| 兰州市气象和环境因子对脑出血和冠心病的影响研究 | |
| Alternative Title | Effects of Meteorological and Environmental Factors on Cerebral Hemorrhage and Coronary Heart Disease in Lanzhou City |
| 李全喜 | |
| Thesis Advisor | 王金艳 |
| 2019-05-01 | |
| Degree Grantor | 兰州大学 |
| Place of Conferral | 兰州 |
| Degree Name | 硕士 |
| Degree Discipline | 气象学 |
| Keyword | 气象因子 环境因子 脑出血 冠心病 广义相加模型 相对危险度 协同作用 |
| Abstract | 环境变化成为人类迄今为止面临最为严峻的挑战，而环境变化对人类健康的影响关系着人类安全稳定和可持续发展，引起了社会各界的广泛关注。近年来，国内外许多学者在气象要素和大气污染物对人体健康的影响和机理方面已经进行了一系列相关研究，但仍需深入开展。当前，中国心脑血管疾病患病率处在持续上升阶段，在城乡居民疾病死亡构成比中，心脑血管病仍占首位。基于此，本文以我国西北地区典型城市-兰州市为研究地点，利用兰州市2014-2016年的气象要素和大气污染数据资料，分析了气象要素和污染物的分布特征和时间变化规律，以及气象要素和污染物之间的相关性。并在上述分析基础上，利用2014-2016年兰州市某三级甲等医院脑出血和冠心病就诊数据，采用广义相加模型(GAM)，分析了气象要素和大气污染物对脑出血和冠心病就诊人数的影响，此外还研究了气象要素和大气污染物的协同效应分别对脑出血和冠心病的影响。得到如下主要结论：(1) 2014-2016年兰州市月平均风速变化为“U”型分布，温度(最高、最低)的月平均变化为“V”型分布。PM10月平均浓度变化呈双峰型，CO、NO2和 SO2和PM2.5月平均浓度变化呈“U”型；O3浓度的月平均变化为倒“U”型。PM2.5、PM10、CO，NO2和SO2与温度、相对湿度、风速之间存在显著的负相关。O3与气压和相对湿度显著负相关，与其他气象因子呈正相关。气温日较差与各污染物均为显著正相关。(2) 兰州市脑出血2014-2016年就诊人数共计5098人次,日均就诊人数为4.65人，男性占总就诊人数的67.7%，成年患者占总人数的59.5%。兰州市冠心病2014-2016年就诊人数共计29820例，男性患者占总就诊人数的77.2%，老年患者占总就诊人数的54.3%,冠心病日均就诊人数为27.21人。春季是兰州市脑出血和冠心病就诊人数最多的季节。(3)兰州市气象要素对脑出血和冠心病就诊人数的影响存在滞后效应，平均气压、平均气温、最低气温和最高气温均是在累积滞后6d与脑出血人数对应的RR值达到最大；当平均气温、最高气温在当天时，相对湿度单滞后4d和平均气压在累积滞后6d时，对应的冠心病就诊人数RR值最大。平均气温，最低温度，最高温度与脑出血和冠心病就诊人数的暴露反应关系均呈倒“U”型分布，脑出血对应的最低、最高温度阈值分别为8.5℃，22.5℃，冠心病对应的最低、最高温度分别为5.5℃和18℃，当低于或高于阈值时，不同气象因子对两种疾病各人群就诊人数的滞后效应有所差异。在性别方面，气象因素对两种疾病男性患者的影响均大于女性；就年龄而言，气象要素对脑出血成年人群的影响更明显，而冠心病则是对老年人群影响更显著。(4)相对湿度与冠心病的暴露-反应关系呈“U”型分布，相对湿度阈值为62%。O3在当天时与冠心病就诊人数相关联的RR值最大。CO和SO2与冠心病就诊人数的暴露-反应关系呈“U”型分布，而O3和SO2与冠心病就诊人数的暴露-反应关系呈倒“U”型分布。O3对男性和老年人群冠心病就诊人数的影响更显著。(5)兰州市平均气温、最高气温和最低气温与O3和CO两种污染物协同作用对脑出血就诊人数的影响表现为：气温处在脑出血高发病的阈值时，污染物浓度升高对脑出血的影响呈现加强效应。兰州市平均气温、最高气温、最低气温和气温日较差与O3协同作用对冠心病就诊人数的影响为气温处于疾病高危险度范围时，污染物浓度升高对冠心病的影响呈现加强效应。而相对湿度分别与PM2.5、PM10协同作用于冠心病时，高湿度高浓度的PM2.5(PM10)对冠心病就诊人数的影响有一个联合增强效果。 |
| Other Abstract | Environmental change has become the most severe challenge facing mankind to date, and the impact of environmental change on human health is related to human security, stability and sustainable development, which has aroused widespread concern from all walks of life. In recent years, many scholars at home and abroad have carried out a series of related research on the impacts and mechanisms of meteorological elements and atmospheric pollutants on human health, and still need to be carried out in depth. At present, the prevalence of cardiovascular and cerebrovascular diseases in China is on the rise. In the proportion of disease deaths in urban and rural residents, cardiovascular and cerebrovascular diseases still occupy the first place.Based on this, this paper analyzes the distribution characteristics and temporal variation of meteorological elements and pollutants, and the meteorological elements and air pollution data of Lanzhou City from 2014 to 2016 in Lanzhou, a typical city in northwest China. By using the data of cerebral hemorrhage and coronary heart disease in a third-grade hospital and the generalized additive model (GAM), the meteorological elements and atmospheric pollutants were analyzed the influence of the number of heart disease visits for cerebral hemorrhage and coronary heart disease. In addition to the synergistic effects of meteorological elements and atmospheric pollutants on cerebral hemorrhage and coronary heart disease were studied. The main conclusions are as follows:(1) The average monthly wind speed change is “U” type distribution, and the monthly mean change of temperature (highest and lowest) is “V” type distribution in Lanzhou City in 2014-2016. The average monthly concentration change of PM10 was bimodal, and the monthly average concentration changes of CO, NO2, SO2 and PM2.5 were “U” type; the monthly average change of O3 concentration was inverted “U” type. There is a significant negative correlation between PM2.5, PM10, CO, NO2, SO2 and temperature (highest, lowest), relative humidity, and wind speed. O3 is significantly negatively correlated with air pressure and relative humidity and positively correlated with other meteorological factors. The temperature difference between day and day is significantly positively correlated with each pollutant.