温度变化对合肥地区精神分裂症发作影响的研究
发布时间：2019-06-26 10:54
【摘要】：目的:1、了解2005-2014年合肥市精神分裂症发作的分布特征;2、利用分布滞后非线性模型分析平均温度与精神分裂症发作的关系,并明确脆弱人群;3、探讨温度变异(昼夜温差和相邻两日温差)对精神分裂症发作的影响。方法:收集合肥市2005年1月1日至2014年12月31日每日气象数据资料,包括最高温度,平均温度,最低温度,相对湿度和降雨量等。同期,收集合肥市精神卫生中心每日入院的精神分裂症发作资料,包括患者的发病时间,年龄,性别,现居地址,婚姻状况和出生季节。采用泊松广义线性回归模型结合分布滞后非线性模型分析温度变化(包括平均温度,昼夜温差和相邻两日温差)与精神分裂症发作的关系,调整季节性和长期趋势和星期几效应等混杂因素的影响。结果:(1)在2005-2014年研究期间内,合肥地区总共有36607人次因精神分裂症发作入院,21-40岁就诊人次显著多于其余年龄组就诊人次;已婚患者就诊人次多于未婚患者,比例为2.7:1(26249:9809);冬季出生的患者就诊人次多于其它季节出生的患者就诊人次。(2)当日均气温较高时(第75百分位数:24.9°C),温度对精神分裂症发作有影响,并存在一定的滞后效应,其中滞后0-7天的累积效应达到1.27%(95%CI:1.14-1.42)。在不同性别,年龄组,婚姻状况和出生季节间,发现男性患者,21-60岁患者,已婚患者和春冬两季出生的患者更易受到温度升高的影响。(3)极端昼夜温差改变(第95百分位数:14.6°C)与精神分裂症发作存在统计学关联,呈现急性效应(RR=1.027,95%CI:1.007-1.047),且其危害效应一直持续至滞后第六天。通过对个体特征进行分层分析,分别发现男性,"g21岁,春秋两季出生以及已婚精神分裂症患者较其他患者更易受到极端昼夜温差变化的影响。同时,第二个5年(2010-2014)相比第一个5年(2005-2009),精神分裂症患者受到极端昼夜温差的危害效应呈上升趋势。然而,尚未发现中等程度的昼夜温差变化(第75百分位数:11°C)对精神分裂症发作有影响。(4)较大的相邻两日温差改变(第75百分位数:1.4°C)可能会增加精神分裂症发作的风险,尤其在滞后当天,危害效应的增加达到1.9%(95%CI:0.4%-3.4%)。并且,找出脆弱人群的特征为21-40岁,已婚和春秋两季出生的患者。结论:温度上升和短时间内温度的快速变化能够显著地增加精神分裂症发作的风险,且温度变化的危害效应受到患者个体特征的修饰。整体而言,男性,21-40岁,已婚和春季出生的患者更易受到温度变化对精神分裂症发作的影响。
[Abstract]:Objective: To study the distribution of the onset of schizophrenia in Hefei from 2005 to 2014, and to analyze the relationship between the average temperature and the onset of schizophrenia by using the distributed lag non-linear model, and to identify the vulnerable groups. The effects of temperature variation (temperature difference between day and night and the temperature difference between two adjacent days) on the onset of schizophrenia were discussed. Method: Collect the daily meteorological data from January 1,2005 to December 31,2014, including the highest temperature, average temperature, minimum temperature, relative humidity and rainfall. In the same period, the information on the onset of schizophrenia, including the time, age, sex, living address, marital status and birth season, was collected on a daily basis in the mental health center of Hefei. The effect of temperature variation (including average temperature, day-and-night temperature difference and the adjacent two-day temperature difference) and the onset of schizophrenia was analyzed by a Poisson generalized linear regression model in combination with the distribution-lag nonlinear model, and the effects of seasonal and long-term and day-of-week effects were adjusted. Results: (1) During the study period from 2005 to 2014, a total of 36607 patients in Hefei were admitted to the hospital due to the onset of schizophrenia, and the number of visits to the 21-40 year-old patients was significantly higher than that of the other age groups; the number of visits to the married patients was 2.7:1 (26249:9809); The number of patients born in winter is more than that of the patients born in other seasons. (2) At the same day, the temperature was higher (the 75th percentile: 24.9 掳 C), and the temperature had an effect on the onset of the schizophrenia, and there was a certain lag effect, in which the cumulative effect of the delay of 0-7 days reached 1.27% (95% CI: 1.14-1.42). In the different sex, age group, marital status and the birth season, male patients,21-60 years of age, married patients and patients born in the spring of the winter are more likely to be affected by elevated temperature. (3) The extreme diurnal temperature difference (95th percentile: 14.6 掳 C) was statistically associated with the onset of schizophrenia, presenting an acute effect (RR = 1.027,95% CI: 1.007-1.047), and its hazard effect continued until the sixth day of the lag. By stratified analysis of individual characteristics, it was found that male, "g21", "Spring and Autumn" and married schizophrenia patients were more likely to be affected by extreme day and night temperature differences compared with other patients, while the second 5 years (2010-2014) were the first five years (2005-2009). The effect of extreme day and night temperature difference on the patients with schizophrenia is on the rise. However, A moderate degree of diurnal temperature change (75th percentile:11 掳 C) has not been found to have an effect on the onset of schizophrenia. (4) The larger adjacent two-day temperature difference (75th percentile: 1.4 掳 C) may increase the risk of the onset of schizophrenia, especially on the day of the lag, The increase in the hazard effect reached 1.9% (95% CI: 0.4%-3.4%) and found that the vulnerable population was characterized by 21-40 years of age, married and spring-and-autumn-born patients. Conclusion: The rapid change in temperature and the temperature in a short period of time can significantly increase the risk of the onset of schizophrenia. In general, men,21-40 years of age, married and spring-born patients are more susceptible to temperature changes on the onset of schizophrenia.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.3
