Objective: To evaluate the effect of daily average temperature on the atteck of allergic rhinitis (AR) by analyzing the changes of the outpatient visits of AR in Lanzhou. Methods: The meteorological and air pollution data of Lanzhou City and the outpatient visits of AR in Departments of Otorhinolaryngology and head and neck surgery of The First Hospital of Lanzhou University, The Second Hospital of Lanzhou University and Gansu Provincial People's Hospital from 2013 to 2017 were collected to describe the meteorological factors, air pollutants and the outpatient visits of AR. The correlation among the three factors was then analyzed by Spearman rank correlation analysis. Using the distributed lag non-linear model, the relationship between daily average temperature and the number of daily outpatient visits of AR was studied and stratified by gender and age with the long-term trend, seasonal trend and other confounding factors controlled. Results: From 2013 to 2017, the outpatient visits of AR in the above three hospitals reached 20 008 person times. Daily average temperature in Lanzhou showed a non-linear correlation to the outpatient visits of AR, with a certain lag effect. When the daily average temperature was 22 ℃ and the cumulative lag was 21 days (lag 0-21 d), the relative risk (RR) peaked at 4.851 (95%CI: 3.986-5.904). The effect of relatively low temperature (2.3 ℃, P25), relatively high temperature (19.8 ℃, P75) and high temperature (25.5 ℃, P95) on lag 0-21 d were the highest, which were 1.761 (95%CI: 1.375-2.255), 4.299 (95%CI: 3.574-5.171) and 3.656 (95%CI: 3.046-4.389), respectively. According to the stratified analysis, low and relatively low temperature had more significant effect on the outpatient visits of AR among women and people aged 0-14 years. When lag was 0-21 days, the RR value of low temperature for female outpatient visits of AR was 1.433 (95%CI: 1.105-1.860); the RR value of relatively low temperature for female outpatient visits of AR was 1.879 (95%CI: 1.460-2.419); the RR value of low temperature for AR outpatient visits for people aged 0-14 years was 1.511 (95%CI: 0.999-2.287), the RR value of relatively low temperature for AR outpatient visits for people aged 0-14 years was 2.051 (95%CI: 1.383-3.042). Relatively high temperature, on the other hand, had a more significant effect on men and people aged 15-59 years. High temperature had a greater impact on the number of AR outpatients in men and people aged 0-14 years. Conclusions: Temperature may be an important influencing factor of AR onset in Lanzhou. At relatively high temperature (19.8 ℃), the risk of AR outpatient visits is significantly increased, and the cumulative lagged effects are observed. The sensitivity of AR patients to temperature is different in different genders and ages.
目的： 通过分析兰州市变应性鼻炎（AR）门诊就诊人次的变化，评估日均气温对当地AR发作的影响。 方法： 收集2013—2017年兰州市的气象及空气污染物数据，以及兰州大学第一医院、兰州大学第二医院、甘肃省人民医院3家医院耳鼻咽喉头颈外科的AR门诊数据，描述气象因素、空气污染物与AR门诊就诊人次的基本情况。采用Spearman等级相关法分析气象因素、空气污染物与AR门诊就诊人次的相关性。采用分布滞后非线性模型，在控制长期趋势、季节趋势和其他混杂因素后，研究日均气温与AR门诊就诊人次的关系，并按照患者性别、年龄进行分层分析。 结果： 2013—2017年，上述3家医院AR患者就诊人次20 008例，兰州市日均气温与AR门诊就诊人次之间呈非线性关系，并存在一定的滞后效应。当日均气温为22 ℃、累积滞后21 d（lag 0~21 d）时，AR门诊的相对危险度（relative risk，RR）最大，为4.851（95%CI：3.986~5.904）。较低温（2.3 ℃，P25）、较高温（19.8 ℃，P75）和高温（25.5 ℃，P95）在lag 0~21 d的效应值均最大，分别为1.761（95%CI：1.375~2.255）、4.299（95%CI：3.574~5.171）和3.656（95%CI：3.046~4.389）。分层分析结果显示，低温和较低温对女性和0~14岁人群AR门诊就诊人次的影响更显著。lag 0~21 d时，低温对于女性AR门诊就诊人次的RR值为1.433（95%CI：1.105~1.860）；较低温对于女性AR门诊就诊人次的RR值为1.879（95%CI：1.460~2.419）；低温对于0~14岁人群AR门诊就诊人次的RR值为1.511（95%CI：0.999~2.287）；较低温对于0~14岁人群AR门诊就诊人次的RR值为2.051（95%CI：1.383~3.042）。较高温对男性和15~59岁人群AR门诊就诊人次的影响更显著。高温对男性和0~14岁人群AR门诊就诊人次的影响较大。 结论： 气温可能是兰州市AR发作的重要影响因素，较高温（19.8 ℃）时AR门诊就诊风险明显增加，且存在累积滞后效应，不同性别和年龄的AR患者对气温的敏感程度不同。.