空气中细颗粒物短期暴露对老年不稳定型心绞痛患者再入院风险的影响及其与炎症因子的关系OA

Objective To investigate the impact of short-term exposure of fine particulate matter(PM2.5)in air on the readmission risk in elderly patients with unstable angina(UA)and its relationship with inflammatory factors.Methods A total of 326 elderly patients with UA admitted to Tianjin Third Central Hospital in 2021 were prospective selected as the research subjects.The clinical data of the patients were collected.The PM2.5 and meteorological factors(humidity,temperature,wind speed,atmospheric pressure)data on the day of patient admission(Lag0)and for 7 consecutive days(Lag1-Lag7)were obtained from the continuous monitoring platform of Tianjin Meteorological Bureau at fixed monitoring points in the city.The patients were divided into Group A(excellent air quality,PM2.5<35 μg/m3,n=190),Group B(good air quality,PM2.5 35-75 μg/m3,n=97),and Group C(mild or higher pollution air quality,PM2.5>75 μg/m3,n=39)according to Lag3 PM2.5.Spearman rank correlation analysis was used to analyze associations between PM2.5 and meteorological factors;conditional Logistic regression analysis was used to analyze the relationship between PM2.5 and readmission risk in elderly patients with UA.Results Spearman rank correlation analysis showed that daily average concentration of PM2.5 was positively correlated with daily average humidity(P<0.05),and negatively correlated with daily average temperature and daily average wind speed(P<0.05);daily average humidity was positively correlated with daily average temperature and daily average atmospheric pressure(P<0.05),and was negatively correlated with daily average wind speed(P<0.05);daily average temperature was negatively correlated with daily average wind speed and daily average atmospheric pressure(P<0.05);daily average wind speed was negatively correlated with daily average atmospheric pressure(P<0.05).Conditional Logistic regression analysis results showed that Lag3 and Lag4 PM2.5 were independent influencing factors for readmission risk in elderly patients with UA(P<0.05).Stratified analysis by season indicated and conditional Logistic regression analysis results showed that Lag3 and Lag4 PM2.5 during the cold season(1-3 months and 11-12 months)were independent influencing factors for readmission risk in elderly patients with UA(P<0.05).The white blood cell count,lymphocyte count,ALT,IL-6,IL-8,tumor necrosis factor-α(TNF-α),and C reactive protein(CRP)in the Group B and the Group C were higher than those in the Group A,and white blood cell count,lymphocyte count,ALT,IL-6,IL-8,TNF-α,and CRP in the Group C were higher than those in the Group B(P<0.05).Conclusion Lag3 and Lag4 PM2.5 during the cold season are independent influencing factors for readmission risk in elderly patients with UA.Lag3 PM2.5 is associated with inflammatory factors(IL-6,IL-8,TNF-α,CRP).