杭州市大气气溶胶与心脑血管病急性发作关系的空间流行病学研究
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摘要
目的:
为了了解心脑血管疾病急性发作是否与时间、地理因素和大气气溶胶有关,研究杭州市大气气溶胶的时空分布及其相关因素,描述杭州市监测人群心脑血管疾病急性发作的时空聚集性,探索大气气溶胶与心脑血管疾病急性发作之间的关系。
方法:
大气气溶胶的时间分布采用空间统计学中的自相关分析和kringing插值法,大气气溶胶的相关因素采用自回归滑动平均模型,心脑血管疾病的空间分布采用空间统计学中的Kringing插值法,心脑血管疾病的聚集性采用回顾性重排模型,大气气溶胶与心脑血管疾病的关系采用交互相关分析和时间序列Poisson回归模型。有关数据的空间统计学中的自相关和Kringing插值法采用DPS 9.50数据处理系统,回顾性时空重排模型分析采用SaTScan 7.0.3统计分析软件,其它统计分析采用SPSS 16.0 for Windows统计分析软件,以双侧α=0.05为检验水准。
结果:
杭州市大气气溶胶(aerosol optical depth,AOD)在时间分布上具有一定的周期性;在滞后96天、383天、479天、766天、1149天和1532天内呈正相关关系,即趋同的趋势;在滞后191天、287天、574天、957天、1340天和1723天内呈负相关关系,其它没有统计学意义。
杭州市AOD在居民区域较高,在有山或有水区域AOD较低;不同月份的AOD分布也不相同。
AOD与次日AOD存在正相关关系(t=39.531,P=0.000);AOD与相对湿度(t=3.700,P=0.000)、SO_2(t=-3.064,P=0.002)、NO_2(t=2.148,P=0.032)以及滞后一日的NO_2(t=-2.769,P=0.006)存在关联,而与温度和云层无统计学关联。
富阳市的渌渚镇、胥口镇、新桐乡、新登镇、场口镇、万市镇、鹿山街道、永昌镇、东洲街道、环山乡、春建乡、湖源乡、常安镇、龙门镇和洞桥镇监测人群心脑血管疾病的急性发作在1998/10/20-2005/11/25期间具有聚集性(SMR=0.05,P=0.001);建德市的大慈岩镇、新安江镇、洋溪街道、更楼街道、莲花镇和寿昌镇监测人群心脑血管疾病的急性发作在2000/12/1-2004/12/22期间具有聚集性(SMR=0.01,P=0.001),富阳市的富春街道、渔山乡监测人群心脑血管疾病的急性发作在1995/6/15-2005/11/18期间具有聚集性(SMR=0.05,P=0.001);建德市的大洋镇、童家乡和富阳市的大源镇监测人群心脑血管疾病的急性发作在2002/1/15-2004/7/17期间具有聚集性(SMR=3.13,P=0.001);富阳市的高桥镇和灵桥镇监测人群心脑血管疾病的急性发作在1997/1/1-2004/5/17期间具有聚集性(SMR=2.77,P=0.001);杭州市的石桥街道、东新街道、文晖街道和潮鸣街道监测人群心脑血管疾病的急性发作在2001/12/21-2004/12/28期间具有聚集性(SMR=0.17,P=0.001);富阳市的大同镇监测人群心脑血管疾病的急性发作在2002/2/2-2004/12/13期间具有聚集性(SMR=2.52,P=0.001)。
富阳市的渌渚镇、新桐乡、新登镇、场口镇、万市镇、鹿山街道、永昌镇、环山乡、春建乡、湖源乡、常安镇、洞桥镇、富春街道、上官乡、灵桥镇、东洲街道、常绿镇、高桥镇、受降镇、里山镇、渔山乡、大源镇和建德市的乾潭镇、杨村桥镇、三都镇、下涯镇、梅城镇、洋溪街道、莲花镇、大洋镇监测人群的冠心病急性发作在2004/7/15-2005/12/11期间具有聚集性(SMR=0.42,P=0.001),杭州市的石桥街道、东新街道、文晖街道和潮鸣街道监测人群的冠心病急性发作在2002/1/5-2005/1/25期间具有聚集性(SMR=0.00,P=0.001),杭州市的紫阳街道、城站街道、小营街道、湖滨街道、望江街道、天水街道、朝晖街道、武林街道、长庆街道和清波街道监测人群的冠心病急性发作在2004/7/4-2006/1/2期间具有聚集性(SMR=1.44,P=0.006)。
富阳市的新登镇、永昌镇、春建乡、万市镇、鹿山街道、场口镇、新义乡、富春街道、环山乡和东洲街道监测人群的脑卒中急性发作在2002/7/28-2005/11/30期间具有聚集性(SMR=0.00,P=0.001),建德市的大同镇监测人群的脑卒中急性发作在2002/8/15-2004/1/25期间具有聚集性(SMR=4.19,P=0.002),杭州市的清波街道,武林街道,天水街道和朝晖街道监测人群的脑卒中急性发作在2005/3/31-2005/9/10期间具有随机性(SMR=5.26,P=0.591),富阳市的富春街道监测人群的脑卒中急性发作在2006/4/14-2006/4/28期间具有随机性(SMR=23.00,P=0.722),建德市的三都镇和洋溪街道监测人群的脑卒中急性发作在2005/1/11-2005/2/15期间具有随机性(SMR=22.08,P=0.754)。
建德市的大同镇、寿昌镇、下涯镇、乾潭镇和富阳市的场口镇监测人群的心源性猝死急性发作在2005/6/20-2006/12/20期间具有聚集性(SMR=0.07,P=0.001),杭州市的长庆街道、小营街道、武林街道、湖滨街道、天水街道、文晖街道、清波街道、紫阳街道、望江街道、朝晖街道、南星桥街道和石桥街道监测人群的心源性猝死急性发作在2002/8/26-2004/12/20期间具有随机性(SMR=0.00,P=0.072),富阳市的受降镇监测人群的心源性猝死急性发作在2004/12/20-2005/4/29期间具有随机性(SMR=10.78,P=0.394),富阳市的万市镇监测人群的心源性猝死急性发作在2006/1/19-2006/1/19期间具有随机性(SMR=48.50,P=0.512),富阳市的高桥镇和灵桥镇监测人群的心源性猝死急性发作在2005/10/18-2005/11/18期间具有随机性(SMR=32.33,P=0.890)。
