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天津市脑卒中高住院风险的气象原因探析

郝天依 韩素芹 姚青 王晓佳 樊文雁 辛江龙

郝天依,韩素芹,姚青,王晓佳,樊文雁,辛江龙. 2022. 天津市脑卒中高住院风险的气象原因探析. 气象学报,80(3):1-11 doi: 10.11676/qxxb2022.041
引用本文: 郝天依,韩素芹,姚青,王晓佳,樊文雁,辛江龙. 2022. 天津市脑卒中高住院风险的气象原因探析. 气象学报,80(3):1-11 doi: 10.11676/qxxb2022.041
Hao Tianyi, Han Suqin, Yao Qing, Wang Xiaojia, Fan Wenyan, Xin Jianglong. 2022. Meteorological reasons for high hospitalization risk of stroke in Tianjin. Acta Meteorologica Sinica, 80(3):1-11 doi: 10.11676/qxxb2022.041
Citation: Hao Tianyi, Han Suqin, Yao Qing, Wang Xiaojia, Fan Wenyan, Xin Jianglong. 2022. Meteorological reasons for high hospitalization risk of stroke in Tianjin. Acta Meteorologica Sinica, 80(3):1-11 doi: 10.11676/qxxb2022.041

天津市脑卒中高住院风险的气象原因探析

doi: 10.11676/qxxb2022.041
基金项目: 天津市科技重大专项(18ZXSZSF00160)
详细信息
    作者简介:

    郝天依,主要从事大气环境与人体健康研究。E-mail:tianyi_hao@126.com

    通讯作者:

    韩素芹,主要从事边界层气象与健康气象研究。E-mail: sq_han@126.com

  • 中图分类号: P49

Meteorological reasons for high hospitalization risk of stroke in Tianjin

  • 摘要: 气象条件的剧烈变化可增加脑卒中危险人群的患病几率。本研究收集天津市2016—2020年脑卒中日住院数据以及气象数据,采用脑卒中日住院人数累积概率分布进行住院风险等级划分,通过相关分析确定高影响气象因子,并利用分布滞后非线性模型与半参数广义相加模型开展高影响气象因子不同时间尺度变化、滞后以及累积效应对脑卒中住院风险的影响研究。结果表明:天津市脑卒中年住院人数约为22.5万,最高月住院人数可达2.1万,日均住院人数为623。男、女住院人数比为8:5,50岁以上人群为易患脑卒中疾病的高危人群。深秋(10—11月)、初冬(12月)和春季(3—5月)为天津市脑卒中住院高风险期。6℃以上的月变温和24 h负变温相叠加可加大脑卒中住院风险,且月变温为负变温时,脑卒中住院风险最高。30℃以上高温和-5℃以下低温均可引起脑卒中住院高风险,低温带来的脑卒中住院风险高于高温,低温效应在滞后2—3 d达到最强。24 h负变温的住院风险高于正变温,且变温幅度越大住院风险越高,7℃以上24 h负变温在滞后3—5 d的住院风险最高。天津市脑卒中高住院风险的气象原因主要是月尺度和日尺度温度剧烈变化的叠加,其次为极端温度及其24 h剧烈变化的影响。

     

  • 图 1  2016—2020年脑卒中住院人数变化

    Figure 1.  Changes in stroke inpatients from 2016 to 2020

    图 2  2016—2020年脑卒中住院患者(a)男、女人数和(b)年龄分布

    Figure 2.  (a) Male and female number of inpatients and (b) age distribution of stroke inpatients from 2016 to 2020

    图 3  脑卒中日住院人数的累积概率分布

    Figure 3.  Cumulative probability distribution of daily stroke hospitalization

    图 4  各月5种脑卒中住院风险等级出现概率 (绿线为中高风险与高风险出现概率之和)

    Figure 4.  Occurrence probabilities of five stroke hospitalization risk levels in each month (green line is the sum of the occurrence probabilities of medium to high risk and high risk)

