分布滞后非线性模型在气象因素对手足口病发病影响研究中的应用

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目的探讨气象因素对北京市海淀区手足口病发病情况的影响。方法收集2008—2014年北京市海淀区手足口病发病例数及同期气象因素(日均气温、相对湿度等),用分布滞后非线性模型分析气象因素与手足口周发病数的关系及其滞后效应。结果 2008—2014年北京市海淀区手足口病共报告33 704例,年均发病率为143.8/10万,其中男女发病例数比为1.6∶1。海淀区手足口病发病与低温呈负相关,且其作用时间较长,低温(P5)的累积效应在滞后7周达到最高,累积相对危险度(RR)为0.05(95%CI:0.02~0.09);手足口病发病与高温(P95)呈正相关,但其影响时间局限于4周内,累积RR值最高可达1.69(95%CI:1.17~2.43)。手足口病发病与周合计日照时数呈非线性关系,日照时数较低、较高时发病危险均增加,累积RR值分别为5.55(95%CI:3.20~9.64)、1.55(95%CI:1.04~2.32)。周相对湿度较高时手足口病发病风险增加,但其效应无统计学意义(P>0.05)。结论气象因素可能是海淀区手足口病发病的重要影响因素,分布滞后非线性模型可用于分析手足口病与气候因素的关系。 Objective To investigate the influence of meteorological factors on the incidence of HFMD in Haidian District, Beijing. Methods The incidence of HFMD in Haidian District, Beijing during 2008-2014 was collected and the meteorological factors (daily average temperature, relative humidity, etc.) were collected. The relationship between the meteorological factors and the number of HFMD was analyzed with the non-linear distribution model and its lag effect. Results A total of 33 704 cases of hand-foot-mouth disease were reported in Haidian District, Beijing from 2008 to 2014, with an average annual incidence of 143.8 / 100 000, of which the ratio of male and female cases was 1.6: 1. The incidence of hand, foot and mouth disease in Haidian district was negatively correlated with low temperature, and its duration of action was longer. The cumulative effect of low temperature (P5) reached the highest at 7 weeks and the cumulative relative risk (RR) was 0.05 (95% CI: 0.02-0.09 ). The incidence of hand-foot-mouth disease was positively correlated with the high temperature (P95), but the influence time was limited to 4 weeks. The cumulative RR was up to 1.69 (95% CI: 1.17-2.43). The incidence of HFMD was non-linear with the number of sunshine hours per week. The sunshine hours were lower and the risk of morbidity increased when the HFMD was higher. The cumulative RRs were 5.55 (95% CI: 3.20-9.64), 1.55 (95% CI : 1.04 ~ 2.32). The relative risk of HFMD increased at the same time, but the effect was not statistically significant (P> 0.05). Conclusion The meteorological factors may be the important influencing factors of HFMD in Haidian District. The non-linear model of distribution delay can be used to analyze the relationship between HFMD and climatic factors.
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