富阳市的渌渚镇、胥口镇、新桐乡、新登镇、场口镇、万市镇、鹿山街道、永昌镇、环山乡、春建乡、湖源乡、常安镇、龙门镇和洞桥镇监测人群的脑出血急性发作在2000/11/20-2005/9/8期间具有聚集性(SMR=0.03,P=0.001),建德市的大慈岩镇、新安江镇、更楼街道、莲花镇和寿昌镇监测人群的脑出血急性发作在2000/12/1-2004/12/20期间具有聚集性(SMR=0.01,P=0.001),建德市的大洋镇、大源镇和童家乡监测人群的脑出血急性发作在2002/2/16-2004/9/28期间具有聚集性(SMR=2.66,P=0.001),杭州市的长庆街道、天水街道、朝晖街道、武林街道、小营街道、潮鸣街道、清波街道、湖滨街道、城站街道、文晖街道、东新街道、紫阳街道、望江街道、石桥街道和富阳市的富春街道和渔山乡监测人群的脑出血急性发作在1999/9/11-2004/4/12期间具有聚集性(SMR=0.37,P=0.001),富阳市的高桥镇和灵桥镇监测人群的脑出血急性发作在2005/12/6-2007/2/8期间具有聚集性(SMR=0.31,P=0.001),富阳市的东洲街道监测人群的脑出血急性发作在2001/8/1-2005/12/19期间具有聚集性(SMR=0.03,P=0.001)。
富阳市的龙门镇、环山乡、上官乡、常安镇、场口镇、鹿山街道、湖源乡、新桐乡、常绿镇、灵桥镇、里山镇、高桥镇、东洲街道、渔山乡、春建乡、富春街道,新登镇、渌渚镇、永昌镇、受降镇、胥口镇、万市镇、洞桥镇,杭州市的南星街道、紫阳街道与望江街道和建德市的寿昌镇监测人群的脑血栓形成急性发作在2001/5/10-2005/12/28期间具有聚集性(SMR=0.44,P=0.001),建德市的乾潭镇监测人群的脑血栓形成急性发作在2002/1/12-2003/11/14期间具有聚集性(SMR=12.73,P=0.001),杭州市的长庆街道、天水街道、朝晖街道、武林街道和小营街道监测人群的脑血栓形成急性发作在2004/3/25-2005/1/28期间具有聚集性(SMR=2.67,P=0.010),杭州市的东新街道监测人群的脑血栓形成急性发作在2007/1/15-2007/1/18期间具有随机性(SMR=84.09,P=0.191)。
富阳市的渌渚镇、胥口镇、新桐乡、新登镇、场口镇、万市镇、鹿山街道、永昌镇、环山乡、春建乡、湖源乡、常安镇、龙门镇和洞桥镇监测人群的脑栓塞急性发作在1995/6/15-2005/11/30期间具有聚集性(SMR=0.01,P=0.001),建德市的大慈岩镇、新安江镇、更楼街道、莲花镇和寿昌镇监测人群的脑栓塞急性发作在1997/11/7-2005/1/13期间具有聚集性(SMR=0.00,P=0.001),富阳市的富春街道和渔山乡监测人群的脑栓塞急性发作在1995/6/15-2005/12/5期间具有聚集性(SMR=0.03,P=0.001),杭州市的城站街道、小营街道、长庆街道和紫阳街道监测人群的脑栓塞急性发作在2002/9/21-2005/2/14期间具有聚集性(SMR=2.02,P=0.001)。
心脑血管疾病急性发作率与星期几[以星期天为参照,其中星期四(t=2.933,P=0.003),星期六(t=3.015,P=0.003)]、与大气气溶胶日平均光学厚度(t=2.962,P=0.003)有关。其中冠心病与云层(t=2.860,P=0.004)、与PM_(10)日平均浓度有(t=2.388,P=0.017),与气溶胶类型(t=2.680,P=0.008)有关;心源性猝死与星期几[以星期天为参照,其中星期六(t=2.918,P=0.004),星期五(t=3.746,P=0.000)]、与云层(t=2.779,P=0.006)有关;脑卒中与云层有关(t=2.088,P=0.037);脑出血与大气气溶胶日平均光学厚度有关(t=2.117,P=0.035);脑血栓与星期几有关[以星期天为参照,其中星期一(t=3.176,P=0.002),星期二(t=2.133,P=0.033),星期六(t=2.600,P=0.009)];脑栓塞与星期几有关[以星期天为参照,其中星期六(t=2.600,P=0.009)]。
结论:
杭州市大气气溶胶具有自相关性和明显的时空特征,大气气溶胶与环境和气象因素有关。心脑血管疾病急性发作具有时空聚集性,大气气溶胶对心脑血管疾病和脑出血急性发作有影响。
Objective:
The aims of the study were to explore whether or not the acute attacks of cardio-cerebral-vascular diseases were associated with time,geographical factors,and atmospheric aerosol,to investigate the space-time distribution of atmospheric aerosol and its related factors in Hangzhou city,to describe the space-time clusters of the acute attacks of cardio-cerebral-vascular diseases among the monitored population in Hangzhou city,and to study the associations of atmospheric aerosol with the acute attacks of cardio- cerebral-vascular diseases.
