目的探讨长沙市日均气温变化与急性脑血管疾病急诊的相关性。方法收集2008--2009年长沙市每日急性脑血管疾病急诊数据及相关气象和大气污染数据,运用季节分层的病例交叉设计分析不同季节日均气温变化对总急性脑血管疾病及主要亚型[脑出血、脑梗死和短暂性脑缺血发作(TIA)]的影响。结果同时控制相对湿度、气压和风速的多气象因素模型分析显示,春季日均气温每升高1℃,脑出血、脑梗死、TIA和总急性脑血管疾病急诊的OR值分别为1.278(95%CI:1.045~1.563)、1.223(95%CI:1.056~1.416)、1.318(95%CI:1.099—1.581)和1.239(95%CI:1.085—1.414),关联均有统计学意义(P〈0.05);夏季日均气温每升高1℃,脑梗死和总急性脑血管疾病急诊的OR值为1.201(95%CI:1.006~1.434)和1.179(95%CI:1.002-1.387),关联有统计学意义(P〈0.05),脑出血和TIA急诊的OR值大于1,但关联无统计学意义;秋季日均气温每升高1℃,脑出血、脑梗死、TIA和总急性脑血管疾病急诊的OR值分别为0.803(95%CI:0.683~0.944)、0.765(95%CI:0.664~0.882)、0.794(95%CI:0.671~0.940)和0.792(95%CI:0.699~0.898),关联均有统计学意义(P〈0.05);冬季日均气温变化与上述疾病的发病关联均无统计学意义。结论长沙地区春季气温升高是脑出血、脑梗死、TIA和总急性脑血管疾病的危险因素,夏季气温升高是脑梗死和总急性脑血管疾病的危险因素,秋季气温下降是脑出血、脑梗死、TIA和总急性脑血管疾病的危险因素。
Objective To investigate the association between ambient average temperature and emergency hospital visits (EHVs) for actue cerebrovascular disease in Changsha, China. Methods The daily EHVs for acute cerebrovascular disease were gathered from the Third Xiangya Hospital during 2008--2009 and the corresponding meteorological, air pollution data were collected. The seasonal-stratified case-crossover design was used for the data analysis. Results After adjustment for the influence of relative humidity, wind speed and atmospheric pressure, a 1℃ increase of daily average was associated with cerebral hemorrhage (OR=1.278, 95%CI: 1.045-1.563), cerebral infarction (OR=1.223, 95%CI: 1.056-1.416),TIA (OR=1.318, 95%CI: 1.099-1.581)and total acute cerebrovascular disease (OR=1.239,95%CI: 1.085-1.414)(P〈0.05) in spring. It was also associated with cerebral infarction (OR=1.201, 95%CI: 1.006-1.434)and total acute cerebrovascular disease (OR=1.179, 95%CI: 1.002-1.387)(P〈0.05) in summer. In autumn, it was associated with cerebral hemorrhage (OR=0.803, 95%CI: 0.683-0.944), cerebral infarction (OR=0.765, 95%CI: 0.664-0.882),TIA(OR=0.794, 95%CI: 0.671-0.940) and total acute cerebrovascular disease (OR =0.792, 95% CI: 0.699-0.898)(P〈0.05). Conclusion The elevated daily average temperature in spring and summer, and the dropped daily average temperature in autumn may increase the daily EHVs for cerebral hemorrhage, cerebral infarction, TIA and total acute cerebrovascular diseases.