上消化道出血与季节变化及气象因素关系的研究

发布时间：2019-04-11 12:51

【摘要】：目的：探讨吉林省上消化道出血(UGIB)的季节性发病规律及其与气象因素的相关性，指导病人及早采取相应的预防保健措施，以降低发病率，减少并发症。方法：收集吉林大学第一医院2011年1月1日至2012年12月31日确诊的UGIB住院患者的临床资料、入院时的月份和季度归属及同期的气象资料，比较各个月份、季度之间UGIB发病的差异，并分析各气象因素与UGIB发病之间的关系。结果：本研究共有681例患者入选，其中男性509例，女性172例，男：女为2.96：1；年龄18-103[平均(58.7±15.8)]岁，其中青年组63例（9.25%），中年组309例（45.37%），老年组312例（45.81%）。春、夏、秋、冬季UGIB的发病例数分别为141、143、201、196例，差异有统计学意义（x2=25.11，P＜0.01）。秋、冬季出血发生率明显高于春、夏季（58.30%vs41.70%, P＜0.01），秋季出血发生率高于春、夏季（29.52%vs20.70%、29.52%vs21.0%，P＜0.01）。秋季发病较多，，以10月份为最高;春季发病较少，以4月份为最少。Spearman双变量相关分析结果显示， UGIB发病与月平均大气压关联最显著（rho=0.738，P=0.000），其次是月平均气温（rho=-0.533，P=0.007），再次是月平均人体舒适度指数（rho=-0.462，P=0.023），月平均风速（rho=-0.359，P=0.085）、月平均相对湿度（rho=0.168，P=0.431）和月平均气温日较差（rho=-0.005，P=0.98）与发病无明显关联。将月平均大气压和月平均气温代入多元线性回归分析，结果表明：在调节了月平均气温因素的影响后（P=0.055），只有月平均大气压对UGIB的月发病例数有独立影响（P=0.002），并可建立回归方程：我院UGIB月发病数=-1211.401+0.349×月平均气温+1.254×月平均大气压。结论：（1）吉林省UGIB的发病存在显著的季节差异，秋、冬季发病率明显高于春、夏季。（2）吉林省UGIB发病与月平均大气压呈正相关，与月平均气温呈负相关，通过多元线性回归分析，可以建立预测方程，进行医疗气象预报。（3）人体舒适度指数及其分级与UGIB发病关系密切，通俗易懂，适合进行科普宣传，预防疾病发生。
[Abstract]:Aim: to investigate the seasonal incidence of upper gastrointestinal hemorrhage (UGIB) in Jilin Province and its correlation with meteorological factors, so as to guide the patients to take preventive and health care measures as soon as possible in order to reduce the incidence rate and reduce the complications. Methods: the clinical data of UGIB inpatients diagnosed in the first Hospital of Jilin University from January 1, 2011 to December 31, 2012 were collected. The month and quarter of admission and the meteorological data of the same period were compared. The difference of the incidence of UGIB among quarters and the relationship between the meteorological factors and the incidence of UGIB were analyzed. Results: a total of 681 patients were enrolled in the study, including 509 males and 172 females, male: female 2.96 ml; There were 63 cases (9.25%) in the young group, 309 cases (45.37%) in the middle-aged group and 312 cases (45.81%) in the elderly group. The incidence of UGIB in spring, summer, autumn and winter was 141143201196 cases, the difference was statistically significant (x2, 25.11, P < 0.01). The incidence of bleeding in autumn and winter was significantly higher than that in spring, summer (58.30% vs 41.70%, P < 0.01), autumn was higher than that in spring and summer (29.52% vs 20.70%, 29.52% vs 21.0%, P < 0.01). The incidence rate in autumn was more than that in October, which was the highest in October. Spearman bivariate correlation analysis showed that the incidence of UGIB was most significantly associated with monthly mean atmospheric pressure (rho=0.738,P=0.000), followed by monthly mean air temperature (rho=-0.533,P=0.007). The third is the monthly average human comfort index (rho=-0.462,P=0.023), monthly mean wind speed (rho=-0.359,P=0.085), monthly mean relative humidity (rho=0.168,P=0.431) and daily mean temperature difference (rho=-0.005,). P < 0. 98) was not significantly associated with the onset of the disease. The monthly mean atmospheric pressure and monthly mean air temperature were applied to multivariate linear regression analysis. The results showed that only the monthly mean atmospheric pressure had an independent effect on the number of monthly cases of UGIB (P = 0.002), after adjusting the influence of monthly mean air temperature factors (P = 0.055), and that only the monthly mean atmospheric pressure had an independent effect on the number of cases per month (P = 0.002). The regression equation can be established as follows: monthly incidence of UGB in our hospital =-1211.401 0.349 脳 monthly mean air temperature 1.254 脳 monthly mean atmospheric pressure. Conclusion: (1) there is a significant seasonal difference in the incidence of UGIB in Jilin Province, the incidence of UGIB in autumn and winter is significantly higher than that in spring and summer. (2) the incidence of UGIB in Jilin Province is positively correlated with monthly mean atmospheric pressure, and negatively correlated with monthly mean air temperature. Through the multi-variable linear regression analysis, the prediction equation can be established to forecast the medical weather. (3) the comfort index and its classification of human body are closely related to the incidence of UGIB and are easy to understand, so it is suitable for popularizing science and preventing the occurrence of diseases.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R573.2

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