Methods:
The temporal pattern of atmospheric aerosol was examined using autocorrelation analysis and Kringing interpolation methods of spatial statistics.The autoregressive-moving average model was used to analyze the related factors of atmospheric aerosol.The spatial distribution of cardio-cerebral-vascular diseases was evaluated by Kringing interpolation method of spatial statistics.The clusters of cardio-cerebral-vascular diseases were examined using the retrospective space-time permutation model.The association of atmospheric aerosol with the attacks of cardio-cerebral-vascular diseases was analyzed using cross-correlation analysis and time series Poisson regression analysis.The autocorrelation analysis and Kringing interpolation of spatial statistics analyses were conducted using DPS version 9.50.The analysis of the retrospective space-time permutation models was performed using SaTscan version 7.0.3.The other statistical analyses were carried out using SPSS version 16.0 program for Windows.A two-tailedαvalue equal to 0.05 served as the threshold for statistical significance.
Results:
To certain extent,the temporal pattern of atmospheric aerosol optical depth(AOD) in Hangzhou city presented the periodicity.There were positive correlations between AODs in 0 day,lag 96~(th),383~(rd),479~(th),766~(th),1149~(th) and 1532~(nd) day.It indicated global spatial clustering.However,there were negative correlations between AODs in 0 day, lag 191~(st),287~(th),574~(th),957~(th),1340~(th) and 1723~(rd) day.
AOD in resident region was higher than that in non-resident region,and there was difference in AOD for various monthes.
AOD in the first day was positively related with AOD in lag 1~(st) day(7=39.531, P<0.001).AOD was related with relative humidity(7=3.700,P<0.001),SO_2(t=-3.064, P=0.002),NO_2(t=2.148,P=0.032),and NO_2 in lag 1~(st) day(t=-2.769,P=0.006).But the statistical significant associations of AOD with temperature and cloud mask were not observed.
There was statistically significance on the geographical cluster of attacks of cardio-cerebral-vascular diseases among the monitored population from October 20, 1998 to November 25,2005 in Lvzhu town,Xukou town,Xintong township,Xindeng town,Changkou town,Wanshi town,Lushan neighbourhood,Yongchang town, Dongzhou neighbourhood,Huangshan township,Chunjian township,Huyuan township, Changan town,Longmen town and Dongqiao town in Fuyang city(SMR=0.05, P=0.001),from December 1,2000 to December 22,2004 in Daciyan town,Xinanjiang town,Yangxi neighbourhood,Genglou neighbourhood,Lianhua town and Shouchang town in Jiande city(SMR=0.01,P=0.001),from June 15,1995 to November 18,2005 in Fuchun neighbourhood,Yushan township in Fuyang city(SMR=0.05,P=0.001),from January 15,2002 to July 17,2004 in Dayang town,Tongjia township in Jiande city and Dayuan town in Fuyang city(SMR=3A3,P=0.001),from January 1,1997 to May 17, 2004 in Gaoqiao town,Lingqiao town in Fuyang city(SMR=2.77,P=0.001),from December 21,2001 to December 28,2004 in Shiqiao neighbourhood,Dongxin neighbourhood,Wenhui neighbourhood,Chaoming neighbourhood in Hangzhou city (SMR=0.17,P=0.001),and from February 2,2002 to December 13,2004 in Datong town in Fuyang city(SMR=2.52,P=0.001).
There was statistically significance on the geographical cluster of attacks of coronary heart disease(CHD) among the monitored population from July 15,2004 to December 11,2005 in Lvzhu town,Xintong township,Xindeng town,Changkou town, Wanshi town,Lushan neighbourhood,Yongchang town,Huanshan township,Chunjian township,Huyuan township,Changan town,Dongqiao town,Fuchun neighbourhood, Shangguan township,lingqiao town,Dongzhou neighbourhood,Changlv town,Gaoqiao town,Shouxiang town,Lishan town,Yushan township,Dayuan town in Fuyang city and Qiantan town,Yangcunqiao town,Sandu town,Xiaya town,Meicheng town, Yangxi neighbourhood,Lianhua town,Dayang town in Jiande city(SMR=0.42, P=0.001),from January 5,2002 to January 25,2005 in Shiqiao neighbourhood, Dongxin neighbourhood,Wenhui neighbourhood and Chaoming neighbourhood in Hangzhou city(SMR=0.00,P=0.001),from July 4,2004 to January 2,2006 in Ziyang neighbourhood,Chengzhan neighbourhood,Xiaoying neighbourhood,Hubin neighbourhood,Wangjiang neighbourhood,Tianshui neighbourhood,Zhaohui neighbourhood,Wulin neighbourhood,Changqing neighbourhood and Qingbo neighbourhood in Hangzhou city(SMR=1.44,P=0.006).
There was statistically significance on the geographical cluster of attacks of stroke among the monitored population from July 28,2002 to Noveber 30,2005 in Xindeng town,Yongchang town,Chunjian township,Wanshi town,Lushan neighbourhood, Changkou town,Xinyi township,Fuchun neighbourhood,Huanshan township,and Dongzhou neighbourhood in Fuyang city(SMR=0.00,P=0.001),form August 15, 2002 to January 25,2004 in Datong in Jiande city(SMR=4.19,P=0.002),there was random on the geographical cluster of attacks of stroke among the monitored population from March 31,2005 to September 10,2005 in Qingbo neighbourhood,Wulin neighbourhood,Tianshui neighbourhood and Zhaohui neighbourhood in Hangzhou city (SMR=5.26,P=0.591),from April 14,2006 to April 28,2006 in Fuchun neighbourhood in Fuyang city(SMR=23.00,P=0.722),from January 11,2005 to Februray 12,2005 in Sandu town and Yangxi neighbourhood in Jiande city(SMR=22.08,P=0.754).
There was statistically significance on the geographical cluster of attacks of cardiogenic sudden death among the monitored population from June 20,2005 to December 20,2006 in Datong town,Shouchang town,Xiaya town,Qiantan town in Jiande city and in Changkou town in Fuyang city(SMR=0.07,P=0.001),there was random on the geographical cluster of attacks of cardiogenic sudden death among the monitored population from August 26,2002 to December 20,2004 in Changqing neighbourhood,Xiaoying neighbourhood,Hubin neighbourhood,Tianshui neighbourhood,Wenhui neighbourhood,Qingbo neighbourhood,Ziyang neighbourhood,Wangjiang neighbourhood,Zhaohui neighbourhood,Nanxing neighbourhood and Shiqiao neighbourhood in Hangzhou city(SMR=0.00,P=0.072), from December 20,2004 to April 29,2005 in Shouxiang town in Fuyang city (SMR=10.78,P=0.394),from January 19,2006 to January 19,2006 in Wanshi town in Fuyang city(SMR=48.50,P=0.512),from October 18,2005 to November 18,2005 in Gaoqiao town and Lingqiao town in Fuyang city(SMR=32.33,P=0.890).
