JACC:我国15万例心梗死亡数据显示:PM2.5,不仅伤肺,更加“伤心”!

2021-03-06 MedSci原创 MedSci原创

短期暴露于PM2.5、PM10和NO2也与心肌梗死死亡风险增加有关。

空气质量指数(AQI)是定量描述空气质量状况的非线性无量纲指数。其数值越大、等级和类别越高,代表空气污染状况越严重,对人体的健康危害也就越大。悬浮颗粒或称颗粒物(PM)、大气颗粒物、颗粒,泛指悬浮在空气中的固体颗粒或液滴,颗粒微小甚至肉眼难以辨识但仍有尺度的差异。

其中,空气动力学直径≤10µm的颗粒物称为颗粒物(PM10);直径≤2.5µm的颗粒物称为细颗粒物(PM2.5),例如室内的二手烟雾。颗粒物能够在大气中停留很长时间,并可随呼吸进入体内,积聚在气管或肺中,影响身体健康。PM2.5细小颗粒 ,比病毒大,比细菌小,容易带有毒物质进入人体。

与PM10相比,PM2.5 表面积更大,更易吸附有毒害的物质。同时,由于体积更小,PM2.5具有更强的穿透力,可能抵达细支气管壁,并干扰肺内的气体交换。更小的微粒(直径小于等于100纳米)会通过肺部传递影响其他器官。

此前,发表在JAMA上的研究证实,PM2.5会导致动脉斑块沉积,引发血管炎症和动脉粥样硬化,最终导致心脏病或其他心血管问题。同时,PM2.5浓度每增加10 μg/m3,总的死亡风险会上升4%,心肺疾病带来的死亡风险上升6%,肺癌带来的死亡风险上升8%。

最近,由我国中山大学公共卫生学院刘跃伟副教授和湖北省疾病预防控制中心的研究人员领衔的研究团队,分析了湖北省15万例心梗死亡病例的数据发现,即使是短期空气污染暴露,心梗死亡风险也显著增加。相关结果发表在最新的《美国心脏病学会杂志》(JACC)上。

本研究旨在评估环境空气污染是否与心肌梗塞的发生有关,试图调查短期暴露于大范围浓度的空气污染与MI死亡率的关系。

这是一项时间分层的病例交叉研究,调查了2013年至2018年湖北省151608例MI死亡病例。根据每个病例的家庭地址,以相邻空气质量监测站的距离加权平均浓度倒数来评估病例和对照日的PM2.5、PM10、二氧化硫、二氧化氮(NO2)、一氧化碳和臭氧的暴露情况。

结果显示,暴露于PM2.5、PM10和NO2(死亡当天和前一天的平均暴露量)与MI死亡率的几率增加显著相关。在PM2.5、PM10水平分别为33.3μg/m³和57.3μg/m³时,心梗死亡风险就飙升到了最高水平,此后即稳定在最高水平。

NO2暴露的关联几乎是线性的,即即心梗死亡风险随二氧化氮暴露水平升高而增加。PM2.5(<33.3μg/m3)、PM10(<57.3μg/m3)和NO2暴露量每增加10μg/m3,分别与MI死亡几率增加4.14%、2.67%和1.46%显著相关。其中,老年人NO2暴露与MI死亡率之间的关联性最强。

综上,短期暴露于PM2.5、PM10和NO2也与心肌梗死死亡风险增加有关。结合WHO在2020年发布的数据,世界上92%以上的人生活在PM2.5超标的地区,我们或许真的该注意空气污染了——毕竟,能拯救我们于雾霾当中的出路目前还没有找到。

 

参考文献:

Liu Y, et al. Short-Term Exposure to Ambient Air Pollution and Mortality From Myocardial Infarction. J Am Coll Cardiol. 2021 Jan 26;77(3):271-281. doi: 10.1016/j.jacc.2020.11.033.

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    2021-04-20 hbwxf
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    2021-03-07 水-晶

    这个问题就大了啊

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1854887, encodeId=7232185488ed2, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Tue Apr 20 20:03:42 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265026, encodeId=e8091265026e0, content=<a href='/topic/show?id=9574144034a' target=_blank style='color:#2F92EE;'>#PM2.5#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14403, encryptionId=9574144034a, topicName=PM2.5)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=87f580, createdName=yilong5287542, createdTime=Mon Mar 08 14:03:42 CST 2021, time=2021-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326742, encodeId=16c61326e4249, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Mon Mar 08 14:03:42 CST 2021, time=2021-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946263, encodeId=c20594626375, content=这个问题就大了啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200627/83a502bff6c14b759a7d0863b4068e7b/32ad40676056418ea58a94afac9c5b81.jpg, createdBy=6f475314305, createdName=水-晶, createdTime=Sun Mar 07 23:14:12 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946078, encodeId=c3ac9460e8fd, content=六六六, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210307/dc29e7f8445e4fc991dc7bc0d74d7ed2/ca8090de5e314b639d0eba1f16028915.jpg, createdBy=38865466360, createdName=ms8000001203770520, createdTime=Sun Mar 07 02:32:39 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946072, encodeId=86a69460e230, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210307/7d39eba577fb409cac9bfe88a80909e4/6e42f5d269724a69847660ed76c6e5d4.jpg, createdBy=d8145463440, createdName=ms6000000853475783, createdTime=Sun Mar 07 01:36:35 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946067, encodeId=3ade94606e39, content=继续来学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200627/83a502bff6c14b759a7d0863b4068e7b/32ad40676056418ea58a94afac9c5b81.jpg, createdBy=6f475314305, createdName=水-晶, createdTime=Sat Mar 06 23:44:03 CST 2021, time=2021-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946066, encodeId=f86194606683, content=baohuhuanj, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=253f5447547, createdName=ms1000001573099445, createdTime=Sat Mar 06 23:40:37 CST 2021, time=2021-03-06, status=1, ipAttribution=)]
    2021-03-07 ms8000001203770520

