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预防医学  2025, Vol. 37 Issue (11): 1145-1150    DOI: 10.19485/j.cnki.issn2096-5087.2025.11.013
  疾病控制 本期目录 | 过刊浏览 | 高级检索 |
PM2.5暴露对急性心肌梗死死亡和寿命损失的影响
梁海晴, 容思靖, 康会丽, 王军
广州市海珠区疾病预防控制中心,广东 广州 510288
Effects of fine particulate matter exposure on acute myocardial infarction mortality and life lost
LIANG Haiqing, RONG Sijing, KANG Huili, WANG Jun
Haizhu District Center for Disease Control and Prevention, Guangzhou, Guangdong 510288, China
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摘要 目的 了解细颗粒物(PM2.5)暴露对急性心肌梗死(AMI)死亡和寿命损失年(YLL)的影响。方法 通过中国人口死亡信息登记管理系统和广东省死亡医学证明管理信息系统收集2020—2024年广州市海珠区死亡病例资料,同期大气污染物资料和气象资料分别来源于全国城市空气质量实时发布平台国家环境监测点和广州市天文台。采用分布滞后非线性模型(DLNM)建立单污染物模型及多污染物模型,分析PM2.5暴露对AMI死亡和YLL的影响。结果 2020—2024年海珠区AMI死亡病例2 466例,男性949例,女性1 517例;<65岁530例,65~74岁494例,>74岁1 442例。日均死亡例数MQR)为1.3(2.0)例,日均YLL MQR)为16.4(24.8)人年。PM2.5日均质量浓度MQR)为24.3(18.0)μg/m3。单污染物模型结果显示,PM2.5暴露对AMI死亡和YLL的影响均在累积滞后7 d时效应最大,PM2.5日均质量浓度每增加10 μg/m3,AMI死亡风险增加8.793%(95%CI:4.201%~13.588%),YLL增加2.059(95%CI:1.081~3.037)人年。性别分层分析结果显示,PM2.5暴露对男性AMI死亡和男性、女性YLL的影响有统计学意义(均P<0.05);年龄分层分析结果显示,PM2.5暴露对<65岁、65~74岁组AMI死亡和YLL的影响有统计学意义(均P<0.05);不同性别、年龄组间差异无统计学意义(均P>0.05)。多污染物模型结果显示,在累积滞后7 d时,原模型分别引入NO2、SO2和O3后,PM2.5暴露对AMI死亡和YLL的影响有统计学意义(均P<0.05),效应值较单污染物模型升高;原模型引入PM10或PM10、SO2、NO2、O3后,PM2.5暴露对AMI死亡和YLL的影响无统计学意义(均P>0.05)。结论 暴露于PM2.5可增加AMI死亡风险和YLL,且对不同性别、年龄居民的影响存在差异。
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梁海晴
容思靖
康会丽
王军
关键词 细颗粒物急性心肌梗死寿命损失年分布滞后非线性模型    
AbstractObjective To investigate the effects of fine particulate matter (PM2.5) exposure on acute myocardial infarction (AMI) mortality and years of life lost (YLL). Methods Mortality data in Haizhu District, Guangzhou City from 2020 to 2024 were collected by the China Population Death Information Registration Management System and Guangdong Death Certificate Management System. Air pollution and meteorological data of the same period were obtained from the national environmental monitoring sites on the National Real-time Air Quality Release Platform and the Guangzhou Observatory, respectively. The single-pollutant model and multi-pollutant model were established by distributed lag non-linear model to analyze the effects of PM2.5 on AMI mortality and YLL. Results From 2020 to 2024, there were 2 466 AMI death cases in Haizhu District, including 949 males and 1 517 females. Among them, 530 cases were aged <65 years, 494 cases were aged 65-74 years, and 1 442 cases were aged >74 years. The median daily average number of deaths was 1.3 (interquartile range, 2.0) cases, and the median daily average YLL was 16.4 (interquartile range, 24.8) person years. The median daily average mass concentration of PM2.5 was 24.3 (interquartile range, 18.0) μg/m3. In single-pollutant models, the maximum effects of PM2.5 on AMI mortality and YLL were observed at a cumulative lag of 7 days. For per 10 μg/m3 increment in the daily average concentration of PM2.5, the excess risk of AMI mortality increased by 8.793% (95%CI: 4.201% to 13.588%), and YLL increased by 2.059 (95%CI: 1.081 to 3.037) person-years. Gender-stratified analyses showed that PM2.5 significantly affected AMI mortality in males and YLL in males and females (all P<0.05). Age-stratified analyses revealed that PM2.5 significantly affected AMI mortality and YLL among residents aged <65 years and 65-74 years (all P<0.05). However, the difference between genders or the two age groups was not statistically significant (both P>0.05). In multi-pollutant models, when NO2, SO2, or O3 were introduced respectively at a cumulative lag of 7 days, the effects of PM2.5 on AMI mortality and YLL were enhanced compared to the single-pollutant model (all P<0.05). When PM10 was introduced alone or in combination with PM10, SO2, NO2, and O3, the effects of PM2.5 on AMI mortality and YLL were not statistically significant (all P>0.05). Conclusion Exposure to PM2.5 may increase the risk of AMI mortality and YLL, with varying effects across populations of different genders and ages.
Key wordsfine particulate matter    acute myocardial infarction    years of life lost    distributed lag non-linear model
收稿日期: 2025-05-16      修回日期: 2025-08-07     
中图分类号:  R122.2  
基金资助:2024年广州市卫生健康科技项目(20241A010090)
作者简介: 梁海晴,硕士,主管医师,主要从事疾病预防与控制工作
通信作者: 王军,E-mail:1046594653@qq.com   
引用本文:   
梁海晴, 容思靖, 康会丽, 王军. PM2.5暴露对急性心肌梗死死亡和寿命损失的影响[J]. 预防医学, 2025, 37(11): 1145-1150.
LIANG Haiqing, RONG Sijing, KANG Huili, WANG Jun. Effects of fine particulate matter exposure on acute myocardial infarction mortality and life lost. Preventive Medicine, 2025, 37(11): 1145-1150.
链接本文:  
http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2025.11.013      或      http://www.zjyfyxzz.com/CN/Y2025/V37/I11/1145
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