上海地区生活环境中主要空气污染物浓度与儿童哮喘发生率的关系
|
摘要
目的研究上海地区生活环境中主要空气污染物浓度与儿童哮喘发生率的关系。方法选择2017年1～12月至上海静安区中心医院(复旦大学附属华山医院静安分院)儿童门诊就诊的160例患者进行临床研究。对所有来诊患儿的哮喘程度进行评估,并给予肺功能测定。本研究空气污染情况来源于上海市环境中心站,采集2017年1～12月主要大气污染物浓度数据,包括空气污染指数(API)、可吸入颗粒物(PM10)、二氧化硫(SO2)、二氧化氮(NO2)。观察2017年全年的API、PM10、SO2、NO2变化情况,以及期间我院儿科哮喘病患儿就诊次数、峰值呼气流量(PEF)水平、第一秒最大呼气量(FEV1)水平以及哮喘患儿评分情况。使用Pearson相关性分析,观察API、PM10、SO2、NO2等指标与就诊次数、PEF水平、FEV1水平以及哮喘患儿评分情况的相关性。结果 2017年1～12月上海地区空气检测结果显示,10月、11月、12月API和PM10明显升高,SO2、NO2水平全年波动不明显,而儿童哮喘发患者数在1月、11月、12月明显增多,在6月、7月、8月最少,PEF、FEV1全年变化不明显,哮喘评分在12月、1月、2月出现升高情况。对PM10、SO2、NO2、API与患儿就诊人数、PEF水平、FEV1水平以及哮喘患儿评分水平进行pearson相关性分析,结果显示,API、PM10与患儿就诊人数及哮喘患儿评分之间具有相关性(P<0.05),其中PM10与患儿就诊人数哮喘患儿评分之间相关性最高,其余无相关性(P>0.05)。结论上海地区生活环境中主要空气污染物API、PM10与儿童哮喘发生情况之间呈正相关,空气污染的加重会导致儿童哮喘发病率的升高和症状严重程度的加重。
Objective To study the relationship between the concentration of major air pollutants in living environment and the incidence of asthma in children in Shanghai. Methods A total of 160 outpatients were selected for the clinical study, who were admitted to the children's clinic at Jing'an District Central Hospital of Shanghai(Jingan Branch, Huashan Hospital Affiliated to Fudan University) from January to December 2017. The degrees of asthma were assessed and lung functions were measured in all children. The air pollution situation of this study was derived from the data of major atmospheric pollutant concentrations from January to December 2017 collected by the Shanghai Environmental Monitoring Center, including air pollution index(API), inhalable particulate matter(PM10), sulfur dioxide(SO_2),nitrogen dioxide(NO_2). The changes of API, PM10, SO_2 and NO_2 in the whole year of 2017 were observed, as well as the number of visits, peak expiratory flow(PEF), forced expiratory volume in 1 second(FEV1) of children with asthma attending the children's clinic in our hospital during the same period and the asthma scores of these asthmatic children.Pearson correlation analysis was used to observe the correlation between API, PM10, SO_2, NO_2 and other factors such as the number of visits, PEF level, FEV1 level and the score of asthmatic children. Results The results of air test in Shanghai from January to December 2017 showed that API and PM10 increased significantly in October, November and December, and the SO_2 and NO_2 levels did not fluctuate significantly throughout the year; while the incidence of childhood asthma increased significantly in January, November and December, with the least in June, July and August. The annual changes of PEF and FEV1 were not obvious, and the asthma score increased in December, January and February. Pearson correlation analysis was made between PM10, SO_2, NO_2, API and the number of children visiting, PEF level, FEV1 level and the score of asthmatic children. The results showed that there was a correlation between API, PM10 and the number of children visiting and the score of asthmatic children(P<0.05). Among them, PM10 had the highest correlation with the number of children visiting and the score of asthmatic children, while the others had no correlation(P>0.05).Conclusion There is a positive correlation between API and PM10 in the living environment of Shanghai and the incidence of childhood asthma. The aggravation of air pollution can lead to an increase in the incidence of childhood asthma and an increase in the severity of symptoms.
