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中华神经创伤外科电子杂志

中华神经创伤外科电子杂志 ›› 2020, Vol. 06 ›› Issue (04) : 202 -207. doi: 10.3877/cma.j.issn.2095-9141.2020.04.003

所属专题： 文献；

临床研究

南充市自发性脑出血发病与气温的相关性及滞后效应
唐辉1, 陈勇2, 邵川1, 罗孝全1, 王潇娅1, 邹成功1, 文国虹3, 何家全1,†()   
  1. 1. 637000　四川南充，南充市中心医院·川北医学院第二临床学院神经外科
    2. 638000　四川广安，广安市气象局公共气象服务中心
    3. 637000　四川南充，南充市中心医院·川北医学院第二临床学院病历统计室
  • 收稿日期:2020-05-20 出版日期:2020-08-15
  • 通信作者: 何家全
  • 基金资助:
    南充市科学技术局市校战略合作科技项目(18SXHZ0559)

Correlation and lag effects between spontaneous intracerebral hemorrhage and ambient temperature in Nanchong city

Hui Tang1, Yong Chen2, Chuan Shao1, Xiaoquan Luo1, Xiaoya Wang1, Chenggong Zou1, Guohong Wen3, Jiaquan He1,†()   

  1. 1. Department of Neurosurgery, Nanchong Central Hospital (The Second Clinical Medical College, North Sichuan Medical College), Nanchong 637000, China
    2. Public Weather Service Center, Meteorological Bureau of Guang’an City, Guang’an 638000, China
    3. Department of Medical Records and Statistics, Nanchong Central Hospital (The Second Clinical Medical College, North Sichuan Medical College), Nanchong 637000, China
  • Received:2020-05-20 Published:2020-08-15
  • Corresponding author: Jiaquan He
  • About author:
    Corresponding author: He Jiaquan, Email:
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引用本文：

唐辉, 陈勇, 邵川, 罗孝全, 王潇娅, 邹成功, 文国虹, 何家全. 南充市自发性脑出血发病与气温的相关性及滞后效应[J]. 中华神经创伤外科电子杂志, 2020, 06(04): 202-207.

Hui Tang, Yong Chen, Chuan Shao, Xiaoquan Luo, Xiaoya Wang, Chenggong Zou, Guohong Wen, Jiaquan He. Correlation and lag effects between spontaneous intracerebral hemorrhage and ambient temperature in Nanchong city[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2020, 06(04): 202-207.

目的

分析南充市自发性脑出血（sICH）发病与气温的相关性及滞后关系。

方法

收集南充市全市范围内二级以上医院2014年1月至2018年12月收治的sICH患者病例资料及同期气温数据，利用Spearman等级相关法确定最佳温度指标，将其组建分布滞后非线性模型，评估其与sICH日发病风险的暴露-剂量反应关系，分层分析各温度节点在性别及年龄组别的滞后-剂量反应关系。

结果

共收集sICH患者资料13 952例。Spearman相关性分析揭示sICH日发病人数与日均气温呈非线性负相关（r=-0.324，P<0.05）。分布滞后非线性模型分析结果表明极低温和低温当天sICH的相对危险度为1.68（1.35~2.08）及1.47（1.24~1.72），危害效应最大，其随着滞后天数增加而减弱，极低温滞后1~2 d，低温持续滞后1~10 d。低龄组（18~60岁）在极低温、低温下滞后2 d，高龄组（>60岁）在极低温下滞后10 d，低温下滞后24 d。不同性别组在极低温、低温下滞后效应趋势一致，随滞后天数增加风险下降。

结论

低温增加sICH发病风险，早期呈明显急性影响，且具有滞后效应，老年人对低温反应更加滞后。

关键词: 自发性脑出血, 分布滞后非线性模型, 日均气温, 发病率
Objective

To analyze the correlation and lag relationship between spontaneous intracerebral hemorrhage (sICH) and temperature in Nanchong City.

Methods

The data of clinical information at grade-C secondary or above hospitals and air temperature were collected retrospectively from January 2014 to December 2018 in Nanchong city. Spearman rank correlation method was used to determine the optimal temperature index, and a distribution lag non-linear model was established to evaluate the exposure response relationship between the temperature and the daily risk of sICH, and analyze the lag response relationship of temperature nodes in gender and age groups.

Results

A total of 13 952 patients with sICH were collected. Spearman correlation analysis revealed that the daily incidence of sICH was negatively correlated with daily average temperature (r=-0.324, P<0.05). The results of the distributed lag nonlinear model analysis showed that the relative risks of sICH on the day of extremely low temperature and low temperature was 1.68 (1.35-2.08) and 1.47 (1.24-1.72), and the hazard effect was the largest, which weakened with the increase of lag days. The extremely low temperature lags for 1-2 d, and low temperature lags 1-10 d. The harmful effects in the younger group (18-60 years old) at extremely low temperature and low temperature lag for 2 d, while the harmful effects in the elderly group (> 60 years old) at extremely low temperature and low temperature lag to 10 d and 24 d, respectively. The lag effect trend of different gender groups in extremely low temperature and low temperature was consistent, and the risk decreased with the increase of lag days.

Conclusion

Low temperature increases the risk of sICH. It has obvious acute effect in the early stage and has lag effect. The elderly people’s response to hypothermia is more delayed.

Key words: Spontaneous intracerebral hemorrhage, Distributed lag non-linear models, Average daily temperature, Morbidity
表1 南充市2014~2018年的气温资料（℃）
温度指标 平均温度 温度范围 P1 P10 P25 P50 P75 P90 P99
日均气温 18.2±7.8 0.8~35.7 3.8 7.8 10.9 18.4 24.3 28.6 33.2
最低气温 15.4±7.3 -2.8~31.3 1.3 5.5 9.2 15.7 21.4 24.7 28.7
最高气温 21.8±8.7 2.9~40.6 5.9 10.2 14.1 22.1 28.6 33.7 38.2
当日温差 6.3±3.3 0.4~15.5 1.1 2.1 3.4 6.0 9.0 10.9 14.0
日间温差 0.0±1.7 -8.6~6.9 -5.4 -2.2 -0.8 0.2 1.1 1.9 3.1
图1 自发性脑出血日发病人数的频率分布及与各温度指标的相关性
图2 日均气温不同滞后天数的相对危险度三维图
图3 日均气温当天与自发性脑出血相关的暴露-剂量反应
图4 不同温度节点的滞后效应
图5 各温度节点在不同年龄组的滞后效应
图6 各温度节点在不同性别组的滞后效应
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