There was statistically significance on the geographical cluster of attacks of intracerebral hemorrhage among the monitored population from November 20,2000 to September 8,2005 in Lvzhu town,Xukou town,Xintong town,Xindeng town, Changkou town,Wanshi town,Lushan neighbourhood,Yongchang town,Huanshan township,Chunjian township,Huyuan township,Changan town,Longmen town and Dongqiao town in Fuyang city(SMR=0.03,P=0.001),from December 1,2000 to December 20,2004 in Daciyan town,Xinanjiang town,Genglou neighbourhood, Lianhua town,and Shouchang town in Jiande city(SMR=0.01,P=0.001),from February 16,2002 to September 28,2004 in Dayang town,Dayuan town and Tongjia township in Jiande city(SMR=2.66,P=0.0.01),from September 11,1999 to April 12,2004 in Changqing neighbourhood,Tianshui neighbourhood,Zhaohui neighbourhood,Wulin neighbourhood,Xiaoying neighbourhood,Chaoming neighbourhood,Qingbo neighbourhood,Hubin neighbourhood,Chengzhan neighbourhood,Wenhui neighbourhood,Dongxin neighbourhood,Ziyang neighbourhood,Wangjiang neighbourhood,Shiqiao neighbourhood in Hangzhou city and Fuchun neighbourhood and Yushan township in Fuyang city(SMR=0.37,P=0.001),from December 6,2005 to February 8,2007 in Gaoqiao town and Lingqiao town in Fuyang city(SMR=0.31, P=0.001),from August 1,2001 to December 19,2005 in Dongzhou in Fuyang city(SMR=0.03,P=0.001).
There was statistically significance on the geographical cluster of attacks of cerebral thrombosis among the monitored population from May 10,2001 to Deccember 28,2005 in Longmen town,Huanshan township,Shangguan township,Changan town, Changkou town,Lushan neighbourhood,Huyuan township,Xintong township,Changlv town,Liangqiao town,Lishan town,Gaoqiao town,Dongzhou neighbourhood,Yushan township,Chunjian township,Xindeng town,Lvzhu town,Yongchang town,Shouxiang town,Xukou town,Wanshi town,Dongqiao town in Fuyang city,in Nanxing neighbourhood,Ziyang neighbourhood and Wangjiang neighbourhood in Hangzhou city and Shouchang town in Jiande city(SMR=0.44,P=0.001),from January 12,2002 to november 14,2003 in Qiantan town in Jiande city(SMR=12.73,P=0.001),from March 25,2004 to January 28,2005 in Changqing neighbourhood,Tianshui neighbourhood, Zhaohui neighbourhood,Wulin neighbourhood,Xiaoying neighbourhood in Hangzhou city(SMR=2.67,P=0.010),There was random on the geographical cluster of attacks of cerebral thrombosis among the monitored population from January 15,2007 to January 18,2007 in Dongxin neighbourhood in Hangzhou city(SMR=84.09,P=0.191).
There was statistically significance on the geographical cluster of attacks of cerebral embolism among the monitored population from June 15,1995 to November 30,2005 in Lvzhu town,Xukou town,Xintong township,Xindeng town,Changkou town,Wanshi town,Lushan neighbourhood,Yongchang town,Huanshan township, Chunjian township,Huyuan township,Changan town,Longmen town and Dongqiao town in Fuyang city(SMR=0.01,P=0.001),from november 7,1997 to January 13,2005 in Daciyan town,Xinanjiang town,Genglou neighbourhood,Lianhua town and Shouchang town in Jiande city(SMR=0.00,P=0.001),from June 15,1995 to December 5,2005 in Fuchun neighbourhood and Yushan township in Fuyang city (SMR=0.03,P=0.001),from September 21,2002 to February 14,2005 in Chengzhan neighbourhood,Xiaoying neighbourhood,Changqing neighbourhood and Ziyang neighbourhood in Hangzhou city(SMR=2.02,P=0.001).
The attacks of cardio-cerebral-vascular diseases were related to the day of a week [attacks on Sunday as control,its on Thursday(t=2.933,P=0.003) and Saturday (t=3.015,P=0.003)],and to the average AOD(t= 2.962,P=0.003).The attacks of coronary heart disease were associated with cloud mask(t=2.860,P =0.004),the daily average concentration of PM_(10)(t=2.388,P=0.017) and type of aerosol(t=2.690, P=0.008).The attacks of cardiogenic sudden death were related to the day of a week [attacks on Sunday as control,its on Saturday(t=2.918,P =0.004) and Friday(t=3.746, P <0.001)],to cloud mask(t=2.680,P=0.008).The attacks of stroke were associated with cloud mask(t=2.088,P=0.037).The attacks of intracerebral hemorrhage were related to AOD(t=2.117,P=0.035).The attacks of cerebral thrombosis were related to the day of a week[attacks on Sunday as control,its on Monday(t=3.176,P=0.002), Tuesday(t=2.133,P=0.033) and Saturday 0=2.600,P 0.009)].The attacks of cerebral emblolism were associated with the day of a week[attacks on Sunday as control,its on Saturday(t=2.600,P=0.009)].
Conclusions:
To certain extent,the space-time distribution of AOD in Hangzhou city appeared positive autocorrelation,which is obvious characteristic of spatial-time.The results supported the hypothesis that AOD associates with the environmental and meteorological factors.The attacks of cardio-cerebral-vascular disease presented space-time cluster.The attacks of cardio-cerebral-vascular disease and intra-cerebral hemorrhage were positively related to AOD.
