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目的研究机动车尾气污染对中老年人心血管系统的影响,探讨可用于评价尾气污染效应的敏感指标。方法于2008年6和12月对居住在广州市靠近交通干道的某社区32位中老年人进行两阶段的panel研究(专门小组研究),测定与心血管系统有关的健康指标,包括动态心电图、肺功能、血细胞指标和炎症因子,同时监测体检前5d的社区区域监测点和社区内3个有代表性的老年人活动点的空气污染物日平均浓度,计算个体室外污染物时间加权暴露浓度,估计机动车尾气主要污染物对中老年人健康指标的影响。结果在单污染物模型中,肿瘤坏死因子-α(TNF-α)和PM10、SO2、NO2呈正相关关系,而用力肺活量(FVC)、白介素-6(IL-6)则呈负相关关系;心率变异性指标(HRV)中的SDNN(24h内每5minR-R间期均值的标准差,β:-0.57,SE:0.18),SDNN index(每5min窦性R-R间期标准差的均值,β:-0.74,SE:0.20)和PM10相关性较强,与NO2相关较大的指标是SDNNindex(β:-0.66,SE:0.17)。在多污染物模型中,调整了其他污染物的影响后,IL-6和PM10呈正相关,和NO2、SO2呈负相关;TNF-α和NO2、SO2呈正相关;而FVC则和PM10呈负相关。结论目标社区的空气污染物的超标状况符合机动车尾气型污染的特征,且污染水平较高;研究对象的TNF-α、IL-6、FVC、SDNN、SDNNindex与机动车尾气暴露密切相关,一定程度上反映了暴露效应,可作为机动车尾气污染对中老年人心血管系统影响研究的参考指标。
Objective To study the influence of vehicle exhaust pollution on the cardiovascular system of middle-aged and elderly people and to explore the sensitive indexes that can be used to evaluate the effect of exhaust pollution. Methods Two-phase panel study (panel study) was conducted in June and December 2008 on 32 elderly people living in a community close to the arterial road in Guangzhou to determine cardiovascular health-related indicators, including ambulatory electrocardiogram, Lung function, blood cell indexes and inflammatory factors. At the same time, the daily average concentrations of air pollutants in community-based monitoring sites at 5 days before physical examination and the activity points of 3 representative elderly in the community were monitored, and the time-weighted exposure concentration of outdoor pollutants was calculated. Estimating the impact of motor vehicle exhaust main pollutants on the health indicators of middle-aged and elderly people. Results There was a positive correlation between tumor necrosis factor-α (TNF-α) and PM10, SO2 and NO2, but negative correlation between FVC and IL-6 in single pollutant model. Heart rate SDNN in standard deviation (HRV) (standard deviation of R-R interval every 5 minutes in 24h, β: -0.57, SE: 0.18), SDNN index (mean value of standard deviation of sinus RR interval every 5min, β: -0.74, SE: 0.20) showed a strong correlation with PM10. The index associated with NO2 was SDNNindex (β: -0.66, SE: 0.17). In the multi-pollutant model, after adjusting for the effects of other pollutants, there was a positive correlation between IL-6 and PM10, negatively correlated with NO2 and SO2, TNF-α and NO2 and SO2 were positively correlated, while FVC was negatively correlated with PM10 . Conclusion The over-standard situation of air pollutants in the target community is in line with the characteristics of motor vehicle exhaust pollution, and the pollution level is high. The TNF-α, IL-6, FVC, SDNN and SDNNindex of the study subjects are closely related to vehicle exhaust exposure. To some extent, it reflects the effect of exposure and can be used as a reference index for studying the influence of vehicle exhaust on the cardiovascular system of middle-aged and elderly people.