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JAMA Netw Open:美国污染严重城市之一的居民研究揭示,空气污染会增加房颤的卒中风险

2020-09-25 心关注 心关注

发表在国际期刊JAMA Network Open上的一项研究发现,过度暴露于≤2.5μm的细颗粒物可能会增加房颤患者的卒中风险。这些结果表明空气污染和卒中事件之间存在剂量依赖性关系。

空气污染,尤其是大气细颗粒物(PM2.5)污染一直是全球重大的环境和公共卫生问题。近日,发表在国际期刊JAMA Network Open上的一项研究发现,过度暴露于≤2.5μm的细颗粒物可能会增加房颤患者的卒中风险。这些结果表明空气污染和卒中事件之间存在剂量依赖性关系,并强调了空气污染对与房颤相关的血管结果的重要性。

在这项队列研究中,研究人员分析了来自匹兹堡地区医疗系统的31,414名房颤患者(平均年龄74岁,50%女性)的数据,并使用了位于宾夕法尼亚州西南部的阿勒格尼县空间饱和空气污染监测活动的数据,这是一个有着重工业活动历史的地区。宾夕法尼亚州的匹兹堡是该地区最大的城市,被美国肺脏协会的2019年空气状况报告列为美国10个污染最严重的城市之一。

研究人员对受试者的地址进行了地理编码,以确定居住水平上颗粒物暴露的年度估计值,同时收集居民的收入和教育水平数据。研究的主要自变量是各居民点每年平均暴露于≤2.5μm(PM2.5)的细颗粒物。主要结果是缺血性卒中住院治疗,卒中的日期被认为是最初的住院日期。事件发生的时间被定义为观察的开始,或在电子健康记录中最早发现房颤,到研究期间的第一次卒中事件。随访时间中位数为3.5年。

研究期间,PM2.5的年平均暴露量为10.6μg/m3。在校正临床和人口统计学变量后,PM2.5每增加1个标准差与卒中风险增加相关(HR=1.08;95%CI 1.03-1.14)。在对教育水平和家庭收入进行全面多变量调整后也观察到了这一点(HR=1.07;95%CI 1-1.14)。与PM2.5暴露水平最低四分位数相比,最高四分位数的卒中风险增加(HR=1.36;95%CI 1.18-1.58)。在调整了临床协变量、教育水平和收入后,卒中的风险增加尽管有所减弱,但仍然存在(HR=1.21;95%CI 1.01-1.45)。

未来的研究需要解决个人和社区层面的因素,这些因素加剧了该研究所指出的关联性。研究结果促进了人们对空气污染在公共卫生方面代价的理解,并强调了继续倡导努力控制污染暴露的重要性。

原始出处:

Zachary J Rhinehart, Ellen Kinnee, Utibe R Essien, et al.Association of Fine Particulate Matter and Risk of Stroke in Patients With Atrial Fibrillation.JAMA Netw Open. 2020 Sep 1;3(9):e2011760. doi: 10.1001/jamanetworkopen.2020.11760.

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    2021-05-22 canlab
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    2021-02-12 feather89
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    2020-09-30 咻凡

    研究结果促进了人们对空气污染在公共卫生方面代价的理解,并强调了继续倡导努力控制污染暴露的重要性。

    0

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1734259, encodeId=19c21e34259f8, content=<a href='/topic/show?id=d4f412668a4' target=_blank style='color:#2F92EE;'>#NET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12668, encryptionId=d4f412668a4, topicName=NET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7ea033781210, createdName=canlab, createdTime=Sat May 22 16:38:08 CST 2021, time=2021-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728667, encodeId=ced81e2866733, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Fri Feb 12 20:38:08 CST 2021, time=2021-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=889462, encodeId=2eb98894621c, content=研究结果促进了人们对空气污染在公共卫生方面代价的理解,并强调了继续倡导努力控制污染暴露的重要性。, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Wed Sep 30 17:04:15 CST 2020, time=2020-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281347, encodeId=0608128134e40, content=<a href='/topic/show?id=455f36085f0' target=_blank style='color:#2F92EE;'>#卒中风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36085, encryptionId=455f36085f0, topicName=卒中风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f1167, createdName=wmr111, createdTime=Sun Sep 27 05:38:08 CST 2020, time=2020-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1472702, encodeId=64b514e270229, content=<a href='/topic/show?id=ba4a6436107' target=_blank style='color:#2F92EE;'>#污染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64361, encryptionId=ba4a6436107, topicName=污染)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dfe67217539, createdName=小刀医生, createdTime=Sun Sep 27 05:38:08 CST 2020, time=2020-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026695, encodeId=79f71026695b2, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Fri Sep 25 17:38:08 CST 2020, time=2020-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031307, encodeId=4e57103130e2a, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Fri Sep 25 17:38:08 CST 2020, time=2020-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036286, encodeId=e2cd10362866d, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Fri Sep 25 17:38:08 CST 2020, time=2020-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045980, encodeId=271b1045980a7, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Fri Sep 25 17:38:08 CST 2020, time=2020-09-25, status=1, ipAttribution=)]
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    2020-09-25 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

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    2020-09-25 心介

    房颤,临床上碰到很多哦

    0

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    2020-09-25 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1734259, encodeId=19c21e34259f8, content=<a href='/topic/show?id=d4f412668a4' target=_blank style='color:#2F92EE;'>#NET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12668, encryptionId=d4f412668a4, topicName=NET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7ea033781210, createdName=canlab, createdTime=Sat May 22 16:38:08 CST 2021, time=2021-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728667, encodeId=ced81e2866733, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Fri Feb 12 20:38:08 CST 2021, time=2021-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=889462, encodeId=2eb98894621c, content=研究结果促进了人们对空气污染在公共卫生方面代价的理解,并强调了继续倡导努力控制污染暴露的重要性。, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Wed Sep 30 17:04:15 CST 2020, time=2020-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281347, encodeId=0608128134e40, content=<a href='/topic/show?id=455f36085f0' target=_blank style='color:#2F92EE;'>#卒中风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36085, encryptionId=455f36085f0, topicName=卒中风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f1167, createdName=wmr111, createdTime=Sun Sep 27 05:38:08 CST 2020, time=2020-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1472702, encodeId=64b514e270229, content=<a href='/topic/show?id=ba4a6436107' target=_blank style='color:#2F92EE;'>#污染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64361, encryptionId=ba4a6436107, topicName=污染)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dfe67217539, createdName=小刀医生, createdTime=Sun Sep 27 05:38:08 CST 2020, time=2020-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026695, encodeId=79f71026695b2, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Fri Sep 25 17:38:08 CST 2020, time=2020-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031307, encodeId=4e57103130e2a, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Fri Sep 25 17:38:08 CST 2020, time=2020-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036286, encodeId=e2cd10362866d, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Fri Sep 25 17:38:08 CST 2020, time=2020-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045980, encodeId=271b1045980a7, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Fri Sep 25 17:38:08 CST 2020, time=2020-09-25, status=1, ipAttribution=)]
    2020-09-25 guging

    中风是俗称,应该称为缺血性卒中吧

    0

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