为了了解心脑血管疾病急性发作是否与时间、地理因素和大气气溶胶有关,研究杭州市大气气溶胶的时空分布及其相关因素,描述杭州市监测人群心脑血管疾病急性发作的时空聚集性,探索大气气溶胶与心脑血管疾病急性发作之间的关系。
方法:
大气气溶胶的时间分布采用空间统计学中的自相关分析和kringing插值法,大气气溶胶的相关因素采用自回归滑动平均模型,心脑血管疾病的空间分布采用空间统计学中的Kringing插值法,心脑血管疾病的聚集性采用回顾性重排模型,大气气溶胶与心脑血管疾病的关系采用交互相关分析和时间序列Poisson回归模型。有关数据的空间统计学中的自相关和Kringing插值法采用DPS 9.50数据处理系统,回顾性时空重排模型分析采用SaTScan 7.0.3统计分析软件,其它统计分析采用SPSS 16.0 for Windows统计分析软件,以双侧α=0.05为检验水准。
结果:
杭州市大气气溶胶(aerosol optical depth,AOD)在时间分布上具有一定的周期性;在滞后96天、383天、479天、766天、1149天和1532天内呈正相关关系,即趋同的趋势;在滞后191天、287天、574天、957天、1340天和1723天内呈负相关关系,其它没有统计学意义。
杭州市AOD在居民区域较高,在有山或有水区域AOD较低;不同月份的AOD分布也不相同。
AOD与次日AOD存在正相关关系(t=39.531,P=0.000);AOD与相对湿度(t=3.700,P=0.000)、SO_2(t=-3.064,P=0.002)、NO_2(t=2.148,P=0.032)以及滞后一日的NO_2(t=-2.769,P=0.006)存在关联,而与温度和云层无统计学关联。
富阳市的渌渚镇、胥口镇、新桐乡、新登镇、场口镇、万市镇、鹿山街道、永昌镇、东洲街道、环山乡、春建乡、湖源乡、常安镇、龙门镇和洞桥镇监测人群心脑血管疾病的急性发作在1998/10/20-2005/11/25期间具有聚集性(SMR=0.05,P=0.001);建德市的大慈岩镇、新安江镇、洋溪街道、更楼街道、莲花镇和寿昌镇监测人群心脑血管疾病的急性发作在2000/12/1-2004/12/22期间具有聚集性(SMR=0.01,P=0.001),富阳市的富春街道、渔山乡监测人群心脑血管疾病的急性发作在1995/6/15-2005/11/18期间具有聚集性(SMR=0.05,P=0.001);建德市的大洋镇、童家乡和富阳市的大源镇监测人群心脑血管疾病的急性发作在2002/1/15-2004/7/17期间具有聚集性(SMR=3.13,P=0.001);富阳市的高桥镇和灵桥镇监测人群心脑血管疾病的急性发作在1997/1/1-2004/5/17期间具有聚集性(SMR=2.77,P=0.001);杭州市的石桥街道、东新街道、文晖街道和潮鸣街道监测人群心脑血管疾病的急性发作在2001/12/21-2004/12/28期间具有聚集性(SMR=0.17,P=0.001);富阳市的大同镇监测人群心脑血管疾病的急性发作在2002/2/2-2004/12/13期间具有聚集性(SMR=2.52,P=0.001)。
富阳市的渌渚镇、新桐乡、新登镇、场口镇、万市镇、鹿山街道、永昌镇、环山乡、春建乡、湖源乡、常安镇、洞桥镇、富春街道、上官乡、灵桥镇、东洲街道、常绿镇、高桥镇、受降镇、里山镇、渔山乡、大源镇和建德市的乾潭镇、杨村桥镇、三都镇、下涯镇、梅城镇、洋溪街道、莲花镇、大洋镇监测人群的冠心病急性发作在2004/7/15-2005/12/11期间具有聚集性(SMR=0.42,P=0.001),杭州市的石桥街道、东新街道、文晖街道和潮鸣街道监测人群的冠心病急性发作在2002/1/5-2005/1/25期间具有聚集性(SMR=0.00,P=0.001),杭州市的紫阳街道、城站街道、小营街道、湖滨街道、望江街道、天水街道、朝晖街道、武林街道、长庆街道和清波街道监测人群的冠心病急性发作在2004/7/4-2006/1/2期间具有聚集性(SMR=1.44,P=0.006)。
富阳市的新登镇、永昌镇、春建乡、万市镇、鹿山街道、场口镇、新义乡、富春街道、环山乡和东洲街道监测人群的脑卒中急性发作在2002/7/28-2005/11/30期间具有聚集性(SMR=0.00,P=0.001),建德市的大同镇监测人群的脑卒中急性发作在2002/8/15-2004/1/25期间具有聚集性(SMR=4.19,P=0.002),杭州市的清波街道,武林街道,天水街道和朝晖街道监测人群的脑卒中急性发作在2005/3/31-2005/9/10期间具有随机性(SMR=5.26,P=0.591),富阳市的富春街道监测人群的脑卒中急性发作在2006/4/14-2006/4/28期间具有随机性(SMR=23.00,P=0.722),建德市的三都镇和洋溪街道监测人群的脑卒中急性发作在2005/1/11-2005/2/15期间具有随机性(SMR=22.08,P=0.754)。
建德市的大同镇、寿昌镇、下涯镇、乾潭镇和富阳市的场口镇监测人群的心源性猝死急性发作在2005/6/20-2006/12/20期间具有聚集性(SMR=0.07,P=0.001),杭州市的长庆街道、小营街道、武林街道、湖滨街道、天水街道、文晖街道、清波街道、紫阳街道、望江街道、朝晖街道、南星桥街道和石桥街道监测人群的心源性猝死急性发作在2002/8/26-2004/12/20期间具有随机性(SMR=0.00,P=0.072),富阳市的受降镇监测人群的心源性猝死急性发作在2004/12/20-2005/4/29期间具有随机性(SMR=10.78,P=0.394),富阳市的万市镇监测人群的心源性猝死急性发作在2006/1/19-2006/1/19期间具有随机性(SMR=48.50,P=0.512),富阳市的高桥镇和灵桥镇监测人群的心源性猝死急性发作在2005/10/18-2005/11/18期间具有随机性(SMR=32.33,P=0.890)。
