不同粒径和大气颗粒物对成年人心律失常的影响

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doi:10.16462/j.cnki.zhjbkz.2023.01.008

1.
100191 北京，北京大学公共卫生学院劳动卫生与环境卫生学系
2.
100191 北京，北京大学医学部校医院预防保健科
3.
100034 北京，北京大学第一医院心内科

基金项目:

中国博士后科学基金2021M690249

北京大学医学部-密歇根大学转化医学联合研究所项目基金BMU20140467

详细信息

通讯作者:
黄薇，E-mail：whuang@bjmu.edu.cn

中图分类号:R122.2;R181
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- 被引次数:0
出版历程
- 收稿日期:2022-03-01
- 修回日期:2022-04-21
- 网络出版日期:2023-02-09
- 刊出日期:2023-01-10

Impacts of ambient particles of differential sizes and sourceson arrhythmias in adults

1.
Department of Occupational and Environmental Health, Peking University School of Public Health, Beijing 100191, China
2.
Department of Prevention and Health Care, Hospital of Health Science Center, Peking University, Beijing 100191, China
3.
Division of Cardiology, Peking University First Hospital, Beijing 100034, China

Funds:

China Postdoctoral Science Foundation2021M690249

The Peking University Health Science Center-University of Michigan Health System Joint Institute for Clinical and Translational ResearchBMU20140467

More Information

Corresponding author:HUANG Wei, E-mail:whuang@bjmu.edu.cn

摘要

摘要: 目的评估不同粒径和大气颗粒物对成年人心律失常的影响。方法对73名健康成年人于2014年11月-2016年1月进行4次临床调查，采用24 h动态心电图监测仪记录心律失常逐时发生次数；测定血清中炎性标志物可溶性白介素-1受体拮抗剂(soluble IL-1 receptor antagonist, sIL-1RA)和巨噬细胞炎性蛋白-1β(macrophage inflammatory protein-1β, MIP-1β)水平；监测同期细颗粒物(fine particles matter, PM _2.5)、空气动力学直径5.6~560.0 nm不同粒径段颗粒物浓度，以及开展不同粒径尺度颗粒物的源解析。利用广义估计方程模型分析大气颗粒物对心律失常的影响。结果累积暴露1 d的超细颗粒物与室性期前收缩(premature ventricular contraction, PVC)、成对室性早搏(ventricular couplets, VC)、室上性期前收缩(supraventricular premature beat, SVPB)、室性心动过速(ventricular tachycardia, VT)的发生存在统计学意义(均有 P< 0.05)；超细颗粒物每升高 IQR浓度的 RR值分别为1.89(95% CI: 1.27~2.51)、2.23(95% CI: 1.45~3.00)、1.44(95% CI: 1.12~1.77)和2.63(95% CI: 1.42~3.83)。汽油车排放、老化机动车来源的颗粒物与心律失常发生也呈正相关。分层分析显示，颗粒物致心律失常效应在可溶性白介素-1受体拮抗剂和巨噬细胞炎性蛋白-1β水平高的研究对象中更强。结论大气颗粒物特别是其中的交通相关来源的颗粒物可增加成年人发生心律失常的风险，且在全身炎症水平较高者中效应更明显。
- 大气颗粒物/
- 超细颗粒物/
- 心律失常/
- 源解析
Abstract: ObjectiveTo assess the impacts of ambient particles of differential sizes and sources on arrhythmias in adults. MethodsA total of 73 healthy adults underwent 4 repeated clinical visits between November 2014 and January 2016. At each visit, 24h-ambulatory electrocardiograms were performed to record hourly arrhythmia episodes; And serum inflammatory biomarkers, including soluble IL-1 receptor antagonist and macrophage inflammatory protein-1β were also measured. Concentrations of ambient fine particles and particles in size fractions of 5.6-560.0 nm were monitored throughout the study period. Generalized estimating equation models were conducted to evaluate the impacts of ambient particles on arrhythmias. ResultsEpisodes of premature ventricular contraction, ventricular couplets, supraventricular premature beat, and ventricular tachycardia were positively associated with interquartile range increases in ultrafine particles at prior 1-day moving average of exposure ( P< 0.05), with relative risks of 1.89 (95% CI: 1.27-2.51), 2.23 (95% CI: 1.45-3.00), 1.44 (95% CI: 1.12-1.77), and 2.63 (95% CI: 1.42-3.83), respectively. Particles originated from secondary aerosols and aged vehicle emissions were also associated with arrhythmia episodes. Stratified analyses showed stronger associations in participants with higher levels of soluble IL-1 receptor antagonist and macrophage inflammatory protein-1β. ConclusionsAmbient particles, especially particles from traffic emission were capable of increasing risks of arrhythmia episodes in adults, and participants with higher levels of systemic inflammation were prone to the proarrhythmic effects of particles.
- Ambient particle/
- Ultrafine particle/
- Arrhythmia/
- Source apportionment

