过敏性鼻炎与花粉、空气污染物的关联性研究

Allergic rhinitis (AR) is a prevalent disease with high morbidity and a significant societal and economic burden. Over the last 20 years, the incidence of AR has grown on a global level. However, there has to date been no comprehensive study focusing on the relationship between the incidence of AR and related environmental risk factors. A three-year medical record of daily medical consultations for AR of residents from various socio-economic levels in Beijing and a corresponding envrionmental data platform will be established based on AR surveillance, out-patient investigation, laboratory bioassay and environmental monitoring. Furthermore, methods such as combined time-serise statistical analysis (GAM-Generalized Additive Models,et al) with non-time-serise statistical analysis (SVM-Support Vector Model, et al.) will be used to investigate the epidemiological characteristics of AR, reveal the relationship between AR prevalence and the level of environmental risk factors, and idenfy the contribution rate of air pollutants, pollen and meteorological parameters on AR, as well as to develop an air pollutants/pollen health risk warning system. The present study focuses on the environment and health problem in megacities, such as Beijing, which suffer from severe air pollution as well as a large population. The work will involve a long period of survellance and investigation in the context of global environmental change. The project is expected to make a theoretical breakthrough in understanding the environmental epidemiological characteristics of AR in Beijing and revealing the combined effects of chemical factors (air pollutants), biological factors (pollen) and physical factors (weather parameters) on AR. This, in turn, will help improve the capacity for responding to disease risks associated with climate change and urbanization.

近20多年来，过敏性鼻炎（AR）的发病率呈全球性增长趋势，但迄今尚无相关环境致病因素的综合研究。本项目以北京为研究区，通过AR疾病监测与患者调查、室内外测定和环境监测等途径，建立3年完整的AR逐日门诊病历及相应的环境数据平台。在此基础上，采用时间序列和非时间序列分析联用的方法，综合研究AR的流行病学特征；结合患者的时间?活动模式，揭示AR与环境风险因素的关联性，解析空气污染物、花粉、气象要素对AR的影响及其贡献率；建立空气污染物/花粉暴露-AR风险预警模型。这是在全球环境变化背景下，针对超大城市北京人口众多、空气污染严重的特点，开展的长周期监测与研究，可望全面揭示北京AR的流行病学规律和化学因素（空气污染物）、生物因素（花粉）、物理因素（气象要素）等对AR的复合影响，不但可取得理论性成果，还可为应对与气候变化、城市化相关疾病风险和促进改善城市空气质量提供策略建议。

过敏性鼻炎的发病率呈全球性增长趋势，空气中花粉、粉尘、气候的多变等因素都能诱发过敏性鼻炎。本项目以北京为研究区，通过AR疾病监测与患者调查、室内外测定和环境监测等途径，分析了AR患者的流行病学特征，探讨了空气污染物、气象因子和花粉对过敏性鼻炎发病的影响及各要素对过敏性鼻炎发病影响的贡献情况，并预测了未来空气污染物、花粉和气象因子发生变化后的过敏性鼻炎发病风险，取得的主要成果有：.北京市空气中PM10、SO2、NO2浓度水平对居民过敏性鼻炎门诊就诊人次均有影响，其中以NO2的影响最为显著，PM10和SO2的影响次之。男性和女性对SO2变化的RR值相近，而女性对NO2和PM10远较男性敏感。此外，空气中SO2和NO2浓度的变化，对年龄为20-60岁的人群影响较为明显。与PM10和SO2相比，NO2对总人群、男性、女性及不同年龄人群的影响较强。. 花粉浓度变化时，过敏性鼻炎患者中，女性要较男性敏感，青年人要较老年人敏感。在模型中加入PM10或NO2后，花粉的RR值有不同程度的增加，但加入SO2后花粉对过敏性鼻炎就诊人次的RR值没有明显的变化。.温度对过敏性鼻炎的影响呈现非线性关系，且当日均温度范围在20-30℃时，过敏性鼻炎相对危险度在滞后天数lag为0-2时有最大值。高温对过敏性鼻炎的影响具有即时性和短期滞后性，而低温对过敏性鼻炎的影响具滞后性，且低温对过敏性鼻炎的滞后性大于高温。湿度对过敏性鼻炎的影响呈现非线性关系，且当日相对湿度范围在60%-70%时且滞后天数lag为1-3时，过敏性鼻炎相对危险度达到最大值。高湿度和低湿度对过敏性鼻炎都有即时性和滞后性，但是低湿度对过敏性鼻炎滞后性大于高湿度。