富阳市的渌渚镇、胥口镇、新桐乡、新登镇、场口镇、万市镇、鹿山街道、永昌镇、环山乡、春建乡、湖源乡、常安镇、龙门镇和洞桥镇监测人群的脑出血急性发作在2000/11/20-2005/9/8期间具有聚集性(SMR=0.03,P=0.001),建德市的大慈岩镇、新安江镇、更楼街道、莲花镇和寿昌镇监测人群的脑出血急性发作在2000/12/1-2004/12/20期间具有聚集性(SMR=0.01,P=0.001),建德市的大洋镇、大源镇和童家乡监测人群的脑出血急性发作在2002/2/16-2004/9/28期间具有聚集性(SMR=2.66,P=0.001),杭州市的长庆街道、天水街道、朝晖街道、武林街道、小营街道、潮鸣街道、清波街道、湖滨街道、城站街道、文晖街道、东新街道、紫阳街道、望江街道、石桥街道和富阳市的富春街道和渔山乡监测人群的脑出血急性发作在1999/9/11-2004/4/12期间具有聚集性(SMR=0.37,P=0.001),富阳市的高桥镇和灵桥镇监测人群的脑出血急性发作在2005/12/6-2007/2/8期间具有聚集性(SMR=0.31,P=0.001),富阳市的东洲街道监测人群的脑出血急性发作在2001/8/1-2005/12/19期间具有聚集性(SMR=0.03,P=0.001)。
富阳市的龙门镇、环山乡、上官乡、常安镇、场口镇、鹿山街道、湖源乡、新桐乡、常绿镇、灵桥镇、里山镇、高桥镇、东洲街道、渔山乡、春建乡、富春街道,新登镇、渌渚镇、永昌镇、受降镇、胥口镇、万市镇、洞桥镇,杭州市的南星街道、紫阳街道与望江街道和建德市的寿昌镇监测人群的脑血栓形成急性发作在2001/5/10-2005/12/28期间具有聚集性(SMR=0.44,P=0.001),建德市的乾潭镇监测人群的脑血栓形成急性发作在2002/1/12-2003/11/14期间具有聚集性(SMR=12.73,P=0.001),杭州市的长庆街道、天水街道、朝晖街道、武林街道和小营街道监测人群的脑血栓形成急性发作在2004/3/25-2005/1/28期间具有聚集性(SMR=2.67,P=0.010),杭州市的东新街道监测人群的脑血栓形成急性发作在2007/1/15-2007/1/18期间具有随机性(SMR=84.09,P=0.191)。
富阳市的渌渚镇、胥口镇、新桐乡、新登镇、场口镇、万市镇、鹿山街道、永昌镇、环山乡、春建乡、湖源乡、常安镇、龙门镇和洞桥镇监测人群的脑栓塞急性发作在1995/6/15-2005/11/30期间具有聚集性(SMR=0.01,P=0.001),建德市的大慈岩镇、新安江镇、更楼街道、莲花镇和寿昌镇监测人群的脑栓塞急性发作在1997/11/7-2005/1/13期间具有聚集性(SMR=0.00,P=0.001),富阳市的富春街道和渔山乡监测人群的脑栓塞急性发作在1995/6/15-2005/12/5期间具有聚集性(SMR=0.03,P=0.001),杭州市的城站街道、小营街道、长庆街道和紫阳街道监测人群的脑栓塞急性发作在2002/9/21-2005/2/14期间具有聚集性(SMR=2.02,P=0.001)。
心脑血管疾病急性发作率与星期几[以星期天为参照,其中星期四(t=2.933,P=0.003),星期六(t=3.015,P=0.003)]、与大气气溶胶日平均光学厚度(t=2.962,P=0.003)有关。其中冠心病与云层(t=2.860,P=0.004)、与PM_(10)日平均浓度有(t=2.388,P=0.017),与气溶胶类型(t=2.680,P=0.008)有关;心源性猝死与星期几[以星期天为参照,其中星期六(t=2.918,P=0.004),星期五(t=3.746,P=0.000)]、与云层(t=2.779,P=0.006)有关;脑卒中与云层有关(t=2.088,P=0.037);脑出血与大气气溶胶日平均光学厚度有关(t=2.117,P=0.035);脑血栓与星期几有关[以星期天为参照,其中星期一(t=3.176,P=0.002),星期二(t=2.133,P=0.033),星期六(t=2.600,P=0.009)];脑栓塞与星期几有关[以星期天为参照,其中星期六(t=2.600,P=0.009)]。
结论:
杭州市大气气溶胶具有自相关性和明显的时空特征,大气气溶胶与环境和气象因素有关。心脑血管疾病急性发作具有时空聚集性,大气气溶胶对心脑血管疾病和脑出血急性发作有影响。
Objective:
The aims of the study were to explore whether or not the acute attacks of cardio-cerebral-vascular diseases were associated with time,geographical factors,and atmospheric aerosol,to investigate the space-time distribution of atmospheric aerosol and its related factors in Hangzhou city,to describe the space-time clusters of the acute attacks of cardio-cerebral-vascular diseases among the monitored population in Hangzhou city,and to study the associations of atmospheric aerosol with the acute attacks of cardio- cerebral-vascular diseases.