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图 1大气颗粒物每升高IQR浓度，发生心律失常的RR值及95%CI值随不同小时累积暴露的变化

注：虚线表示RR值为1的参考线；红色代表结果差异有统计学意义(P< 0.05)。

Figure 1.Arrhythmia episodes (RRand 95%CI) associated with perIQRincrease in ambient particles over deferential hours of exposure

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图 2大气颗粒物每升高IQR浓度，发生心律失常的RR值及95%CI值随不同天累积暴露的变化

注：虚线表示RR值为1的参考线；红色代表结果差异有统计学意义(P< 0.05)。

Figure 2.Arrhythmia episodes (RRand 95%CI) associated with perIQRincrease in ambient particles over deferential days of exposure

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表 1研究期间大气颗粒物和气象因素分布特征

Table 1.Descriptive characteristics of ambient particles and meteorological factors during the study period

变量	M(P₂₅,P₇₅)	IQR
PM_2.5(μg/m³)	50.2(22.7, 86.6)	63.9
UFPs(个/cm³)	19 083(14 972, 23 604)	8 632
5.6~560.0 nm不同粒径段的颗粒物
PNC_5-50(个/cm³)	14 140(10 955, 17 331)	6 376
PNC_50-100(个/cm³)	3 997(2 825, 6 546)	3 721
PNC_100-200(个/cm³)	1 638(810, 2 858)	2 048
PNC_200-560(个/cm³)	268(84, 642)	558
5.6~560.0 nm不同粒径段的颗粒物源解析
汽油车排放颗粒(个/cm³)	4 253(1 965, 8 816)	6 851
老化机动车颗粒(个/cm³)	392(115, 1 432)	1 317
二次颗粒(个/cm³)	2 004(560, 4 281)	3 721
核模态颗粒(个/cm³)	10 381(7 729, 13 409)	5 680
其他(个/cm³)	697(118, 2 286)	2 168
气象参数
温度(℃)	6.9(0.7, 20.7)	20.0
相对湿度(%)	27.9(21.0, 44.6)	23.6

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表 2大气颗粒物每升高IQR浓度时以研究对象炎症指标水平中位数分层的心律失常RR值及95%CI值

Table 2.Arrhythmia episodes (RRand 95%CI)associated with perIQRincrease in ambient particles stratified by median levels of inflammatory indicators of study participants

指标	污染物	累积暴露(d)	RR(95%CI)值		P值	RR(95%CI) 值		P值
指标	污染物	累积暴露(d)	sIL-1RA <M	sIL-1RAM	P值	MIP-1β <M	MIP-1βM	P值
PVC	UFPs	1	1.20 (0.96~1.44)	2.21 (1.45~2.98)	0.012	1.15 (0.75~1.55)	2.49 (1.30~3.69)	0.053
		2	1.24 (0.81~1.67)	4.37 (2.12~6.61)	0.003	1.95 (0.86~3.05)	4.51 (1.87~7.14)	0.174
		5	1.03 (0.53~1.53)	5.54 (1.75~9.34)	0.013	1.30 (0.40~2.20)	5.42 (1.65~9.19)	0.095
	汽油车排放颗粒物	1	0.93 (0.61~1.25)	1.45 (0.93~1.96)	0.155	0.86 (0.52~1.19)	2.09 (1.36~2.83)	0.008
		2	0.92 (0.44~1.40)	4.97 (1.69~8.24)	0.011	0.91 (0.38~1.43)	6.31 (2.98~9.64)	< 0.001
		5	1.25 (0.34~2.16)	2.03 (0.80~3.27)	0.551	0.30 (0.09~1.04)	2.78 (1.32~4.24)	0.003
VC	UFPs	1	1.01 (0.98~1.04)	2.07 (1.44~2.71)	< 0.001	1.15 (0.75~1.55)	1.75 (1.08~2.42)	0.202
		2	1.01 (0.97~1.05)	3.83 (2.06~5.59)	< 0.001	1.95 (0.86~3.05)	2.49 (1.30~7.14)	0.648
		5	1.03 (0.99~1.07)	5.94 (1.89~9.98)	0.003	1.30 (0.40~2.20)	4.23 (1.65~6.81)	0.124
	汽油车排放颗粒物	1	1.00 (0.57~1.44)	1.48 (0.93~2.04)	0.300	0.84 (0.44~1.24)	2.28 (1.38~3.18)	0.017
		2	0.77 (0.33~1.22)	4.65 (1.49~7.82)	0.014	0.83 (0.30~1.36)	6.38 (2.80~9.96)	0.002
		5	1.68 (0.39~2.97)	2.07 (0.78~3.36)	0.814	0.32 (0.08~1.27)	2.67 (1.21~4.14)	0.009
注：sIL-1RA的M值为53.8 pg/mL；MIP-1β的M值为333.3 pg/mL。

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