(2) The number of cerebral hemorrhages was 5,098 in Lanzhou City in 2014-2016. The number of daily visits was 4.65, males accounted for 67.7% of the total number of patients, and adult patients accounted for 59.5% of the total. There were 29,820 cases of coronary heart disease, and male patients accounted for 77.2% of the total number of patients, old patients accounted for 54.3% of the total number of patients, the daily average number of patients with coronary heart disease was 27.21. Spring is the season with the largest number of cerebral hemorrhage and coronary heart disease in Lanzhou.(3) There is a lagging effect on the influence of meteorological elements with cerebral hemorrhage and coronary heart disease patients in Lanzhou City. The average pressure, average temperature, minimum temperature and maximum temperature are the maximum RR value corresponding to the number of cerebral hemorrhage in the cumulative lag 6d; When the average temperature and maximum temperature are on the same day, the relative humidity is delayed by 4d and the average pressure is 6d, the corresponding RR number of coronary heart disease is the largest. The average temperature, the lowest temperature, the highest temperature and the exposure response of cerebral hemorrhage and coronary heart disease patients all showed an inverted "U" type distribution. The lowest and highest temperature thresholds corresponding to cerebral hemorrhage were 8.5℃, 22.5℃, corresponding to coronary heart disease. The minimum and maximum temperatures are 5.5℃ and 18℃ respectively. In terms of gender, meteorological factors have a greater impact on male patients with both diseases than females; in terms of age, have a greater impact on the adult population of cerebral hemorrhage, while meteorological factors has a more significant impact on the elderly population of coronary heart disease.(4) The relative humidity and the exposure-response relationship of coronary heart disease showed a "U"-type distribution with a relative humidity threshold of 62%. O3 had the largest RR value associated with coronary heart disease patients on the same day. The exposure-response relationship between CO and SO2 and coronary heart disease patients showed a “U”-type distribution, while the exposure-response relationship between O3 and NO2 and coronary heart disease patients showed an inverted “U”-type distribution. The impact of O3 on coronary heart disease visits in men and the elderly is more pronounced. (5) The effect of temperature of Lanzhou City on cerebral hemorrhage patients in synergy with O3 and CO pollutants is as follows: when the temperature is at the threshold of high incidence of cerebral hemorrhage, the concentration of pollutants elevation has a reinforcing effect on cerebral hemorrhage. The impact of temperature and O3 synergy on coronary heart disease patients is that when the temperature is in the high risk range of disease, high pollutants concentration will strengthen the result. When the relative humidity is synergistic with PM2.5 and PM10 in coronary heart disease, the effect of high humidity and high concentration of PM2.5 (PM10) on coronary heart disease patients has a joint enhancement effect. |
| Pages | 88 |
| URL | 查看原文 |
| Language | 中文 |
| Document Type | 学位论文 |
| Identifier | https://ir.lzu.edu.cn/handle/262010/338309 |
| Collection | 大气科学学院 |
| Affiliation | 大气科学学院 |
| First Author Affilication | College of Atmospheric Sciences |
| Recommended Citation GB/T 7714 | 李全喜. 兰州市气象和环境因子对脑出血和冠心病的影响研究[D]. 兰州. 兰州大学,2019. |
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