目的 探讨大气污染物与儿科呼吸系统常见疾病门急诊日均就诊人次数之间的关系.方法 选取2014—2016年新疆医科大学第一附属医院儿科门急诊收治的常见呼吸系统疾病患儿452357例,包括上呼吸道感染184757例、支气管炎162965例、肺炎91055例、哮喘13580例.统计采暖期与非采暖期门急诊日均就诊人次数与空气质量检测指标〔包括PM2.5、PM10、二氧化硫(SO2)、一氧化碳(CO)、二氧化氮(NO2)、臭氧(O3)〕的关系.结果 采暖期上呼吸道感染、哮喘日均就诊人次数均低于非采暖期,支气管炎、肺炎日均就诊人次数及总日均就诊人次数均高于非采暖期(P<0.001).采暖期PM2.5、PM10、SO2、CO、NO2浓度均高于非采暖期,O3浓度低于非采暖期(P<0.001).多元线性回归分析结果显示,PM2.5、SO2、CO、NO2是采暖期上呼吸道感染日均就诊人次数的影响因素(t=5.020、4.165、-4.693、-2.280,P<0.05);PM10、SO2、NO2、O3是采暖期支气管炎日均就诊人次数(t=5.013、4.485、-8.430、-16.125)、总日均就诊人次数(t=4.260、3.608、-5.921、-13.084)的影响因素(P<0.05);CO、O3是采暖期肺炎日均就诊人次数的影响因素(t=6.845、-13.988,P<0.05);SO2、CO、O3是采暖期哮喘日均就诊人次数的影响因素(t=-9.305、2.518、-3.643,P<0.05).PM10、SO2、CO、NO2、O3是非采暖期上呼吸道感染(t=7.085、2.941、-9.571、2.149、2.149)、肺炎日均就诊人次数(t=7.021、-4.831、-5.558、2.751、-14.798)的影响因素(P<0.05);PM2.5、PM10、O3是非采暖期支气管炎日均就诊人次数的影响因素(t=-1.964、6.748、-16.077,P<0.05);PM2.5、PM10、NO2、O3是非采暖期哮喘日均就诊人次数的影响因素(t=3.141、-7.705、3.649、4.828,P<0.05);PM10、CO、NO2、O3是非采暖期总日均就诊人次数的影响因素(t=9.491、-8.649、4.042、-10.321,P<0.05).结论 大气污染物在不同程度上与儿童呼吸系统常见疾病门急诊日均就诊人次数有关,可通过对大气污染物浓度监测及对环境污染控制来降低儿童呼吸系统疾病的就诊率.%Objective To discuss the correlation of air pollutant concentrations with the number of average daily hospital pediatric emergency outpatient visits due to common respiratory disease.Methods We selected 452 357 pediatric patients with common respiratory disease who received pediatric emergency outpatient care from the First Affiliated Hospital of Xinjiang Medical University between 2014 and 2016,including 184 757 with upper respiratory tract infection,162 965 with bronchitis,91 055 with pneumonia,and 13 580 with asthma.We calculated the number of daily hospital pediatric emergency outpatient visits and collected the data about air quality(including concentrations of PM2.5,PM10,SO2,CO,NO2,and O3).Results Compared with non-heating period,in heating period,the average number of daily pediatric outpatient visits for upper respiratory tract infection or asthma was less,but that for bronchitis and orpneumonia was more,and the total number of daily pediatric outpatient visits for common respiratory disease was more,the concentrations of PM2.5,PM10,SO2,CO,and NO2were all higher except those of O3were lower (P<0.001).Multiple linear regression analysis found that,during the heating period,the concentrations of PM2.5,SO2,CO and NO2affected the number of average daily pediatric emergency outpatient visits for upper respiratory tract infection (t=5.020,t=4.165,t=-4.693,t=-2.280,P<0.05),the concentrations of PM10,SO2,NO2,O3were associated factors for the number of average daily pediatric emergency outpatient visits for bronchitis (t=5.013,t=4.485,t=-8.430,t=-16.125,P<0.05) and the total number of daily pediatric outpatient visits due to common respiratory disease (t=4.260,t=3.608,t=-5.921,t=13.084,P<0.05),the concentrations of CO and O3were associated factors for the number of average daily pediatric emergency outpatient visits for pneumonia (t=6.845,t=-13.988,P<0.05), and the concentrations of SO2,CO and O3were associated factors for the number of average daily pediatric emergency outpatient visits for asthma (t=-9.305,t=2.518,t=-3.643,P<0.05);during the non-heating period,the concentrations of PM10, SO2,CO,NO2and O3affected the number of average daily pediatric emergency outpatient visits for upper respiratory tract infection (t=7.085,t=2.941,t=-9.571,t=2.149,t=2.149,P<0.05) and that for pneumonia (t=7.021,t=-4.831, t=-5.558,t=2.751,t=-14.798,P<0.05),PM2.5,PM10,and O3were associated factors for the number of average daily pediatric emergency outpatient visits for bronchitis (t=-1.964,t=6.748,t=-16.077,P<0.05),PM2.5,PM10,NO2 and O3were associated factors for the number of average daily pediatric emergency outpatient visits for asthma (t=3.141, t=-7.705,t=3.649,t=4.828,P<0.05)and PM10,CO,NO2and O3were associated factors for the total number of average daily pediatric emergency outpatient visits for common respiratory disease (t=9.491,t=-8.649,t=4.042,t=-10.321, P<0.05).Conclusion Air pollutant concentrations correlate with the number of average daily hospital pediatric emergency outpatient visits due to common respiratory disease to varying degrees.Therefore,the visits can be reduced by controlling the environmental pollution based on the monitoring results of air pollutant concentrations.
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