长期细颗粒物及其化学成分暴露与动脉粥样硬化亚临床疾病的横断面研究

发布时间：2018-03-29 08:32

本文选题：动脉粥样硬化　切入点：心血管疾病　出处：《天津医科大学》2013年博士论文

【摘要】：背景：细颗粒物(Fine Particulate Matter, PM2.5)室外浓度已经证实与心血管疾病有联系。PM2.5暴露的效应有可能是因为PM的化学成分而造成的。目的：探讨PM2.5及其化学成分对亚临床心血管效应的作用。方法：使用“动脉粥样硬化多种族研究队列(Multi-Ethnic Study of Atherosclerosis[MESA]))基线资料(2000年-2002年)进行横断面分析,PM2.5及其化学成分(元素碳elemental carbon [EC]［有机碳organic carbon [OC]］硅[silicon]和硫[sulfur])与动脉粥样硬化亚临床指标,冠状动脉钙化(coronary artery calcium [CAC]),和颈动脉中层厚度(carotid intima-media thickness [CIMT])之间的联系。研究对象由6,256名45-84岁未患临床心血管疾病的成人组成。使用3种方法估计PM成分暴露浓度：1)最近监测点(首要方法)；2)反距离权重法(Inverse Distance Weighting, IDW);3)城市内部平均值。分别使用B超和CT检测CIMT和CAC,依据以往的研究结果,结合调查问卷获取的相关协变量信息,分析PM2.5及其成分与亚临床心血管疾病的关系。结果：最近监测点估计暴露时,OC与CIMT的联系有统计学意义,但是与PM2.5、EC、silicon和sulfur的联系没有统计学意义。在其他方法估计暴露时也观察到了某些联系,尤其是silicon,尽管这种联系并不是始终如一的。未见PM2.5及其化学成分与CAC(是否存在冠状动脉钙化或者冠状动脉钙化的程度)的联系。敏感性分析中,某些结果对研究城市的调整比较敏感。结论：主要方法(最近监测点和Model1)估计的OC与CIMT的增加之间的联系有统计学意义;同时,使用第二种方法(IDW),OC与CIMT也存在着有统计学意义的联系。PM2.5化学成分的组成对PM暴露对动脉粥样硬化的效应是一个重要的因素。
[Abstract]:Background: fine Particulate matter (PM2.5) outdoor concentrations have been shown to be associated with cardiovascular disease. The effects of PM2.5 exposure may be due to the chemical composition of PM. Objective: to investigate the effects of PM2.5 and its chemical constituents on subclinical cardiovascular effects. Methods: the baseline data of "Multi-Ethnic Study of Atherosclerosis [MESA]" (2000-2002) were used for cross-sectional analysis of PM2.5 and its chemical constituents (elemental elemental carbon [EC] [organic organic carbon [OC] Si [silicon] and sulfur [sulfur]) and atherosclerosis. Sclerosing subclinical index, The association between coronary artery calcium [CAC] and carotid medial thickness intima-media thickness [CIMT]. The subjects were 6256 adults aged 45-84 years without clinical cardiovascular disease. Three methods were used to estimate PM component exposure concentration: 1) recently. The average value of city interior is measured by inverse Distance weighting (IDWX 3) using B-ultrasound and CT, respectively, according to the results of previous studies. The relationship between PM2.5 and its components and subclinical cardiovascular diseases was analyzed by using the covariate information obtained from the questionnaire. Results: the association of OC with CIMT was statistically significant at the most recent monitoring site estimation, but there was no significant association with PM2.5 CIMT and sulfur. Some associations were also observed at the time of exposure estimation by other methods. Silicon, in particular, although the association is not consistent. There is no association between PM2.5 and its chemical constituents (whether or not coronary artery calcification exists or the extent of coronary calcification). Some of the results are sensitive to the adjustment of the study city. Conclusion: there is a statistically significant correlation between the OC estimated by the main methods (the nearest monitoring point and Model1) and the increase in CIMT; at the same time, Using the second method, there was also a significant relationship between CIMT and IDWN OC. The composition of PM2.5 was an important factor in the effect of PM exposure on atherosclerosis.
【学位授予单位】：天津医科大学
【学位级别】：博士
【学位授予年份】：2013
【分类号】：R543.5;R122

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