文献类型：期刊文献

中文题名：2016—2020年兰州市二氧化硫暴露对慢性阻塞性肺病患者入院影响的时间序列研究

英文题名：Time series study on influence of sulfur dioxide exposure on hospitalization of chronic obstructive pulmonary disease in Lanzhou from 2016 to 2020

作者：林昇[1];冯渤曦[1];李永悦[1];黄怡炜[1];郑锴[1];刘铭轩[1];杨盈盈[1];魏兴民[1];吴建军[1]

第一作者：林昇

机构：[1]甘肃中医药大学公共卫生学院,甘肃兰州730101

第一机构：甘肃中医药大学公共卫生学院

年份：2026

卷号：43

期号：4

起止页码：451

中文期刊名：环境与职业医学

外文期刊名：Journal of Environmental and Occupational Medicine

收录：;北大核心:【北大核心2023】；

基金：甘肃省联合科研基金重大项目(24JRRA876);2025年度甘肃中医药大学研究生“创新创业基金”项目(2025CXCY-060)。

语种：中文

中文关键词：慢性阻塞性肺病;二氧化硫;入院人数;广义加性模型;分布滞后非线性模型

外文关键词：chronic obstructive pulmonary disease;sulfur dioxide;hospital admission;generalized additivity model;distributed lag nonlinear model

摘要：[背景]2021年慢性阻塞性肺病(COPD)已成为全球第四大死亡原因,目前关于空气污染物对COPD影响的研究结果仍存在不一致性。[目的]分析兰州市空气污染物二氧化硫(SO_(2))暴露与COPD入院人次间的关系,探讨SO_(2)在不同性别、年龄、季节对COPD人群的影响。[方法]收集兰州市2016—2020年共计20718例COPD患者的住院记录、同期SO_(2)浓度和相关气象资料。运用广义加性模型结合分布滞后非线性模型分析SO_(2)与COPD入院人数的关联及滞后效应,控制气象因素、星期效应及节假日等混杂因素,设定最大滞后天数为7 d。经双污染物模型和敏感性分析验证,结果以相对危险度(RR)及95%置信区间(95%CI)呈现。[结果]研究期间,COPD患者平均每日入院人数为(11.34±7.03)例;SO_(2)浓度为(23.72±12.35)μg·m^(-3)。SO_(2)暴露与COPD住院人次呈正相关,SO_(2)浓度每升高10μg·m^(-3),COPD入院RR值为1.440(95%CI:1.317~1.573)。分层分析显示,在累积滞后7 d时,女性、年龄≥65岁、冷季的RR更高,而暖季没有发现SO_(2)引起COPD入院RR增高的现象。SO_(2)浓度每增加10μg·m^(-3),女性COPD入院RR值为1.483(95%CI:1.311~1.678);年龄≥65岁人群COPD入院RR值为1.441(95%CI:1.311~1.583);冷季COPD入院相对风险RR值为1.595(95%CI:1.313~1.937)。[结论]兰州市短期SO_(2)暴露会导致COPD入院风险增加,这一效应在女性、65岁以上老年人、冷季更为明显。
[Background]In 2021,chronic obstructive pulmonary disease(COPD)emerged as the forth leading cause of death in the world.However,the impact of air pollutants on COPD is still inconsistent across current studies.[Objective]To analyze the relationship between ambient sulfur dioxide(SO_(2))exposure and hospital admissions for COPD in Lanzhou,and to examine the modified effects of SO_(2) across different genders,age groups,and seasons.[Methods]A total of 20718 hospital admission records for COPD were collected from Lanzhou between 2016 and 2020,alongside synchronized data on SO_(2) concentration and meteorological variables.A generalized additive model integrated with a distributed lag nonlinear model was used to assess the relationship and the lag effects between SO_(2) exposure and COPD admissions.Potential confounders,including meteorological factors,day-of-the-week effect,and holidays,were controlled for,with a maximum lag period set at 7 d.Two-pollutant models and sensitivity analyses were conducted to ensure robustness.Results are expressed as relative risks(RR)with 95%confidence intervals(95%CI).[Results]During the study period,the average daily number of COPD admissions was 11.34±7.03.The average mass concentration of SO_(2) was(23.72±12.35)μg·m^(-3).SO_(2) exposure was positively correlated with COPD admissions;specifically,each 10μg·m^(-3) increase in SO_(2) concentration was associated with an RR of 1.440(95%CI:1.317,1.573).Stratified analyses found that at a cumulative lag of 7 d,the RRs were higher among females,individuals aged≥65 years,and during the cold season.Conversely,no significant increase in COPD admission risk related to SO_(2) was observed during the warm season.For every 10μg·m^(-3) increase in SO_(2) concentration,the RR was 1.483(95%CI:1.311,1.678)for females,1.441(95%CI:1.311,1.583)for those aged>65 years,and 1.595(95%CI:1.313,1.937)during the cold season.[Conclusion]Short-term exposure to ambient SO_(2) exposure in Lanzhou is associated with an increased risk of COPD admission.The association is more pronounced among females,the elderly(aged>65 years)and during the cold season.