极端高温引发第一次急性心肌梗塞:来自中国天津的一项案例交叉研究的证据
Zinuo Wang1,2, Rui Hu3, Jinglin Li1,2
1Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China.
American journal of preventive cardiology
|December 31, 2025
概括
极端的热量和热浪显著增加了第一次急性心肌梗塞 (AMI) 的风险,但不是复发事件. 这些风险持续数天,特别是在年轻男性和NSTEMI患者中.
科学领域:
- 环境健康 环境健康
- 心血管流行病学心血管流行病学
- 气候变化影响 气候变化影响
背景情况:
- 极端高温 (EHT) 和热浪 (HW) 构成越来越多的公共卫生挑战.
- 了解EHT和HW对急性心肌梗塞 (AMI) 的特定风险对于有针对性的干预至关重要.
- 对于个性化风险评估来说,区分对首次和反复发生的AMI事件的影响至关重要.
研究的目的:
- 评估EHT/HW和AMI风险之间的关联.
- 为了确定这种关联是否在首次和反复发生的AMI事件之间有所不同.
- 确定最容易受到与热有关的AMI影响的子组.
主要方法:
- 采用了时间分层的案例交叉研究设计.
- 分析了来自中国天津7573例AMI病例 (2021-2023) 的数据.
- 使用分布式滞后非线性模型进行条件后勤回归,评估温度-AMI关联,按事件类型和效应修饰因素分层.
主要成果:
- 无论是EHT还是HW都与AMI风险增加有关,主要是第一次事件.
- 对于首次AMI,最显著的单日关联发生在暴露后4-5天.
- 在男性,65岁以下的个体和非ST段升高心肌梗塞 (NSTEMI) 患者中观察到首次AMI的风险更高.
结论:
- 短期暴露于极端高温会增加第一次AMI的风险,其影响会持续几天.
- 反复发生的AMI事件与极端高温暴露没有显著的关联.
- 研究结果强调,需要制定量身定制的热健康策略,特别是在气候变化中首次预防AMI.
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