Objective To study the relationship between the concentration of major air pollutants in living environment and the incidence of asthma in children in Shanghai. Methods A total of 160 outpatients were selected for the clinical study, who were admitted to the children's clinic at Jing'an District Central Hospital of Shanghai(Jingan Branch, Huashan Hospital Affiliated to Fudan University) from January to December 2017. The degrees of asthma were assessed and lung functions were measured in all children. The air pollution situation of this study was derived from the data of major atmospheric pollutant concentrations from January to December 2017 collected by the Shanghai Environmental Monitoring Center, including air pollution index(API), inhalable particulate matter(PM10), sulfur dioxide(SO_2),nitrogen dioxide(NO_2). The changes of API, PM10, SO_2 and NO_2 in the whole year of 2017 were observed, as well as the number of visits, peak expiratory flow(PEF), forced expiratory volume in 1 second(FEV1) of children with asthma attending the children's clinic in our hospital during the same period and the asthma scores of these asthmatic children.Pearson correlation analysis was used to observe the correlation between API, PM10, SO_2, NO_2 and other factors such as the number of visits, PEF level, FEV1 level and the score of asthmatic children. Results The results of air test in Shanghai from January to December 2017 showed that API and PM10 increased significantly in October, November and December, and the SO_2 and NO_2 levels did not fluctuate significantly throughout the year; while the incidence of childhood asthma increased significantly in January, November and December, with the least in June, July and August. The annual changes of PEF and FEV1 were not obvious, and the asthma score increased in December, January and February. Pearson correlation analysis was made between PM10, SO_2, NO_2, API and the number of children visiting, PEF level, FEV1 level and the score of asthmatic children. The results showed that there was a correlation between API, PM10 and the number of children visiting and the score of asthmatic children(P<0.05). Among them, PM10 had the highest correlation with the number of children visiting and the score of asthmatic children, while the others had no correlation(P>0.05).Conclusion There is a positive correlation between API and PM10 in the living environment of Shanghai and the incidence of childhood asthma. The aggravation of air pollution can lead to an increase in the incidence of childhood asthma and an increase in the severity of symptoms.
引文
[1]李快乐,洪新如,孙庆华.空气污染对儿童哮喘的不良效应[J].中华医学杂志,2016,96(2):155-157.
[2]中华医学会儿科学分会呼吸学组.儿童支气管哮喘诊断与防治指南[J].中华儿科杂志,2016,54(3):1671-1681.
[3]ZHANG Y,HE M,WU S,et a1.Short-term effects of fine particulate matter and temperature on 1ung function among healthy college students in Wuhan,China[J].Int J Environ Res Public Health,2015,12(7):7777-7793.
[4]陈小聪,吴红娟,李锦燕.温州儿童哮喘发作与空气污染及气象因子的相关性分析[J].中国儿童保健杂志,2015,23(1):11-14.
[5]SCHULTZ ES,HALLBERG J,BELLANDER T,et al.Early-Life exposure to traf-fic-related air pollution and lung function in ado1escence[J].Am JRespir Crit Care Med,2016,193(2):171-177.
[6]丁玲,朱道娟,彭东宏.大气颗粒物与儿童哮喘住院人数相关性的Meta分析[J].中华儿科杂志,2015,53(2):129-135.
[7]张娟娟,汪东海,代继宏.大气可吸入性颗粒物暴露与儿童哮喘显著关联:基于22篇观察性研究的Meta分析[J].中国循证儿科杂志,2015,10(5):337-344.
[8]GEHRING U,WIJGA AH,HOEK G,et al.Exposure to air pollution and de-velopment of asthma and rhinoconjunctivitis throughout childhood and adolescence:a population-based birth cohort study[J].Lancet RespirMed,2015,3(12):933-942.
