Abstract: Objective　To explore the correlation between air pollutants and cerebral hemorrhage occurrence in Dalian.Methods　The data of 1 688 patients with initial cerebral hemorrhage were collected retrospectively from First Affiliated Hospital of Dalian Medical University，Second Affiliated Hospital of Dalian Medical University and Affiliated Zhongshan Hospital of Dalian University from 2014 to 2015.The information of air pollutants （PM2.5，PM10，NO2，SO2，O3） during the same period were collected from Dalian Environmental Protection Agency.A single retrospective crossover study was designed with a 1 to 1 matched case.Multivariate Logistic regression analysis was used to evaluate associations between air pollutants and cerebral hemorrhage.The hysteresis effect of PM2.5 and PM10 concentration on the 0-3 day before onset of cerebral hemorrhage was analyzed.The optimal hysteresis period was determined according to the OR value.Results　The result of multivariate Logistic regression analysis showed that the concentrations of PM2.5，PM10 and NO2 were correlated with the incidence of cerebral hemorrhage〔OR=1.022，95%CI（1.003，1.040），P=0.022；OR=1.014，95%CI（1.000，1.028），P=0.045；OR=1.006，95%CI（1.001，1.110），P=0.018〕.The result of hysteresis effect analysis showed that the incidence of cerebral hemorrhage was related to the concentration of PM2.5 on the day of onset and 1 day before onset〔OR=1.031，95%CI（1.008，1.054），P=0.007；OR=1.027，95%CI（1.004，1.050），P=0.023〕，and the maximum OR was on the day of onset.The incidence of cerebral hemorrhage was related to the concentration of PM10 on the day of onset〔OR=1.019，95%CI（1.003，1.036），P=0.020〕.Conclusion　The daily number incidence of cerebral hemorrhage is positively correlated to the concentration of PM10，PM2.5，and NO2.The particulate matter concentrations on the day of onset are significantly associated with the cerebral hemorrhage.

Key words: Cerebral hemorrhage, Air pollutants, Dalian

摘要：
目的　探讨大连市空气污染物对脑出血发病的影响。方法　回顾性收集2014—2015年大连医科大学附属第一医院、大连医科大学附属第二医院、大连大学附属中山医院收治的首发脑出血患者1 688例，收集大连市同期空气污染物数据（包括PM2.5、PM10、NO2、SO2、O3），相关数据来源于大连市环境保护局。采用单项回顾性1∶1配对病例交叉研究设计，多因素Logistic回归分析各空气污染物对脑出血发病的影响；分析发病前0~3 d颗粒物（PM2.5、PM10）浓度对脑出血发病影响存在的滞后效应，根据所得OR值确定最佳滞后期。结果　多因素Logistic回归分析结果显示，PM2.5、PM10、NO2浓度与脑出血发病相关〔OR=1.022，95%CI（1.003，1.040），P=0.022；OR=1.014，95%CI（1.000，1.028），P=0.045；OR=1.006，95%CI（1.001，1.110），P=0.018〕。滞后效应分析显示，发病当天及发病前1 d PM2.5浓度与脑出血发病相关〔OR=1.031，95%CI（1.008，1.054），P=0.007；OR=1.027，95%CI（1.004，1.050），P=0.023〕，发病当天OR值最大；发病当天PM10浓度与脑出血发病相关〔OR=1.019，95%CI（1.003，1.036），P=0.020〕。结论　大连市PM2.5、PM10、NO2浓度与脑出血发病相关；发病当天颗粒物（PM2.5、PM10）浓度与脑出血发病显著相关。
脑出血；空气污染物；大连
10.12114/j.issn.1007-9572.2018.00.247