儿童耳鼻咽喉科疾病与环境气象因素的相关研究

王新兰; 王梅; 王金艳; 田海月; 钟翠萍

doi:10.13201/j.issn.2096-7993.2020.06.016

儿童耳鼻咽喉科疾病与环境气象因素的相关研究

- 1.
  中国人民解放军联勤保障部队第九四〇医院耳鼻咽喉头颈外科(兰州，730050)
- 2.
  宁夏医科大学临床学院研究生院
- 3.
  兰州大学大气学院
基金项目:
甘肃省重点研发计划项目(No：18YF1FA13)；甘肃省卫生行业科研计划项目(No：GSWGKY8-25)；2018年度军队医学科技青年培育计划项目(No：18QNP047)

详细信息

通讯作者: 钟翠萍, Email: doctor.zhong@hotmail.com

中图分类号: R76

收稿日期: 2019-11-25

刊出日期: 2020-06-05

Research on the correlation between otorhinolaryngologic diseases and environmental meteorological factors in children

- 1.
  Department of Otolaryngology Head and Neck Surgery, the 940^th Hospital of the Joint Logistics Support Unit of the Chinese PLA, Lanzhou, 730050, China
- 2.
  Graduate School of Clinical Medicine, Ningxia Medical University
- 3.
  From the School of Atmospheric Sciences, Lanzhou University

More Information

Corresponding author: ZHONG Cuiping, E-mail: doctor.zhong@hotmail.com

Received Date: 25 November 2019

Publish Date: 05 June 2020

摘要

摘要: 目的探讨兰州地区儿童急性中耳炎(AOM)、急性咽喉炎(AP)、变应性鼻炎(AR)与环境气象因素的相关性。方法收集20l5—2017年期间解放军第940医院AOM、AP、AR患儿的临床资料，结合同期兰州市空气质量指数(AQI)及环境气象数据(PM_2.5、PM₁₀、CO、NO₂、SO₂、O₃、平均气温、平均气压、平均风速、平均湿度)，分析环境气象因素与儿童AOM、AP、AR就诊人数的相关性。结果儿童AOM日就诊人数与AQI、PM_2.5、PM₁₀、CO、NO₂、SO₂、平均气压均呈正相关，与O₃、平均气温、平均风速均呈负相关，而与平均湿度无相关性；儿童AP日就诊人数与平均温度、平均湿度呈正相关，与其他9项因子无相关性；儿童AR日就诊人数除与O₃无相关性外，与其他10项因子存在相关。不同季节对儿童AOM、AP、AR日就诊人数的影响因素不同，环境气象因素对儿童AOM、AP、AR的发病具有单滞后和累积滞后效应，但单滞后和累积滞后时间具有一定的差异。结论环境气象因素对儿童AOM、AP、AR的发病可能存在一定的相关性，且有滞后性，儿童AOM、AP、AR发病受季节因素的影响。
- 中耳炎 /
- 咽喉炎 /
- 鼻炎，变应性 /
- 环境气象因素 /
- 儿童
Abstract: Objective To explore the correlation between acute otitis media(AOM), acute pharyngitis(AP) and allergic rhinitis(AR) and environmental-meteorological factors in children in Lanzhou.Method Data were collected in 2015-2017 from the outpatient department and emergency department of Otolaryngology of one hospital in Lanzhou. The association between clinical data and the environmental meteorological factors during the same period, including the air quality index(AQI), PM_2.5, PM₁₀, CO, NO₂, SO₂, O₃, average temperature, average air pressure, average wind speed, average humidity in Lanzhou, was analyzed.Result The incidence of AOM was positively correlated with AQI, PM_2.5, PM₁₀, CO, NO₂, SO₂, average air pressure, and was negatively correlated with O₃, average wind speed and average air temperature, but not correlated with average humidity. The incidence of AP was positively correlated with average temperature and average humidity, and not correlated with other 9 factors. The incidence of AR was correlated with all 10 environmental meteorological factors except for O₃.The number of children with AOM, AP and AR varied with different seasons. Environmental meteorological factors have single lag and cumulative lag effects on the incidence of children with AOM, AP and AR, and difference between the single lag and cumulative lag time was observed.Conclusion There may be some correlation between the environmental meteorological factors and the incidence of AOM, AP, AR in children, and there is a lag effect. The incidence of pediatric AOM, AP and AR is affected by seasonal factors.
- otitis media /
- pharyngitis /
- rhinitis, allergic /
- environmental meteorological factors /
- children