Methods:
The temporal pattern of atmospheric aerosol was examined using autocorrelation analysis and Kringing interpolation methods of spatial statistics.The autoregressive-moving average model was used to analyze the related factors of atmospheric aerosol.The spatial distribution of cardio-cerebral-vascular diseases was evaluated by Kringing interpolation method of spatial statistics.The clusters of cardio-cerebral-vascular diseases were examined using the retrospective space-time permutation model.The association of atmospheric aerosol with the attacks of cardio-cerebral-vascular diseases was analyzed using cross-correlation analysis and time series Poisson regression analysis.The autocorrelation analysis and Kringing interpolation of spatial statistics analyses were conducted using DPS version 9.50.The analysis of the retrospective space-time permutation models was performed using SaTscan version 7.0.3.The other statistical analyses were carried out using SPSS version 16.0 program for Windows.A two-tailedαvalue equal to 0.05 served as the threshold for statistical significance.
Results:
To certain extent,the temporal pattern of atmospheric aerosol optical depth(AOD) in Hangzhou city presented the periodicity.There were positive correlations between AODs in 0 day,lag 96~(th),383~(rd),479~(th),766~(th),1149~(th) and 1532~(nd) day.It indicated global spatial clustering.However,there were negative correlations between AODs in 0 day, lag 191~(st),287~(th),574~(th),957~(th),1340~(th) and 1723~(rd) day.
AOD in resident region was higher than that in non-resident region,and there was difference in AOD for various monthes.
AOD in the first day was positively related with AOD in lag 1~(st) day(7=39.531, P<0.001).AOD was related with relative humidity(7=3.700,P<0.001),SO_2(t=-3.064, P=0.002),NO_2(t=2.148,P=0.032),and NO_2 in lag 1~(st) day(t=-2.769,P=0.006).But the statistical significant associations of AOD with temperature and cloud mask were not observed.
There was statistically significance on the geographical cluster of attacks of cardio-cerebral-vascular diseases among the monitored population from October 20, 1998 to November 25,2005 in Lvzhu town,Xukou town,Xintong township,Xindeng town,Changkou town,Wanshi town,Lushan neighbourhood,Yongchang town, Dongzhou neighbourhood,Huangshan township,Chunjian township,Huyuan township, Changan town,Longmen town and Dongqiao town in Fuyang city(SMR=0.05, P=0.001),from December 1,2000 to December 22,2004 in Daciyan town,Xinanjiang town,Yangxi neighbourhood,Genglou neighbourhood,Lianhua town and Shouchang town in Jiande city(SMR=0.01,P=0.001),from June 15,1995 to November 18,2005 in Fuchun neighbourhood,Yushan township in Fuyang city(SMR=0.05,P=0.001),from January 15,2002 to July 17,2004 in Dayang town,Tongjia township in Jiande city and Dayuan town in Fuyang city(SMR=3A3,P=0.001),from January 1,1997 to May 17, 2004 in Gaoqiao town,Lingqiao town in Fuyang city(SMR=2.77,P=0.001),from December 21,2001 to December 28,2004 in Shiqiao neighbourhood,Dongxin neighbourhood,Wenhui neighbourhood,Chaoming neighbourhood in Hangzhou city (SMR=0.17,P=0.001),and from February 2,2002 to December 13,2004 in Datong town in Fuyang city(SMR=2.52,P=0.001).
There was statistically significance on the geographical cluster of attacks of coronary heart disease(CHD) among the monitored population from July 15,2004 to December 11,2005 in Lvzhu town,Xintong township,Xindeng town,Changkou town, Wanshi town,Lushan neighbourhood,Yongchang town,Huanshan township,Chunjian township,Huyuan township,Changan town,Dongqiao town,Fuchun neighbourhood, Shangguan township,lingqiao town,Dongzhou neighbourhood,Changlv town,Gaoqiao town,Shouxiang town,Lishan town,Yushan township,Dayuan town in Fuyang city and Qiantan town,Yangcunqiao town,Sandu town,Xiaya town,Meicheng town, Yangxi neighbourhood,Lianhua town,Dayang town in Jiande city(SMR=0.42, P=0.001),from January 5,2002 to January 25,2005 in Shiqiao neighbourhood, Dongxin neighbourhood,Wenhui neighbourhood and Chaoming neighbourhood in Hangzhou city(SMR=0.00,P=0.001),from July 4,2004 to January 2,2006 in Ziyang neighbourhood,Chengzhan neighbourhood,Xiaoying neighbourhood,Hubin neighbourhood,Wangjiang neighbourhood,Tianshui neighbourhood,Zhaohui neighbourhood,Wulin neighbourhood,Changqing neighbourhood and Qingbo neighbourhood in Hangzhou city(SMR=1.44,P=0.006).
There was statistically significance on the geographical cluster of attacks of stroke among the monitored population from July 28,2002 to Noveber 30,2005 in Xindeng town,Yongchang town,Chunjian township,Wanshi town,Lushan neighbourhood, Changkou town,Xinyi township,Fuchun neighbourhood,Huanshan township,and Dongzhou neighbourhood in Fuyang city(SMR=0.00,P=0.001),form August 15, 2002 to January 25,2004 in Datong in Jiande city(SMR=4.19,P=0.002),there was random on the geographical cluster of attacks of stroke among the monitored population from March 31,2005 to September 10,2005 in Qingbo neighbourhood,Wulin neighbourhood,Tianshui neighbourhood and Zhaohui neighbourhood in Hangzhou city (SMR=5.26,P=0.591),from April 14,2006 to April 28,2006 in Fuchun neighbourhood in Fuyang city(SMR=23.00,P=0.722),from January 11,2005 to Februray 12,2005 in Sandu town and Yangxi neighbourhood in Jiande city(SMR=22.08,P=0.754).
There was statistically significance on the geographical cluster of attacks of cardiogenic sudden death among the monitored population from June 20,2005 to December 20,2006 in Datong town,Shouchang town,Xiaya town,Qiantan town in Jiande city and in Changkou town in Fuyang city(SMR=0.07,P=0.001),there was random on the geographical cluster of attacks of cardiogenic sudden death among the monitored population from August 26,2002 to December 20,2004 in Changqing neighbourhood,Xiaoying neighbourhood,Hubin neighbourhood,Tianshui neighbourhood,Wenhui neighbourhood,Qingbo neighbourhood,Ziyang neighbourhood,Wangjiang neighbourhood,Zhaohui neighbourhood,Nanxing neighbourhood and Shiqiao neighbourhood in Hangzhou city(SMR=0.00,P=0.072), from December 20,2004 to April 29,2005 in Shouxiang town in Fuyang city (SMR=10.78,P=0.394),from January 19,2006 to January 19,2006 in Wanshi town in Fuyang city(SMR=48.50,P=0.512),from October 18,2005 to November 18,2005 in Gaoqiao town and Lingqiao town in Fuyang city(SMR=32.33,P=0.890).
