中华皮肤科杂志 ›› 2017, Vol. 50 ›› Issue (8): 575-578.

• 论著 • 上一篇    下一篇

兰州市日均气温对两所三甲医院门诊湿疹人次的影响

武奕1,石春蕊2,董继元3,潘亚娟4,骆志成5,郗群6,王亚婷1   

  1. 1. 兰州大学
    2. 甘肃省兰州市兰州大学第一医院皮肤科
    3. 甘肃省兰州市兰州大学公共卫生学院
    4. 甘肃省兰州市兰州大学第一医院计算机中心
    5. 兰州大学第二临床医学院
    6. 兰州大学信息中心
  • 收稿日期:2016-10-20 修回日期:2017-05-24 出版日期:2017-08-15 发布日期:2017-08-01
  • 通讯作者: 石春蕊 E-mail:m18394140657@163.com

Effects of daily average temperature on the daily number of outpatient visits for eczema in two third-grade class-A hospitals in Lanzhou city

  • Received:2016-10-20 Revised:2017-05-24 Online:2017-08-15 Published:2017-08-01

摘要: 目的 探讨兰州市日均气温对门诊湿疹人次的影响。方法 收集2007年1月1日至2015年12月31日兰州地区两所三甲医院皮肤科门诊湿疹患者的资料和同时期气象数据,在控制长期趋势、星期几效应的基础上,采用分布滞后非线性模型,通过quasi-Poisson连接函数进行拟合,并根据季节、性别和年龄分层后分析日均气温对湿疹门诊人次的影响。结果 日均气温与湿疹门诊人次的暴露-反应关系大致呈“W”型。按照季节、性别、年龄分层后,日均气温改变对湿疹门诊人次的影响主要以秋、冬季为重,夏季次之,春季最弱。低温对湿疹的影响可能存在滞后作用、累积作用及持续作用,即在-9 ℃、滞后14 d时,RR值为1.12(95% CI:1.03~1.22),达到最大,且温度每降低1 ℃,男性、青少年、中年人群湿疹发病的风险分别增加16%(RR:1.16,95% CI:1.05~1.27)、14%(RR:1.14,95% CI:1.02~1.26)及13%(RR:1.13,95% CI:1.02~1.25),均有统计学意义(P <0.05);而在女性及老年人群中,低温对湿疹的影响均不具有统计学意义(P > 0.05)。高温的影响效应在暴露当天即已出现,随着滞后日的推移其影响效应渐减弱,但这种效应无统计学意义(P > 0.05)。结论 在兰州地区日均气温对湿疹门诊人次的影响以秋、冬季为重,日均气温的改变可能为湿疹患者的危险因素之一,且低温对湿疹的影响存在滞后作用,滞后时间约为14 d。

Abstract: Wu Yi, Shi Chunrui, Dong Jiyuan, Pan Yajuan, Luo Zhicheng, Xi Qun, Wang Yating Department of Dermatology, The First Hospital of Lanzhou University, Lanzhou 730000, China (Wu Y, Shi CR, Wang YT); Information Center, The First Hospital of Lanzhou University, Lanzhou 730000, China (Pan YJ); Institute of Occupational and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, China (Dong JY); Department of Dermatology, Lanzhou University Second Hospital, Lanzhou 730030, China (Luo ZC); Information Center, Lanzhou University Second Hospital, Lanzhou 730030, China (Xi Q) Corresponding author: Shi Chunrui, Email: stone7207@126.com 【Abstract】 Objective To evaluate effects of the daily average temperature on the daily number of outpatient visits for eczema in Lanzhou city. Methods Clinical data were obtained from outpatients with eczema in the Department of Dermatology of 2 third-grade class-A hospitals in Lanzhou city from January 1st 2007 to December 31st 2015, and meteorological data during this period were also collected. Controlling for confounding factors like long-term trends and day of the week, a distributed lag non-linear model (DLNM) fitted with quasi-Poisson link function was used to assess the effects of daily average temperature on the daily number of outpatient visits for eczema, and the analysis was stratified by season, age and gender. Results The exposure-response relationship between the daily average temperature and daily number of outpatient visits for eczema could be roughly described by a "W-shaped" curve. Stratification analysis showed that the effect of the daily average temperature on outpatient visits for eczema was strongest in autumn and winter, followed by summer, and weakest in spring. Low temperature may have lagged, cumulative and persistent effects on the daily number of outpatient visits for eczema, with the maximum relative risk (RR) value (1.12 [95% CI: 1.03 - 1.22]) observed at -9 ℃ on lag day 14. With a 1 ℃ decrease in the temperature, 16% (RR = 1.16, 95% CI: 1.00 - 1.03), 14% (RR = 1.14, 95% CI: 1.02 - 1.26) and 13% (RR = 1.13, 95% CI: 1.02 - 1.25) increases in the daily number of outpatient visits for eczema were observed in men, teenagers and middle-aged adults respectively (P < 0.05). However, low temperature had no significant effects on outpatient visits for eczema among women or the elderly (P > 0.05). The effect of high temperature usually occurred following exposure without lag periods, and was gradually weakened over lag time (P > 0.05). Conclusions In Lanzhou, the effect of daily average temperature on outpatient visits for eczema was strongest in autumn and winter. Changes of the daily temperature may be one of risk factors for eczema. Low temperature had lagged effects on the daily number of outpatient visits for eczema, and the effects were strongest on lag day 14.