，
本文编号：2506129
[Abstract]:Objective: To study the distribution of the onset of schizophrenia in Hefei from 2005 to 2014, and to analyze the relationship between the average temperature and the onset of schizophrenia by using the distributed lag non-linear model, and to identify the vulnerable groups. The effects of temperature variation (temperature difference between day and night and the temperature difference between two adjacent days) on the onset of schizophrenia were discussed. Method: Collect the daily meteorological data from January 1,2005 to December 31,2014, including the highest temperature, average temperature, minimum temperature, relative humidity and rainfall. In the same period, the information on the onset of schizophrenia, including the time, age, sex, living address, marital status and birth season, was collected on a daily basis in the mental health center of Hefei. The effect of temperature variation (including average temperature, day-and-night temperature difference and the adjacent two-day temperature difference) and the onset of schizophrenia was analyzed by a Poisson generalized linear regression model in combination with the distribution-lag nonlinear model, and the effects of seasonal and long-term and day-of-week effects were adjusted. Results: (1) During the study period from 2005 to 2014, a total of 36607 patients in Hefei were admitted to the hospital due to the onset of schizophrenia, and the number of visits to the 21-40 year-old patients was significantly higher than that of the other age groups; the number of visits to the married patients was 2.7:1 (26249:9809); The number of patients born in winter is more than that of the patients born in other seasons. (2) At the same day, the temperature was higher (the 75th percentile: 24.9 掳 C), and the temperature had an effect on the onset of the schizophrenia, and there was a certain lag effect, in which the cumulative effect of the delay of 0-7 days reached 1.27% (95% CI: 1.14-1.42). In the different sex, age group, marital status and the birth season, male patients,21-60 years of age, married patients and patients born in the spring of the winter are more likely to be affected by elevated temperature. (3) The extreme diurnal temperature difference (95th percentile: 14.6 掳 C) was statistically associated with the onset of schizophrenia, presenting an acute effect (RR = 1.027,95% CI: 1.007-1.047), and its hazard effect continued until the sixth day of the lag. By stratified analysis of individual characteristics, it was found that male, "g21", "Spring and Autumn" and married schizophrenia patients were more likely to be affected by extreme day and night temperature differences compared with other patients, while the second 5 years (2010-2014) were the first five years (2005-2009). The effect of extreme day and night temperature difference on the patients with schizophrenia is on the rise. However, A moderate degree of diurnal temperature change (75th percentile:11 掳 C) has not been found to have an effect on the onset of schizophrenia. (4) The larger adjacent two-day temperature difference (75th percentile: 1.4 掳 C) may increase the risk of the onset of schizophrenia, especially on the day of the lag, The increase in the hazard effect reached 1.9% (95% CI: 0.4%-3.4%) and found that the vulnerable population was characterized by 21-40 years of age, married and spring-and-autumn-born patients. Conclusion: The rapid change in temperature and the temperature in a short period of time can significantly increase the risk of the onset of schizophrenia. In general, men,21-40 years of age, married and spring-born patients are more susceptible to temperature changes on the onset of schizophrenia.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.3
，
本文编号：2506129
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