【摘要】 目的 评估大气细颗粒物(PM_2.5)持续高浓度暴露对哈尔滨市第一医院人群呼吸系统疾病入院的急性影响，并探索PM2.5持续高浓度暴露与寒潮联合暴露对呼吸系统不良的健康影响。方法 收集2014-2016年哈尔滨市大气PM_2.5浓度、气象因素数据以及哈尔滨市第一医院人群呼吸系统疾病入院的住院病例资料。根据PM_2.5浓度水平（≥75μg/m³和≥150μg/m³）和暴露持续时间（≥2, 3或4 d）共定义4种持续高暴露情景(又称大气PM_2.5重污染事件)，采用时间序列设计，应用准泊松广义线性模型（GLM）和交互作用分析的统计策略，探究大气PM_2.5重污染事件及与寒潮联合暴露对人群呼吸系统疾病入院的急性影响。结果 2014-2016年间共有12 727例因呼吸系统疾病入院的患者，浓度水平≥75μg/m³且持续时间≥2 d的PM_2.5重度污染事件共发生59次。浓度水平≥75μg/m³且持续时间≥3 d的PM_2.5重污染事件会增加下呼吸道感染（RR=1.12,95%CI:1.01～1.25）和肺炎（RR=1.19,95%CI:1.06～1.33）的入院风险，其中≥65岁人群易感下呼吸道感染，0-64岁人群易感肺炎。大气PM_2.5重污染事件与寒潮联合暴露会增加总呼吸系统疾病、下呼吸道感染和肺炎的发病风险，并表现出协同效应。结论 大气PM_2.5重污染事件会导致人群呼吸系统疾病的入院风险增加，与寒潮的联合暴露会进一步增加呼吸系统的疾病负担。更多还原

【Abstract】 Objective To evaluate the acute effects of persistent high fine particulate matter PM_2.5exposure(PM_2.5) exposure on respiratory hospital admissions in the population of the First Hospital of Harbin, and to explore the advance effects of persistent high PM_2.5exposure co-exposure with cold spell on respiratory health. MethodsData on atmospheric PM_2.5concentrations,meteorological factors, and hospitalized cases of respiratory diseases admitted to the population of Harbin No. 1 Hospital were collected from 2014 to 2016 in Harbin City. A total of four sustained high-exposure scenarios（also known as atmospheric PM2.5 heavy pollution events） were defined based on PM_2.5concentration levels（≥75 μg/m³ and ≥150 μg/m³） and exposure durations（≥2, 3, or 4 days）, and a time-series epidemiological study was adopted, applying a quasi-poisson generalized linear model（GLM） and the statistical strategy of interaction analysis to explore the impact of the acute effects of co-exposure to heavy PM_2.5pollution episodes and with cold spell on hospital admissions for respiratory diseases. Results A total of 12 727 hospital admissions for respiratory diseases, the number of heavy PM_2.5pollution episodes was 59(PM_2.5≥75 μgm³ with ≥2-day duration). It was found that heavy PM_2.5pollution episodes defined by PM_2.5≥75 μg/m³ with ≥ 3-day duration increased the risk of hospitalization for lower respiratory tract infections（RR = 1.12, 95% CI: 1.01-1.25） and pneumonia（RR = 1.19,95% CI: 1.06-1.33）, as well as individuals aged ≥65 more sensitive to lower respiratory tract infections, while individuals aged0-64 more sensitive to pneumonia. It was also observed that the co-exposure of heavy PM_2.5pollution episodes with cold spells have positive interaction to trigger respiratory disease, pneumonia and lower respiratory tract infections hospitalization（with APs ranging from 0.34 to 0.38）. Conclusion The risks of respiratory diseases hospitalization increase during heavy PM_2.5pollution episodes, which further increase with co-exposure with cold spells.更多还原