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图 1 2015-2017年不同月份(1a)、年龄(1b)、季节(1c)AOM就诊人数的分布

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图 2 2015-2017年不同月份(2a)、年龄(2b)、季节(2c)AP就诊人数的分布

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图 3 2015-2017年不同月份(3a)、年龄(3b)、季节(3c)AR就诊人数的分布

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表 1 AOM、AP、AR日就诊人数与大气环境因素的相关性

环境因素	AOM	AP	AR
AQI	0.193²⁾	-0.005	-0.221²⁾
PM2.5	0.216²⁾	0.017	-0.208²⁾
PM₁₀	0.198²⁾	-0.025	-0.239²⁾
SO₂	0.132²⁾	0.025	-0.110²⁾
CO	0.184²⁾	0.014	-0.147²⁾
NO₂	0.206²⁾	-0.020	-0.143²⁾
O₃	-0.139²⁾	-0.029	-0.002
平均温度	-0.285²⁾	0.069¹⁾	0.397²⁾
平均气压	0.135²⁾	-0.059	-0.096²⁾
平均湿度	-0.005	0.060¹⁾	0.129²⁾
平均风速	-0.064¹⁾	-0.012	0.073¹⁾
¹⁾P < 0.05; ²⁾P < 0.01。

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表 2 春季AOM、AP、AR日就诊人数与大气环境因素的相关性

环境因素	AOM	AP	AR
AQI	-0.038	-0.091	-0.031
PM_2.5	-0.009	-0.126¹⁾	-0.063
PM₁₀	-0.043	-0.119¹⁾	-0.038
CO	-0.024	-0.019	-0.029
NO₂	0.040	-0.026	-0.008
SO₂	-0.047	-0.063	-0.012
O₃	0.022	0.047	0.011
平均温度	0.179²⁾	0.086	0.079
平均气压	-0.047	-0.049	-0.065
平均湿度	0.018	0.086	-0.030
平均风速	-0.121¹⁾	0.045	0.072

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表 3 夏季AOM、AP、AR日就诊人数与大气环境因素的相关性

环境因素	AOM	AP	AR
AQI	0.029	0.034	-0.152¹⁾
PM_2.5	0.092	0.045	0.151¹⁾
PM₁₀	-0.012	0.030	0.097
CO	-0.047	0.101	0.144¹⁾
NO₂	0.022	0.021	-0.076
SO₂	0.091	0.030	-0.054
O₃	-0.077	-0.039	0.027
平均温度	-0.159¹⁾	0.057	0.179¹⁾
平均气压	-0.093	-0.023	0.139¹⁾
平均湿度	0.014	0.079	0.034
平均风速	0.026	0.004	-0.009

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表 4 秋季AOM、AP、AR日就诊人数与大气环境因素的相关性

环境因素	AOM	AP	AR
AQI	0.321²⁾	0.146¹⁾	-0.185²⁾
PM_2.5	0.361²⁾	0.211²⁾	-0.241²⁾
PM₁₀	0.303²⁾	0.142¹⁾	-0.213²⁾
CO	0.335²⁾	0.174²⁾	-0.217²⁾
NO₂	0.249²⁾	0.004	-0.167²⁾
SO₂	0.212²⁾	0.179²⁾	-0.185²⁾
O₃	-0.096	-0.166²⁾	0.125¹⁾
平均温度	-0.553²⁾	-0.187²⁾	0.513²⁾
平均气压	0.062	0.052	-0.120¹⁾
平均湿度	-0.089	0.014	-0.017
平均风速	-0.100	-0.127¹⁾	0.136¹⁾

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表 5 冬季AOM、AP、AR日就诊人数与大气环境因素的相关性

环境因素	AOM	AP	AR
AQI	0.123¹⁾	-0.017	0.009
PM_2.5	0.185²⁾	0.040	0.056
PM₁₀	0.162²⁾	-0.009	-0.024
CO	0.238²⁾	0.012	0.071
NO₂	0.311²⁾	0.041	0.055
SO₂	0.129¹⁾	0.047	0.122¹⁾
O₃	-0.313²⁾	-0.035	0.066
平均温度	-0.139¹⁾	-0.098	-0.129¹⁾
平均气压	0.256²⁾	0.021	-0.043
平均湿度	0.112	0.105	0.021
平均风速	-0.215²⁾	-0.080	-0.044