    六六六

    0

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    2021-03-07 ms6000000853475783

    不错

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1854887, encodeId=7232185488ed2, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Tue Apr 20 20:03:42 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265026, encodeId=e8091265026e0, content=<a href='/topic/show?id=9574144034a' target=_blank style='color:#2F92EE;'>#PM2.5#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14403, encryptionId=9574144034a, topicName=PM2.5)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=87f580, createdName=yilong5287542, createdTime=Mon Mar 08 14:03:42 CST 2021, time=2021-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326742, encodeId=16c61326e4249, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Mon Mar 08 14:03:42 CST 2021, time=2021-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946263, encodeId=c20594626375, content=这个问题就大了啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200627/83a502bff6c14b759a7d0863b4068e7b/32ad40676056418ea58a94afac9c5b81.jpg, createdBy=6f475314305, createdName=水-晶, createdTime=Sun Mar 07 23:14:12 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946078, encodeId=c3ac9460e8fd, content=六六六, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210307/dc29e7f8445e4fc991dc7bc0d74d7ed2/ca8090de5e314b639d0eba1f16028915.jpg, createdBy=38865466360, createdName=ms8000001203770520, createdTime=Sun Mar 07 02:32:39 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946072, encodeId=86a69460e230, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210307/7d39eba577fb409cac9bfe88a80909e4/6e42f5d269724a69847660ed76c6e5d4.jpg, createdBy=d8145463440, createdName=ms6000000853475783, createdTime=Sun Mar 07 01:36:35 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946067, encodeId=3ade94606e39, content=继续来学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200627/83a502bff6c14b759a7d0863b4068e7b/32ad40676056418ea58a94afac9c5b81.jpg, createdBy=6f475314305, createdName=水-晶, createdTime=Sat Mar 06 23:44:03 CST 2021, time=2021-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946066, encodeId=f86194606683, content=baohuhuanj, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=253f5447547, createdName=ms1000001573099445, createdTime=Sat Mar 06 23:40:37 CST 2021, time=2021-03-06, status=1, ipAttribution=)]
    2021-03-06 水-晶

    继续来学习了

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1854887, encodeId=7232185488ed2, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Tue Apr 20 20:03:42 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265026, encodeId=e8091265026e0, content=<a href='/topic/show?id=9574144034a' target=_blank style='color:#2F92EE;'>#PM2.5#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14403, encryptionId=9574144034a, topicName=PM2.5)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=87f580, createdName=yilong5287542, createdTime=Mon Mar 08 14:03:42 CST 2021, time=2021-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326742, encodeId=16c61326e4249, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Mon Mar 08 14:03:42 CST 2021, time=2021-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946263, encodeId=c20594626375, content=这个问题就大了啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200627/83a502bff6c14b759a7d0863b4068e7b/32ad40676056418ea58a94afac9c5b81.jpg, createdBy=6f475314305, createdName=水-晶, createdTime=Sun Mar 07 23:14:12 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946078, encodeId=c3ac9460e8fd, content=六六六, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210307/dc29e7f8445e4fc991dc7bc0d74d7ed2/ca8090de5e314b639d0eba1f16028915.jpg, createdBy=38865466360, createdName=ms8000001203770520, createdTime=Sun Mar 07 02:32:39 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946072, encodeId=86a69460e230, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210307/7d39eba577fb409cac9bfe88a80909e4/6e42f5d269724a69847660ed76c6e5d4.jpg, createdBy=d8145463440, createdName=ms6000000853475783, createdTime=Sun Mar 07 01:36:35 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946067, encodeId=3ade94606e39, content=继续来学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200627/83a502bff6c14b759a7d0863b4068e7b/32ad40676056418ea58a94afac9c5b81.jpg, createdBy=6f475314305, createdName=水-晶, createdTime=Sat Mar 06 23:44:03 CST 2021, time=2021-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946066, encodeId=f86194606683, content=baohuhuanj, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=253f5447547, createdName=ms1000001573099445, createdTime=Sat Mar 06 23:40:37 CST 2021, time=2021-03-06, status=1, ipAttribution=)]
    2021-03-06 ms1000001573099445

    baohuhuanj

    0