暖季夜间高温对淄博市居民心血管疾病死亡的影响

doi:10.6040/j.issn.1671-7554.0.2025.0238

摘要/Abstract

摘要： 目的分析暖季夜间高温对淄博市居民心血管疾病死亡的影响,探讨心血管疾病患者中对夜间高温易感的人群。方法收集淄博市2015年1月1日至2019年12月31日每日心血管疾病死亡资料、每日气象和空气污染资料;计算热夜过量(hot night excess, HNE),即夜间每小时高于热夜阈值的过量温度累加之和,以评估夜间高温强度;采用分布滞后非线性模型探究夜间高温对心血管疾病死亡的影响及滞后效应,并根据年龄、性别进行亚组分析。结果研究期间暖季(5~9月)淄博市因心血管疾病死亡28 097人。暴露-反应关系曲线显示HNE与心血管疾病死亡相关,且存在滞后性。极端HNE与心血管疾病死亡的单日滞后效应在暴露当天最大,RR值为1.09(95%CI: 1.03~1.15);累积滞后效应在第7天最大,RR值为1.40(95%CI: 1.27~1.54)。HNE对缺血性心脏病和心肌梗死的死亡效应较高,导致女性和≥65岁人群死亡的归因风险较大。结论夜间高温会增加淄博市居民心血管疾病死亡风险,缺血性心脏病患者、女性和≥65岁人群对夜间极端高温较敏感。应在高温预警系统中考虑夜间高温,关注脆弱人群,根据夜间高温的危害制定有针对性的干预保护措施。

关键词: 夜间高温, 心血管疾病, 死亡风险, 分布滞后非线性模型

Abstract: Objective To investigate the impact of nighttime heat on cardiovascular disease mortality during warm seasons in Zibo City, and to identify patients with cardiovascular disease who are sensitive to nighttime heat. Methods The daily cardiovascular disease death data, meteorological and air pollution data in Zibo City were collected from December 31 2015 to January 1 2019. The intensity of nighttime heat was assessed using the hot night excess(HNE)index, which was calculated by determining the excess sum of high temperatures during the night. The distributed lag nonlinear model was used to analyse the impact and lag effects of nighttime heat on cardiovascular disease mortality. Subgroup analyses were performed by age and gender. Results During the study period, there were 28,079 deaths due to cardiovascular disease in warm seasons(May to September). The exposure-response relationship curve showed that HNE was associated with cardiovascular disease mortality, with a lag effect. The relative risk of extreme HNE peaked at days 0 after exposure, with RR of 1.09(95%CI: 1.03-1.15); the cumulative effect peaked at the 7th day, with RR of 1.40(95%CI: 1.27-1.54). Mortality risk was higher for ischemic heart disease and myocardial infarction than for cardiovascular disease and cerebrovascular disease. Furthermore, females and the elderly(aged ≥65 years)had a higher attributable risk. Conclusions Nighttime heat was associated with an increased risk of mortality from cardiovascular disease. Patients with ischemic heart disease, females and people aged ≥65 years were more susceptible to extreme nighttime heat. It is necessary to consider nighttime heat in heatwave warning systems and to focus on vulnerable populations. Targeted public intervention strategies should be implemented based on the hazards of nighttime heat.

Key words: Nighttime heat, Cardiovascular disease, Mortality risk, Distributed lag nonlinear model

中图分类号:

R122

岳芳,乔颖异,石兴龙,徐欣颖,吕婧,程传龙,左慧,崔峰,李秀君. 暖季夜间高温对淄博市居民心血管疾病死亡的影响[J]. 山东大学学报 (医学版), 2025, 63(9): 116-124.

YUE Fang, QIAO Yingyi, SHI Xinglong, XU Xinying, LYU Jing, CHENG Chuanlong, ZUO Hui, CUI Feng, LI Xiujun. Effect of nighttime heat on mortality risk of cardiovascular disease during warm seasons in Zibo City[J]. Journal of Shandong University (Health Sciences), 2025, 63(9): 116-124.

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