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表 6 环境气象因素对儿童耳鼻喉科相关疾病的单滞后效应分析

环境因素	疾病	单滞后1 d	单滞后2 d	单滞后3 d	单滞后4 d	单滞后5 d	单滞后6 d
AQI	AOM	0.194¹⁾	0.188²⁾	0.250²⁾	0.236²⁾	0.231²⁾	0.230²⁾
	AP	-0.014	-0.042	-0.005	-0.047	-0.043	-0.014
	AR	-0.221²⁾	-0.244²⁾	-0.204¹⁾	-0.200²⁾	-0.227²⁾	-0.231²⁾
PM_2.5	AOM	0.215²⁾	0.196²⁾	0.250²⁾	0.246²⁾	0.243²⁾	0.236²⁾
	AP	0.020	0.015	0.013	-0.034	-0.026	-0.003
	AR	-0.211²⁾	-0.242²⁾	-0.207²⁾	-0.197²⁾	-0.201²⁾	-0.217²⁾
PM₁₀	AOM	0.217²⁾	0.189²⁾	0.260²⁾	0.224²⁾	0.230²⁾	0.232²⁾
	AP	-0.039	-0.060¹⁾	-0.048	-0.062¹⁾	-0.081²⁾	-0.049
	AR	-0.239²⁾	-0.247²⁾	-0.216²⁾	-0.224²⁾	-0.261²⁾	-0.263²⁾
SO₂	AOM	0.136²⁾	0.138²⁾	0.158²⁾	0.137²⁾	0.146¹⁾	0.139¹⁾
	AP	0.036	0.031	0.042	0.037	0.037	0.033
	AR	-0.124²⁾	-0.121²⁾	-0.126²⁾	-0.121²⁾	-0.112²⁾	-0.110²⁾
CO	AOM	0.182²⁾	0.178²⁾	0.179²⁾	0.210¹⁾	0.222²⁾	0.201²⁾
	AP	-0.001	-0.018	-0.028	-0.032	-0.038	-0.027
	AR	-0.179²⁾	-0.184²⁾	-0.189²⁾	-0.170²⁾	-0.170²⁾	-0.180²⁾
NO₂	AOM	0.209²⁾	0.182²⁾	0.223²⁾	0.226²⁾	0.245²⁾	0.216²⁾
	AP	-0.025	-0.052	-0.048	-0.061¹⁾	-0.070¹⁾	-0.048
	AR	-0.157²⁾	-0.169²⁾	-0.180²⁾	-0.143²⁾	-0.126²⁾	-0.151²⁾
O₃	AOM	-0.113¹⁾	-0.120²⁾	-0.171²⁾	-0.132²⁾	-0.124²⁾	-0.117²⁾
	AP	-0.034	-0.047	-0.033	-0.027	-0.049	-0.052
	AR	0.008	0.021	0.019	0.035	0.007	0.002
平均温度	AOM	-0.287²⁾	-0.280²⁾	-0.267²⁾	-0.272²⁾	-0.265²⁾	-0.261²⁾
	AP	0.058	0.061¹⁾	0.070¹⁾	0.073¹⁾	0.065¹⁾	0.077¹⁾
	AR	0.393²⁾	0.403²⁾	0.406²⁾	0.417²⁾	0.411²⁾	0.413²⁾
平均气压	AOM	0.113²⁾	0.104²⁾	0.100²⁾	0.132²⁾	0.140²⁾	0.130²⁾
	AP	-0.056	-0.078²⁾	-0.085²⁾	-0.100	-0.077¹⁾	0.076¹⁾
	AR	0.091²⁾	0.005	-0.001²⁾	0.000	-0.023	-0.018
平均湿度	AOM	0.007	0.011	-0.020	-0.076	0.003	0.005
	AP	0.053	0.062¹⁾	0.047	0.018	0.041	0.015
	AR	0.115²⁾	0.118²⁾	0.129²⁾	0.097²⁾	0.152²⁾	0.149²⁾
平均风速	AOM	-0.067²⁾	-0.018	-0.056	-0.120¹⁾	-0.113²⁾	-0.071¹⁾
	AP	-0.001	-0.002	-0.005	0.022	-0.007	-0.004
	AR	-0.040	-0.024	-0.031	-0.006	0.102²⁾	-0.029

