greater than in men during the heat wave period.(4)The risk of AMI death among those older than 64 age group was greater than the under 65 year olds.(5)The impact of heat wave to the elderly female was greater.

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