西安市空气污染物与出生缺陷的时序变化及相关性的生态学研究
Ecological research on time series changes in air pollutants and birth defects in Xi’an and their correlation

摘要：目的 分析西安市出生缺陷、空气污染的趋势变化和季节规律，探讨空气污染暴露与出生缺陷结局的相关性。方法 利用时间序列乘法模型，分解出生缺陷发病人数和空气污染物浓度的时间序列，描述二者的长期趋势及季节变动；采用生态学研究思路，分析出生缺陷与空气污染物的秩相关和交叉相关关系。 结果 2010-2015年西安市空气污染分析结果显示，NO2总体趋势在2013年出现上升，随后在高水平波动；SO2总体呈缓慢下降趋势，但在2012和2013年出现2次高峰；PM10总体趋势在2013和2014年出现2个小高峰，其余时间变化较为平稳；PM2.5总体趋势呈现缓慢下降，但在2015年后出现小幅上升。2010-2015年西安市出生缺陷分析结果显示，总出生缺陷和先天性心脏病的长期趋势在2010-2014年呈上升态势，之后迅速下降；唇腭裂和神经管畸形的长期趋势在低水平小范围波动。空气污染物与出生缺陷的相关性分析结果显示，总出生缺陷、先天性心脏病在孕前3个月和孕早期3个月与NO2正相关；先天性心脏病在孕前3个月与PM10正相关。结论 西安市出生缺陷、空气污染存在趋势变化及季节规律，妊娠妇女在孕前3个月和孕早期3个月暴露于NO2与先天性心脏病的发生正相关。
ABSTRACT: Objective To analyze the trend of birth defects and air pollution in Xi’an and discuss the correlation between air pollution exposure and birth defects. Methods Time series multiplication model was used to decompose the time series of birth defects and concentration of air pollutants to describe their long-term trend and seasonal variations. The rank correlation and cross-correlation between birth defects and air pollutants were analyzed by ecological approach. Results During 2010-2015, the results of air pollution analysis in Xi’an showed that the overall trend of NO2 increased in 2013 and then fluctuated at a high level. Generally, SO2 showed a trend of slow decline, but there were two peaks in 2012 and 2013. The overall trend of PM10 had two small peaks in 2013 and 2014, and during the rest of the time the change was stable. The overall trend of PM2.5 showed a slow decline, but after 2015 it showed a slight increase. Analysis of the birth defects during 2010-2015 in Xi’an showed that the long-term trend of total birth defects and congenital heart disease increased in 2010-2014, but then decreased rapidly. The long-term trend of cleft lip and palate and neural tube defects fluctuated at a low level. Analysis of the correlation between air pollutants and birth defects showed that total birth defects and congenital heart disease were positively correlated with NO？？2 at 3 months before pregnancy and early 3 months of pregnancy. Congenital heart disease 3 months before pregnancy had a positive correlation with PM10. Conclusion Birth defects and air pollution in Xi’an have trend variations and seasonal regularity. There is a positive correlation of women’s exposure to NO2 3 months before pregnancy and the first 3 months of pregnancy with the incidence of congenital heart disease