    图 5  (a) 日最高气压、(b) 24 h变压、(c) 日最低气温、(d) 24 h变温与脑卒中住院人数的关系

    Figure 5.  Relationship between (a) daily maximum barometric pressure,(b)24 h pressure variation,(c) daily minimum temperature,(d) 24 h temperature variation and the number of stroke hospitalizations

    Continued

    图 6  月变温与脑卒中住院风险的关系

    Figure 6.  Relationship between monthly temperature change and hospitalization risk of stroke

    图 7  24 h负变温与卒中住院人数的关系

    Figure 7.  Relationship between 24 h negative temperature change and the number of stroke hospitalizations

    图 8  (a) 日平均气温、(b) 24 h变温、(c) 气温日较差与脑卒中住院人数的暴露-滞后-反应关系

    Figure 8.  Exposure-lag-response relationship between (a) daily average temperature,(b) 24 h temperature variation,(c) daily temperature range and stroke hospitalizations

    图 9  (a) 平均气温、(b) 24 h变温、(c) 气温日较差与脑卒中住院人数的暴露-反应关系

    Figure 9.  Exposure-response relationship between (a) mean temperature,(b) 24 h temperature variation,(c) daily temperature range and stroke hospitalizations

    图 10  (a) 平均气温和(b) 24 h变温在不同时间自由度下对住院风险影响的敏感性分析

    Figure 10.  Sensitivity analysis of the effects of (a) mean temperature and (b) 24 h temperature variation on the risk of hospitalization at different time degrees of freedom

    表  1  医疗数据来源

    Table  1.   Number of hospitals based on medical data source

    年份二级以上医院总数三级医院总数
    20166540
    20177040
    20187541
    20197942
    20207941
    下载: 导出CSV

    表  2  脑卒中5种住院风险等级划分统计表

    Table  2.   Statistics for the classification of five types of stroke hospitalization risk level

    日住院人数累积概率0—25%25%—50%50%—75%75%—95%95%—100%
    风险等级低风险中低风险中风险中高风险高风险
    日数占比36.5%24.1%21.1%15.0%3.3%
    日住院人数范围(人)≤517518—619620—705706—812>812
    下载: 导出CSV

    表  3  当天及前7 d气象因子累积与高风险等级住院人数的相关系数

    Table  3.   Correlation coefficients of the accumulation of meteorological factors on the day and the previous 7 d with the number of high-risk hospitalizations

    气象因子累积天数
    1(当天)234567
    平均气压0.419**0.421**0.398**0.376**0.353**0.336**0.324**
    最高气压0.422**0.424**0.411**0.386**0.360**0.344**0.332**
    最低气压0.402**0.402**0.373**0.351**0.330**0.317**0.303*
    平均气温−0.381**−0.392**−0.396**−0.392**−0.386**−0.378**−0.369**
    最高气温−0.390**−0.397**−0.413**−0.405**−0.391**−0.385**−0.380**
    最低气温−0.361**−0.368**−0.368**−0.360**−0.359**−0.352**−0.345**
    平均相对湿度−0.108−0.103−0.043−0.013−0.052−0.081−0.079
    最小水平能见度0.0370.0670.0240.0430.0550.0580.025
    20时—20时降水量−0.055−0.098−0.115−0.099−0.061−0.046−0.057
    平均风速0.0320.2140.1140.011−0.009−0.015−0.006
    日照时数−0.048−0.096−0.136−0.152−0.107−0.075−0.104
    气温日较差−0.14−0.202−0.243*−0.264*−0.250*−0.242−0.256*
    24 h变压(20时—20时)−0.0050.1770.246*0.294*0.329**0.308*0.385**
    24 h变温(08时—08时)−0.051−0.138−0.184−0.16−0.270*−0.329**−0.318**
     注:* p<0.05,**p<0.01。
    下载: 导出CSV
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  • 收稿日期:  2021-12-09
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