四川大学学报（医学版）2023，Vol.54Issue(6)：1176-1183,8.DOI:10.12182/20231160504
短期空气污染物暴露对终末期肾脏病血液透析患者入院次数的影响
Effect of Short-Term Exposure to Air Pollutants on Hospital Admissions for End-Stage Renal Disease Patients Undergoing Hemodialysis
摘要
Abstract
Objective To evaluate the association between short-term exposure to air pollutants of end-stage renal disease(ESRD)patients on maintenance hemodialysis and the number of daily hospital admissions.Methods The data on hospitalizations were obtained from the database of the municipal Urban Employees'Basic Medical Insurance and Urban Residents'Basic Medical Insurance of a city in Southwest China.Single and multiple pollutant generalized additive models were utilized to estimate the effect of air pollutants(CO,NO2,O3,PM10,PM25,and SO2)on patient admissions after the lag time of different numbers of days.In addition,subgroup analyses stratified by sex,age,PM25 and PM10 concentration thresholds,seasonality,and comorbidity status for cardiovascular diseases and hypertension were conducted.Results In the single pollutant models,the pollutants significantly associated with patient admissions and the corresponding lag time of the strongest association were as follows,every time CO increased by 0.1 mg/m3,there was a 2.39％increase(95％confidence interval[CI]:0.96％-3.83％)in patient admissions after 7 days of lag time;every time NO2,O3,PM2.5,PM10,and SO2 increased by 10 μg/m3,patient admissions increased by 4.02％(95％CI:1.21％-6.91％)after 7 days of lag time,3.57％(95％CI:0.78％-6.44％)after 0-4 days of lag time,2.00％(95％CI:1.07％-2.93％)after 6 days of lag time,1.19％(95％CI:0.51％-1.88％)after 7 days of lag time,and 8.37％(95％CI:3.08％-13.93％)after 7 days of lag time,respectively.In the multiple pollutant model,every time O3 and PM2.5 increased by 10 μg/m3,there was an increase of 3.18％(95％CI:0.34％-6.09％)in daily patient admissions after 0-4 days of lag time and an increase of 1.85％(95％CI:0.44％-3.28％)after 7 days of lag time.Furthermore,subgroup analyses showed that seasonality,the severity of air pollution,and patients'comorbidities might be the effect modifiers for the association between ambient air pollution and hospital admissions in ESRD patients receiving maintenance hemodialysis.Conclusion Air pollution is closely associated with hospital admissions in ESRD patients undergoing maintenance hemodialysis and the strength of this association varies according to seasonality,the severity of air pollution,and patients'status of comorbidities.关键词
空气污染/入院/血液透析/终末期肾脏疾病/关联Key words
Air pollution/Admission/Hemodialysis/End-stage renal disease/Association引用本文复制引用
陈一龙,胡耀,詹宇,孙雅婧,李春漾,辜永红,曾筱茜..短期空气污染物暴露对终末期肾脏病血液透析患者入院次数的影响[J].四川大学学报（医学版）,2023,54(6):1176-1183,8.基金项目
四川省科技厅项目重大项目(No.2021YFQ0035)资助 （No.2021YFQ0035）
