Abstract
劳家辉,刘志东,刘言玉,张静,姜宝法.昼夜温差对老年人群流感的影响及亚组分析[J].Chinese journal of Epidemiology,2018,39(11):1454-1458
昼夜温差对老年人群流感的影响及亚组分析
Influence of diurnal temperature range on influenza incidence in the elderly
Received:June 23, 2018  
DOI:10.3760/cma.j.issn.0254-6450.2018.11.007
KeyWord: 昼夜温差  老年人群  流感  分布滞后非线性模型
English Key Word: Diurnal temperature range  Elderly  Influenza  Distributed lag non-linear model
FundProject:国家科技基础资源调查专项(2017FY101202)
Author NameAffiliationE-mail
Lao Jiahui Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, China  
Liu Zhidong Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, China  
Liu Yanyu Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, China  
Zhang Jing Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, China  
Jiang Baofa Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, China bjiang@sdu.edu.cn 
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Abstract:
      目的 探讨昼夜温差对北京市老年人群流感发病的影响,并进行亚组分析。方法 收集2014-2016年北京市≥60岁老年人群流感日发病资料、逐日气象资料,并整理成时间序列形式。首先利用广义相加模型(GAM)探讨昼夜温差与日发病数之间是否为线性关系,然后利用分布滞后非线性模型(DLNM)定量评估昼夜温差对北京市老年人群流感发病的滞后效应。将研究人群按性别、年龄构成进行亚组分析。结果 研究期间北京市老年人群共发生流感4 097例,平均昼夜温差为10.153℃。昼夜温差与老年人群流感日发病数之间呈线性关系,昼夜温差越大,流感日发病数越多。昼夜温差对日发病数的影响最长可至滞后5 d,最大效应出现在滞后0 d。昼夜温差每增加1℃,老年人群流感的发病风险增加2.0%(95% CI: 0.9%~3.0%)。昼夜温差增大时,各亚组人群的流感发病风险均增加。老年男性、老年女性、60~69岁人群、≥70岁人群的RR值分别为1.018(95% CI:1.005~1.032)、1.021(95% CI:1.007~1.035)、1.012(95% CI:1.002~1.022)、1.025(95% CI:1.012~1.039)。昼夜温差对老年女性流感发病的影响最长可至滞后6 d,比老年男性(滞后2 d)更长。结论 昼夜温差增大能增加北京市老年人群流感的发病风险,各亚组人群普遍受其影响。昼夜温差增大时,应加强老年人群流感的预防。
English Abstract:
      Objective To understand the influence of diurnal temperature range (DTR) on influenza incidence in the elderly in Beijing and to conduct a subgroup analysis. Methods The incidence data of daily influenza cases in the elderly and daily meteorological data from 2014 to 2016 in Beijing were collected for this study. A generalized additive model (GAM) was used to explore whether the relationship between daily influenza cases and DTR is a linear one. A distributed lag non-linear model (DLNM) was established to quantify the lagged effect of DTR on daily influenza incidence in the elderly. The model was also used to estimate the effects of DTR on daily influenza incidence among various subgroups. Results A total of 4 097 influenza cases in the elderly were notified during study period. The mean DTR was 10.153℃. A linear relationship between daily influenza incidence and DTR was detected by using GAM. DTR was significantly associated with daily influenza incidence between lag0 and lag5 with a maximal effect at lag0. An 1℃ increase of DTR was associated with a 2.0% increase in daily influenza incidence in the elderly (95% CI:0.9%-3.0%). The RR values of males, females, people aged 60-69 years, people aged ≥ 70 years were 1.018 (95% CI:1.005-1.032), 1.021(95% CI:1.007-1.035), 1.012 (95% CI:1.002-1.022), 1.025 (95% CI:1.012-1.039), respectively. The influencing time of DTR on females (lag6) was longer than males (lag2). Conclusions DTR was associated with increased risk of influenza in the elderly in Beijing. It is necessary to take targeted measures in the elderly to control the incidence of influenza when DTR becomes greater.
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