中国神经再生研究(英文版) ›› 2017, Vol. 12 ›› Issue (3): 351-353.doi: 10.4103/1673-5374.202917

• 综述:脑损伤修复保护与再生 • 上一篇    下一篇

室外空气污染可作为减少脑卒中后人群死亡率的可能风险因素

  

  • 收稿日期:2017-03-14 出版日期:2017-03-15 发布日期:2017-03-15

Outdoor air pollution as a possible modifiable risk factor to reduce mortality in post-stroke population

Anita Desikan   

  1. Milken Institute of Public Health, George Washington University, Washington, DC, USA
  • Received:2017-03-14 Online:2017-03-15 Published:2017-03-15
  • Contact: Anita Desikan, M.S.,adesikan@gwmail.gwu.edu.

摘要:

如今颗粒物(PM)室外空气污染对一般人群的有害影响已得到充分证实,然而,有证据表明,较高PM浓度的相关死亡风险可能在整个人群中不均匀分布;某些亚群似乎表现出对颗粒物质反应强烈,这可能使他们更易于发病和死亡。已有科学家开始研究可能更易受PM污染影响并且具有更高死亡风险的群体表征。在北美洲、欧洲和亚洲的许多城市中,与心血管疾病相关的发病率和死亡率已经在短期PM峰值和长期慢性PM暴露中得到了很好的记录。现在有证据表明,脑卒中幸存者也可能易受PM污染的影响。因此,空气污染可能是一个潜在的可修正的风险因素,可能目标是减少脑卒中幸存者人口的长期死亡。考虑到卒中后生存率极差的因素,即使在卒中后几年,卒中幸存者也会出现表现较好的代表人群,每10万人中约有500例,即使减少接触PM污染而导致死亡率小幅度或适度减少,也会出现相对大量人口幸免于早期死亡。本文研究了具有卒中病史的人群,以及在PM高度暴露区域是如何可能导致该人群的早期死亡。

ORCID:0000-0002-5999-018X(Anita Desikan)

Abstract:

Outdoor air pollution is a known risk factor for mortality and morbidity. The type of air pollutant most reliably associated with disease is particulate matter (PM), especially finer particulate matter that can reach deeper into the lungs like PM2.5 (particulate matter diameter < 2.5 μm). Some subpopulations may be particularly vulnerable to PM pollution. This review focuses on one subgroup, long-term stroke survivors, and the emerging evidence suggesting that survivors of a stroke may be at a higher risk from the deleterious effects of PM pollution. While the mechanisms for mortality are still under debate, long-term stroke survivors may be vulnerable to similar mechanisms that underlie the well-established association between PM pollution and cardiovascular disease. The fact that long-term stroke survivors of ischemic, but not hemorrhagic, strokes appear to be more vulnerable to the risk of death from higher PM pollution may also bolster the connection to ischemic heart disease. Survivors of an ischemic stroke may be more vulnerable to dying from higher concentrations of PM pollution than the general population. The clinical implications of this association suggest that reduced exposure to PM pollution may result in fewer deaths amongst stroke survivors.

Key words: stroke, particulate matter, air pollution, mortality, ischemic stroke, PM2.5