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表 7 环境气象因素对儿童耳鼻喉科相关疾病的累积滞后效应分析

环境因素	疾病	累积滞后1 d	累积滞后2 d	累积滞后3 d	累积滞后4 d	累积滞后5 d	累积滞后6 d
AQI	AOM	0.212²⁾	0.230²⁾	0.256²⁾	0.274²⁾	0.277²⁾	0.293²⁾
	AP	-0.013	-0.019	-0.015	-0.030	-0.034	-0.034
	AR	-0.257²⁾	-0.293²⁾	-0.298²⁾	-0.320²⁾	-0.332²⁾	-0.352²⁾
PM_2.5	AOM	0.246²⁾	0.265²⁾	0.277²⁾	0.307²⁾	0.308²⁾	0.325²⁾
	AP	0.017	0.018	0.018	0.003	0.003	0.004
	AR	-0.244²⁾	-0.280²⁾	-0.287²⁾	-0.304²⁾	-0.312²⁾	-0.323²⁾
PM₁₀	AOM	0.214	0.240	0.253	0.274	0.279	0.290
	AP	-0.035	-0.044	-0.050	-0.060¹⁾	-0.068¹⁾	-0.069¹⁾
	AR	-0.276²⁾	-0.304²⁾	-0.305²⁾	-0.330²⁾	-0.345²⁾	-0.366²⁾
SO₂	AOM	0.149²⁾	0.153²⁾	0.228²⁾	0.157²⁾	0.156²⁾	0.155²⁾
	AP	0.030	0.031	0.036	0.034	0.040	0.038
	AR	-0.124²⁾	-0.128²⁾	-0.134²⁾	-0.132²⁾	-0.135²⁾	-0.131²⁾
CO	AOM	0.212²⁾	0.227²⁾	0.260²⁾	0.242²⁾	0.243²⁾	0.255²⁾
	AP	0.005	-0.009	-0.016	-0.022	-0.021	0.020
	AR	-0.189²⁾	-0.207²⁾	-0.227²⁾	-0.226²⁾	-0.241²⁾	-0.241²⁾
NO₂	AOM	0.240²⁾	0.248²⁾	0.234²⁾	0.292²⁾	0.291²⁾	0.315²⁾
	AP	-0.038	-0.052	-0.057²⁾	-0.070²⁾	-0.074¹⁾	-0.078¹⁾
	AR	-0.167²⁾	-0.189²⁾	-0.211²⁾	-0.219²⁾	-0.231²⁾	-0.236²⁾
O₃	AOM	-0.121²⁾	-0.125²⁾	-0.128²⁾	-0.136²⁾	-0.135¹⁾	-0.139²⁾
	AP	-0.032	-0.039	-0.040	-0.037	-0.040	-0.041
	AR	-0.006	0.014	0.020	0.024	0.025	0.020
平均温度	AOM	-0.287²⁾	-0.285²⁾	-0.282²⁾	-0.285²⁾	-0.283²⁾	-0.284²⁾
	AP	0.065¹⁾	0.065¹⁾	0.067¹⁾	0.069¹⁾	0.071¹⁾	0.072¹⁾
	AR	0.400²⁾	0.407²⁾	0.409²⁾	0.417²⁾	0.418²⁾	0.419²⁾
平均气压	AOM	0.169²⁾	0.175²⁾	0.162²⁾	0.181²⁾	0.152²⁾	0.182²⁾
	AP	-0.071¹⁾	-0.084²⁾	-0.114²⁾	-0.110¹⁾	-0.116²⁾	-0.114²⁾
	AR	-0.091²⁾	-0.096²⁾	-0.109²⁾	-0.137²⁾	-0.137²⁾	-0.159²⁾
平均湿度	AOM	-0.003	0.000	-0.033	-0.016	-0.015	-0.014
	AP	0.063¹⁾	0.067¹⁾	0.068¹⁾	0.061¹⁾	0.055	0.053
	AR	0.133²⁾	0.138²⁾	0.148²⁾	0.151²⁾	0.155²⁾	0.166²⁾
平均风速	AOM	-0.130²⁾	-0.128²⁾	-0.133²⁾	-0.146²⁾	-0.162²⁾	-0.174²⁾
	AP	0.013	0.019	0.023	0.033	0.031	0.028
	AR	0.062¹⁾	0.077¹⁾	0.083²⁾	0.095²⁾	0.115²⁾	0.115²⁾

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