摘要
目的 探讨兰州市日均气温变化与水痘发病的相关性。方法 从全国传染病报告信息管理系统和甘肃省气象局分别收集兰州市2008—2016年水痘逐日发病例数，结合同期气象资料，采用分布滞后非线性模型分析不同的滞后天数（lag）、气温与水痘发病的关联性及对于敏感人群的影响；以最低风险温度为参照，估计不同气温P5（-5.2 ℃）、P25（1.7 ℃）、P75（20.1 ℃）、P95（25.4 ℃）对水痘发病造成的相对风险。结果 2008—2016年兰州市共报告水痘21 254例，其中男性11 951例，女性9 303例，男、女性别比为1.28∶1。6~14岁儿童最多，占52.87%（11 237例）。气温与水痘日发病例数的暴露反应关系曲线呈M型，最低风险温度为13.7 ℃。lag 0~14 d时，温度为-5.2 ℃、1.7 ℃和20.1 ℃时，全人群的气温的累积效应的RR（95%CI）值分别为1.87（1.64~2.12）、1.33（1.10~1.62）、1.60（1.38~1.86）；温度为25.4 ℃时，lag 0~7 d的累积效应RR（95%CI）值为2.51（1.93~3.27）；温度为5.2 ℃、lag 7 d的累计效应RR（95%CI）值最大，为6.23（4.38~8.86）。对6~14岁儿童，当温度为-5.2 ℃时，lag 5 d的累计效应最大，RR（95%CI）值为6.12（3.71~10.10）。结论 高温和低温均造成兰州市人群水痘发病风险上升，低温效应大于高温，6~14岁儿童是敏感人群。
Objective To explore the effects of temperature on the daily cases of varicella.Methods The data of daily cases of varicella was collected during 2008 to 2016 in Lanzhou from National Notifiable Disease Report System, and the meteorological data at the same period was integrated from Gansu Meteorological Administration. Distributed lag nonlinear model was fitted to reveal the relationship between the daily mean temperature and the daily cases of varicella and susceptible population. The minimum morbidity temperature was defined as the reference for the estimation of RRs in different temperature level （-5.2 ℃, 1.7 ℃, 20.1 ℃ and 25.4 ℃）.Results The total of 21 254 cases were reported from 2008 to 2016, of which the ratio of male to female was 1.28 （11 951/9 303） and people aged 6-14 years accounted for 52.87%. The relationship between the daily mean temperature and the daily cases of varicella was M type. For all subjects, the accumulative effects of temperature had statistical significance from lag 0-14 d when temperatures was at -5.2 ℃, 1.7 ℃ and 20.1 ℃,while the RRs （95%CI） were 1.87 （1.64-2.12） , 1.33 （1.10-1.62） ,1.60 （1.38-1.86） ,while from lag 0-7 d when temperatures was at 25.4 ℃,and the RR （95%CI） was 2.51 （1.93-3.27） . The RR value of accumulative effects was 6.23（95%CI： 4.38-8.86） on lag 7 d when temperatures was at -5.2 ℃, which was the highest value at different temperature during lag days. The cumulative effects trends of different temperatures were similar for different gender population or different age subjects. However, the cumulative effects of was highest for children aged 6-14 years among all subjects, and the value of RR was 6.12 （95%CI：3.71-10.10） on lag 5d when temperatures was at -5.2 ℃.Conclusion We conclude that the increasing risk of varicella is associative with low and high temperature in Lanzhou. The effects of low temperature are stronger than those of high temperature. The children aged 6-14 years belong to the high-risk population of varicella.
作者
王金玉
李盛
马汉平
董继元
王宇红
张薇
张晓宇
李普
李守禹
Wang Jinyu;Li Sheng;Ma Hanping;Dong Jiyuan;Wang Yuhong;Zhang Wei;Zhang Xiaoyu;Li Pu;Li Shouyu(Institute of Human Anatomy and Histology and Embryology,School of Basic Medicine,Lanzhou University,Lanzhou 730000,Chin)
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2018年第8期842-848,共7页
Chinese Journal of Preventive Medicine
基金
甘肃省自然科学基金项目（17JR5RA347）
兰州市人才创新创业项目（2015-RC-34、2016-RC-29）
关键词
温度
水痘
分布滞后非线性模型
滞后效应
Temperature
Chickenpox
Distributed lag nonlinear model
Lag effects
