颗粒物和多环芳烃的暴露在不同Framingham风险评分人群中对心率变异性的影响

发布时间：2018-04-30 22:16

本文选题：空气污染 + 颗粒物　；参考：《华中科技大学》2013年硕士论文

【摘要】：目的：在固定群组中分析可吸入颗粒物（PM_(10)）和细颗粒物（PM_(2.5)）与心率变异性（HRV）的关系，以及颗粒物和Framingham风险评分（FRS）对HRV的交互作用。在大样本的社区居民中研究尿中羟基多环芳烃（OH-PAHs）对HRV的影响以及FRS与HRV的关系，并进一步探讨OH-PAHs和FRS对HRV可能存在的联合作用。方法：固定群组研究中选取了82名珠海和70名武汉社区居民志愿者作为研究对象，采用PM_(10)和PM_(2.5)的个体采样器以及动态心电图仪Holter监测24小时颗粒物浓度和HRV，FRS的计算基于年龄、性别、低密度脂蛋白或总胆固醇、高密度脂蛋白、血压、吸烟和糖尿病七个心血管危险因素。大样本的社区居民研究中从武汉两个社区共选取了1978名20-74岁、居住年限超过5年的社区居民作为研究对象。采用Holter测定短时HRV，气象色谱-质谱联用仪检测尿中OH-PAHs的水平。结果：固定群组研究中发现，随着PM_(10)的增加，武汉居民的TP（P_(trend)=0.005）和LF（P_(trend)=0.041）显著降低，PM_(10)和FRS对TP和LF有交互作用（P_(interaction)=0.013和P_(interaction)=0.021），但在珠海居民中未发现类似的结果。另外，在武汉居民低FRS组中，暴露于高水平PM_(10)的居民其HRV显著低于暴露于低水平PM_(10)的居民（P=0.023和P=0.004），而在高FRS组中未发现HRV存在这种差别。在总人群的研究得到了与武汉类似的结果。大样本社区居民研究中，，尿中四类OH-PAHs和尿中总羟基多环芳烃（ΣOH-PAHs）之间的相关具有显著性，相关系数为0.41-0.84。随着ΣOH-PAHs的增加，LF显著降低（P_(trend)=0.008）。萘代谢产物（ΣOHNa）与SDNN存在负向的剂量反应关系（P_(trend)=0.013）。增加的芴代谢产物（ΣOHFlu）与降低的SDNN和LF均存在显著的剂量反应关系（P_(trend)=0.031和P_(trend)=0.005）。同时，随着FRS的增加，HRV各指标均显著降低（P_(trend)0.001），而且ΣOHNa和ΣOHFlu分别与FRS对SDNN具有联合作用（P_(trend)=0.016和P_(trend)=0.030），ΣOH-PAHs和ΣOHFlu分别与FRS对LF存在联合作用（P_(trend)=0.006和P_(trend)=0.005）。结论：增加的PM_(10)与降低的HRV存在显著的剂量反应关系，PM_(10)和FRS对HRV存在交互作用，未发现PM_(2.5)与HRV有显著的剂量反应关系。尿中OH-PAHs和FRS均可独立地引起HRV的改变，而且，OH-PAHs和FRS对HRV的降低有联合作用。
[Abstract]:Objective: to analyze the relationship between inhalable particulate matter (PM_ (10)) and fine particulate matter (PM_ (2.5)) and heart rate variability (HRV) in fixed groups, as well as the interaction of particulate matter and Framingham risk score (FRS) on HRV. In the community residents of large samples, the effects of hydroxyl polycyclic aromatic hydrocarbons (OH-PAHs) on HRV and the relationship between FRS and HRV were studied in the community residents of large samples. To further explore the possible joint effects of OH-PAHs and FRS on HRV.
Methods: 82 Zhuhai and 70 Wuhan community residents were selected as subjects in the study. The concentration of particulate matter and HRV were monitored by the individual sampler of PM_ (10) and PM_ (2.5) and the dynamic electrocardiograph (Holter). The calculation of FRS was based on age, sex, low density lipoprotein or total cholesterol, high density lipoprotein. Seven cardiovascular risk factors of blood pressure, smoking and diabetes. A total of 1978 community residents in two communities in Wuhan were selected from two communities in Wuhan. The community residents who lived for more than 5 years were used as the research subjects. The short-term HRV was measured by Holter, and the level of urine in urine was detected by the meteorological chromatography-mass spectrometry.
Results: with the increase of PM_ (10), the TP (P_ (trend) =0.005) and LF (P_ (trend) =0.041) of Wuhan residents decreased significantly. PM_ (10) and FRS were interacted with TP and trend, but no similar results were found among residents in Zhuhai. Residents exposed to high level PM_ (10) were significantly lower than those exposed to low level PM_ (10) (P=0.023 and P=0.004), while the difference in HRV was not found in the high FRS group. The study in the total population was similar to that in Wuhan. In large sample community residents, four types of OH-PAHs and urinary polyhydroxy polycyclic aromatic hydrocarbons (sigma OH-PAHs) in urine were found in the large sample community. The correlation between 0.41-0.84. and LF decreased significantly (P_ (trend) =0.008) with the increase of sigma OH-PAHs. The negative dose-response relationship between naphthalene metabolite (sigma OHNa) and SDNN (P_ (trend) =0.013). The increased fluorene metabolites (sigma OHFlu) were both significantly dose-dependent. 1 and P_ (trend) =0.005). At the same time, with the increase of FRS, each index of HRV is significantly reduced (P_ (trend) 0.001), and the sigma OHNa and the sigma OHFlu are respectively combined with FRS for SDNN.
Conclusion: there is a significant dose response relationship between the increased PM_ (10) and the reduced HRV. PM_ (10) and FRS have interaction with HRV. There is no significant dose response relationship between PM_ (2.5) and HRV. Both OH-PAHs and FRS in urine can independently cause the change of HRV. Moreover, OH-PAHs and FRS have a joint effect on the reduction of HRV.

【学位授予单位】：华中科技大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R114

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