[9]李怡,王雯.污染气象条件对支气管哮喘发病的影响研究进展[J].国家呼吸杂志,2013,33(15):1174-1177.
[10]董继元,刘兴荣,张本忠,等.我国臭氧短期暴露与人群死亡风险的Meta分析[J].环境科学学报,2016,36(4):1477-1485.
[11]胡晓光,金义,金江兵,等.空气污染物与儿童呼吸道疾病的相关性调查[J].教育生物学杂志,2015,3(1):26-30.
[12]BARTOLI ML,VAGAGGINI B,MALAGRINòL,et al.Baseline airway inflammation may be a determinant of the response to ozone exposure in asthmatic patients[J].Inhalation Toxicology,2013,25(3):127-133.
[13]孙艳.空气污染导致儿童呼吸系统疾病的相关研究进展[J].医学信息,2014,28(11):544-545.
[14]马依拉·尔肯,晓开提·依不拉音,吴文华.乌鲁木齐市大气污染与儿童哮喘住院人数的相关性[J].新疆医科大学学报,2014,37(10):1382-1384.
[15]朱丽,操基玉,侯丽娟,等.空气质量与医院儿科呼吸系统疾病门诊量相关性研究[J].安徽医学,2016,37(3):360-362.
[2]中华医学会儿科学分会呼吸学组.儿童支气管哮喘诊断与防治指南[J].中华儿科杂志,2016,54(3):1671-1681.
[3]ZHANG Y,HE M,WU S,et a1.Short-term effects of fine particulate matter and temperature on 1ung function among healthy college students in Wuhan,China[J].Int J Environ Res Public Health,2015,12(7):7777-7793.
[4]陈小聪,吴红娟,李锦燕.温州儿童哮喘发作与空气污染及气象因子的相关性分析[J].中国儿童保健杂志,2015,23(1):11-14.
[5]SCHULTZ ES,HALLBERG J,BELLANDER T,et al.Early-Life exposure to traf-fic-related air pollution and lung function in ado1escence[J].Am JRespir Crit Care Med,2016,193(2):171-177.
[6]丁玲,朱道娟,彭东宏.大气颗粒物与儿童哮喘住院人数相关性的Meta分析[J].中华儿科杂志,2015,53(2):129-135.
[7]张娟娟,汪东海,代继宏.大气可吸入性颗粒物暴露与儿童哮喘显著关联:基于22篇观察性研究的Meta分析[J].中国循证儿科杂志,2015,10(5):337-344.
[8]GEHRING U,WIJGA AH,HOEK G,et al.Exposure to air pollution and de-velopment of asthma and rhinoconjunctivitis throughout childhood and adolescence:a population-based birth cohort study[J].Lancet RespirMed,2015,3(12):933-942.
[9]李怡,王雯.污染气象条件对支气管哮喘发病的影响研究进展[J].国家呼吸杂志,2013,33(15):1174-1177.
[10]董继元,刘兴荣,张本忠,等.我国臭氧短期暴露与人群死亡风险的Meta分析[J].环境科学学报,2016,36(4):1477-1485.
[11]胡晓光,金义,金江兵,等.空气污染物与儿童呼吸道疾病的相关性调查[J].教育生物学杂志,2015,3(1):26-30.
[12]BARTOLI ML,VAGAGGINI B,MALAGRINòL,et al.Baseline airway inflammation may be a determinant of the response to ozone exposure in asthmatic patients[J].Inhalation Toxicology,2013,25(3):127-133.
[13]孙艳.空气污染导致儿童呼吸系统疾病的相关研究进展[J].医学信息,2014,28(11):544-545.
[14]马依拉·尔肯,晓开提·依不拉音,吴文华.乌鲁木齐市大气污染与儿童哮喘住院人数的相关性[J].新疆医科大学学报,2014,37(10):1382-1384.
[15]朱丽,操基玉,侯丽娟,等.空气质量与医院儿科呼吸系统疾病门诊量相关性研究[J].安徽医学,2016,37(3):360-362.