There was statistically significance on the geographical cluster of attacks of intracerebral hemorrhage among the monitored population from November 20,2000 to September 8,2005 in Lvzhu town,Xukou town,Xintong town,Xindeng town, Changkou town,Wanshi town,Lushan neighbourhood,Yongchang town,Huanshan township,Chunjian township,Huyuan township,Changan town,Longmen town and Dongqiao town in Fuyang city(SMR=0.03,P=0.001),from December 1,2000 to December 20,2004 in Daciyan town,Xinanjiang town,Genglou neighbourhood, Lianhua town,and Shouchang town in Jiande city(SMR=0.01,P=0.001),from February 16,2002 to September 28,2004 in Dayang town,Dayuan town and Tongjia township in Jiande city(SMR=2.66,P=0.0.01),from September 11,1999 to April 12,2004 in Changqing neighbourhood,Tianshui neighbourhood,Zhaohui neighbourhood,Wulin neighbourhood,Xiaoying neighbourhood,Chaoming neighbourhood,Qingbo neighbourhood,Hubin neighbourhood,Chengzhan neighbourhood,Wenhui neighbourhood,Dongxin neighbourhood,Ziyang neighbourhood,Wangjiang neighbourhood,Shiqiao neighbourhood in Hangzhou city and Fuchun neighbourhood and Yushan township in Fuyang city(SMR=0.37,P=0.001),from December 6,2005 to February 8,2007 in Gaoqiao town and Lingqiao town in Fuyang city(SMR=0.31, P=0.001),from August 1,2001 to December 19,2005 in Dongzhou in Fuyang city(SMR=0.03,P=0.001).
There was statistically significance on the geographical cluster of attacks of cerebral thrombosis among the monitored population from May 10,2001 to Deccember 28,2005 in Longmen town,Huanshan township,Shangguan township,Changan town, Changkou town,Lushan neighbourhood,Huyuan township,Xintong township,Changlv town,Liangqiao town,Lishan town,Gaoqiao town,Dongzhou neighbourhood,Yushan township,Chunjian township,Xindeng town,Lvzhu town,Yongchang town,Shouxiang town,Xukou town,Wanshi town,Dongqiao town in Fuyang city,in Nanxing neighbourhood,Ziyang neighbourhood and Wangjiang neighbourhood in Hangzhou city and Shouchang town in Jiande city(SMR=0.44,P=0.001),from January 12,2002 to november 14,2003 in Qiantan town in Jiande city(SMR=12.73,P=0.001),from March 25,2004 to January 28,2005 in Changqing neighbourhood,Tianshui neighbourhood, Zhaohui neighbourhood,Wulin neighbourhood,Xiaoying neighbourhood in Hangzhou city(SMR=2.67,P=0.010),There was random on the geographical cluster of attacks of cerebral thrombosis among the monitored population from January 15,2007 to January 18,2007 in Dongxin neighbourhood in Hangzhou city(SMR=84.09,P=0.191).
There was statistically significance on the geographical cluster of attacks of cerebral embolism among the monitored population from June 15,1995 to November 30,2005 in Lvzhu town,Xukou town,Xintong township,Xindeng town,Changkou town,Wanshi town,Lushan neighbourhood,Yongchang town,Huanshan township, Chunjian township,Huyuan township,Changan town,Longmen town and Dongqiao town in Fuyang city(SMR=0.01,P=0.001),from november 7,1997 to January 13,2005 in Daciyan town,Xinanjiang town,Genglou neighbourhood,Lianhua town and Shouchang town in Jiande city(SMR=0.00,P=0.001),from June 15,1995 to December 5,2005 in Fuchun neighbourhood and Yushan township in Fuyang city (SMR=0.03,P=0.001),from September 21,2002 to February 14,2005 in Chengzhan neighbourhood,Xiaoying neighbourhood,Changqing neighbourhood and Ziyang neighbourhood in Hangzhou city(SMR=2.02,P=0.001).
The attacks of cardio-cerebral-vascular diseases were related to the day of a week [attacks on Sunday as control,its on Thursday(t=2.933,P=0.003) and Saturday (t=3.015,P=0.003)],and to the average AOD(t= 2.962,P=0.003).The attacks of coronary heart disease were associated with cloud mask(t=2.860,P =0.004),the daily average concentration of PM_(10)(t=2.388,P=0.017) and type of aerosol(t=2.690, P=0.008).The attacks of cardiogenic sudden death were related to the day of a week [attacks on Sunday as control,its on Saturday(t=2.918,P =0.004) and Friday(t=3.746, P <0.001)],to cloud mask(t=2.680,P=0.008).The attacks of stroke were associated with cloud mask(t=2.088,P=0.037).The attacks of intracerebral hemorrhage were related to AOD(t=2.117,P=0.035).The attacks of cerebral thrombosis were related to the day of a week[attacks on Sunday as control,its on Monday(t=3.176,P=0.002), Tuesday(t=2.133,P=0.033) and Saturday 0=2.600,P 0.009)].The attacks of cerebral emblolism were associated with the day of a week[attacks on Sunday as control,its on Saturday(t=2.600,P=0.009)].
Conclusions:
To certain extent,the space-time distribution of AOD in Hangzhou city appeared positive autocorrelation,which is obvious characteristic of spatial-time.The results supported the hypothesis that AOD associates with the environmental and meteorological factors.The attacks of cardio-cerebral-vascular disease presented space-time cluster.The attacks of cardio-cerebral-vascular disease and intra-cerebral hemorrhage were positively related to AOD.
引文
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