合肥市2010-2013年温度变化对儿童急性支气管炎的影响：时间序列研究

发布时间：2018-04-05 22:19

  本文选题：急性支气管炎　切入点：时间序列　出处：《安徽医科大学》2017年硕士论文

【摘要】：目的:1.了解合肥市儿童急性支气管炎的流行特征;2.采用时间序列分析方法,探讨温度变化与儿童急性支气管炎的关系,并且明确相应的易感人群,为开展有效的儿童急性支气管炎的预防工作提供科学合理的依据。方法:1.从安徽省儿童医院搜集2010~2013年的每日合肥地区儿童急性支气管炎的就诊发病资料,包括患者姓名,性别,年龄,发病时间,居住地址等。合肥市气象局提供了合肥市辖区内自2010年至2013年的每日详细气象数据资料,包括日最高温度,日平均温度,日最低温度,和相对湿度等;2.通过建立急性支气管炎和气象变量的时间序列,利用R软件中分布滞后非线性模型(DLNM)来探索温度,昼夜温差(一天内最高温度与最低温度的差值)对急性支气管炎的影响以及是否存在滞后效应;3.将儿童急性支气管炎发病资料分别按性别和年龄分为:男性与女性组、0-4岁组和5-14岁组,进一步分析易感人群。结果:1.研究显示,2010-2013年儿童急性支气管炎的发病资料存在一定的季节性,冬季高发。2.在研究期间,儿童急性支气管炎的总发病数为14055人,平均每日儿童急性支气管炎患者的就诊量为51.9(范围:0~115)。从性别分组上看,男性儿童患者明显多于女性儿童患者,比例为2.4:1(9918:4137)。平均温度、最高温度和最低温度的均值分别为3.9℃(范围:-2.8℃~15.3℃),8.2℃(范围:-1.1℃~22.3℃)和0.4℃(范围-8.0℃~11.0℃);相对湿度的平均值为69.5%(范围:22.0%~100%)。3.温度与儿童急性支气管炎发病率之间存在着非线性关系,其影响是急性的,滞后时间较短。平均温度的降低能够显著增加儿童急性支气管炎的发病风险。平均温度每降低1℃时,滞后效应的最大值在滞后0天,其相对危险度为1.016(95%CI:1.003~1.076)。女性和0-4岁儿童更容易受到温度的影响。4.昼夜温差能够增加儿童急性支气管炎的发病风险。昼夜温差每增加1℃时,滞后效应的最大值在滞后第三天,其相对危险度为1.010(95%CI:1.005~1.016)。女性和0-4岁儿童比其他儿童更容易受到昼夜温差的影响。结论:1.合肥市儿童急性支气管炎的发病高峰期是冬季。2.平均温度的降低能够增加儿童急性支气管炎的发病风险,其中女性和0-4岁儿童更容易受到低温的影响。3.随着昼夜温差的增大,儿童急性支气管炎发病风险也随之增加,女性和0-4岁儿童对昼夜温差的变化更加易感。
[Abstract]:Purpose 1.To understand the epidemic characteristics of acute bronchitis in children in Hefei.The relationship between temperature change and acute bronchitis in children was studied by using time series analysis method, and the corresponding susceptible population was identified, which provided a scientific and reasonable basis for the effective prevention of acute bronchitis in children.Method 1: 1.The data of acute bronchitis of children in Hefei from 2010 to 2013 were collected from Anhui Children's Hospital, including patient name, sex, age, onset time, residence address and so on.Hefei Meteorological Bureau provided daily detailed meteorological data from 2010 to 2013, including daily maximum temperature, daily average temperature, daily minimum temperature, and relative humidity.By establishing the time series of acute bronchitis and meteorological variables and using the distributed lag nonlinear model (DLNM) in R software to explore the temperature,The effect of diurnal temperature difference (the difference between the highest and lowest temperatures in a day) on acute bronchitis and whether there is a lag effect.The data of acute bronchitis in children were divided into male and female groups according to sex and age: male and female groups aged 0-4 and 5-14 years old.The result is 1: 1.The study showed that the incidence of acute bronchitis in children from 2010 to 2013 was seasonal, with a high incidence of. 2. 2 in winter.During the study period, the total incidence of acute bronchitis in children was 14055, and the average daily attendance of children with acute bronchitis was 51.9 (range: 0115).In terms of gender groups, male children have more children than women, with a ratio of 2.4: 1 9918: 4137.The mean values of average temperature, maximum temperature and minimum temperature are 3.9 鈩，

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