2025 年第 8 期 第 20 卷

空气污染物暴露对脑卒中发病的影响

Effect of air pollution exposure on the incidence of stroke

作者：陈超1盖思齐2王皓3曹若瑾1

英文作者：Chen Chao1 Ge Siqi2 Wang Hao3 Cao Ruojin1

单位：1首都医科大学宣武医院全科医学科，北京100053；2首都医科大学附属北京天坛医院北京市神经外科研究所流行病室，北京100071；3首都医科大学附属北京友谊医院北京市临床医学研究所临床流行病学与循证医学研究室，北京100050

英文单位：1Department of General Medicine Xuanwu Hospital Capital Medical University Beijing 100053 China; 2Department of Epidemiology Beijing Tiantan Hospital Capital Medical University Beijing Institute of Neurosurgery Beijing 100071 China; 3Department of Clinical Epidemiology and Evidence-based Medicine Beijing Friendship Hospital Capital Medical University Beijing Institute of Clinical Medicine Beijing 100050 China

关键词：脑卒中；空气污染物；PM2.5；PM10；时间序列分析

英文关键词：

• 摘要：

• 目的 探讨空气污染物暴露对脑卒中发病的影响。方法 本研究以北京市城乡居民为研究人群，使用2023年1月1日至2024年12月31日来自北京4个社区监测点的时间序列数据进行分析。收集日常空气污染物浓度（PM2.5、PM10、二氧化硫、一氧化碳、臭氧、二氧化氮）和气象数据。采用时间分层病例交叉设计和类泊松回归模型，评估空气污染物对脑卒中事件的影响。结果  在研究期间，共登记了1 100例脑卒中患者。PM2.5和PM10的浓度在不同监测点和不同日期之间存在显著变化。分析结果表明，PM2.5和PM10的暴露显著增加了脑卒中事件的风险，其中PM2.5的影响高峰出现在滞后期3～5 d，PM10的影响高峰出现在滞后期4～7 d。PM2.5浓度每增加10 μg/m3，脑卒中发生的相对危险度为1.022（95%置信区间：1.008～1.039），滞后期为0～7 d；PM10浓度每增加10 μg/m3，脑卒中发生的相对危险度为1.027（95%置信区间：1.008～1.055），滞后期为0～12 d。结论  本研究结果表明环境污染物特别是PM2.5和PM10与脑卒中事件存在显著关联。这些发现提示了空气质量管理在降低脑卒中风险中的重要性。

• Objective To explore the effect of air pollution exposure on the incidence of stroke. Methods From January 1, 2023 to December 31, 2024, time series data from four community surveillance points in Beijing were used for analysis, with urban and rural residents of Beijing as the research population. Daily air pollutant concentrations (PM2.5, PM10, sulfur dioxide, carbon monoxide, ozone, nitrogen dioxide) and meteorological data were collected. A time-stratified case-crossover design and a Poisson-like regression model were used to estimate the association between air pollutants and stroke events. Results A total of 1 100 stroke patients were registered during the study period. Concentrations of PM2.5 and PM10 varied significantly between monitoring sites and between days. The results  showed that the exposure to PM2.5 and PM10 significantly increased the risk of stroke events. The peak effect of PM2.5 appeared in the lag period of 3-5 d, and the peak effect of PM10 appeared in the lag period of 4-7 d. For every 10 μg/m3 increase in PM2.5 concentration, the relative risk of stroke was 1.022 (95% confidence interval: 1.008-1.039), and the lag period was 0-7 d. For every 10 μg/m3 increase in PM10 concentration, the relative risk of stroke was 1.027 (95% confidence interval: 1.008-1.055), and the lag period was 0-12 d. Conclusion The results  of this study showed that environmental pollutants, especially PM2.5 and PM10, were significantly associated with stroke events. These findings suggest the importance of air quality management in reducing the risk of stroke.