波兰66,651例炎症性肠病急诊住院研究：二氧化氮同日暴露关联最强，联合高日照时19至60岁患者住院几率高17%
《科学报告》11月14日刊出的一项波兰全国性研究，分析了2012年至2019年间66,651例炎症性肠病（IBD）患者的急诊住院病例，考察短期环境暴露与这类住院之间的关联。病例包括以克罗恩病或溃疡性结肠炎为主要诊断或合并诊断的住院记录。研究采用全国范围的时间分层病例交叉设计，先以49项环境暴露、0至10天滞后做全国筛查，再在城市层面做针对性分析，包括多城市合并分析与华沙单城分析。
在多城市分析阶段，同日的二氧化氮与氮氧化物关联最强：二氧化氮的比值比为1.081（95%置信区间1.050至1.113），氮氧化物为1.056（95%置信区间1.030至1.082），两项在多城市分析中经校正后的 p 值均小于0.001。气象因素中，滞后3天的太阳辐射关联最强。
联合暴露的效应更明显：在19至60岁患者中，同时处于高二氧化氮与滞后3天高太阳辐射之下，急诊住院几率高17%；同时处于高二氧化氮与气温高于20摄氏度之下，几率高9%。研究称，这些关联在19至60岁的工作年龄成年人、城市居民与溃疡性结肠炎患者中最为一致。
作者表示，研究结果显示波兰的环境空气污染、特别是氮氧化物，与气象条件同炎症性肠病急诊住院之间存在短期关联，观察到的联合暴露模式值得进一步调查。该研究未获外部资助，研究方案经华沙研究生医学教育中心伦理委员会批准，所用数据为波兰公共统计系统中的匿名登记数据。
Study of 66,651 Urgent IBD Admissions in Poland: Same-Day Nitrogen Dioxide Showed the Strongest Association, With 17% Higher Odds Under Joint High Exposure
A nationwide Polish study published in Scientific Reports on November 14 examined short-term associations between environmental exposures and urgent hospital admissions among patients with inflammatory bowel disease (IBD). The analysis included 66,651 cases of urgent hospital admissions among patients with Crohn's disease or ulcerative colitis, recorded as either a primary or comorbid diagnosis in Poland between 2012 and 2019. It used a nationwide time-stratified case-crossover design: an exploratory nationwide screening evaluated 49 environmental exposures at lags of 0 to 10 days, followed by targeted urban analyses at pooled multi-city and Warsaw-specific levels.
At the multi-city stage, same-day nitrogen dioxide and nitrogen oxides showed the strongest associations: NO2 had an odds ratio of 1.081 (95% CI 1.050-1.113) and NOx 1.056 (95% CI 1.030-1.082), both with adjusted p values below 0.001 in the multi-city analysis. Among meteorological factors, solar radiation at lag 3 days showed the strongest association.
Joint exposures showed larger effects. Among patients aged 19 to 60, joint exposure to high NO2 and high solar radiation at lag 3 was associated with 17% higher odds of urgent IBD admission, and joint exposure to high NO2 with temperatures above 20°C at lag 0 with 9% higher odds. The associations were most consistent among working-age adults aged 19 to 60, urban residents, and patients with ulcerative colitis.
The authors state that the findings indicate short-term associations between ambient air pollution, particularly nitrogen oxides, and meteorological conditions, and urgent IBD hospitalisations in Poland, while the observed joint exposure patterns warrant further investigation. The research received no external funding; the protocol was approved by the Ethics Committee at the Centre of Postgraduate Medical Education in Warsaw, and the analysis used anonymised registry data from the Polish public statistics system.
来源：《科学报告》
发布：GSM·美国（发布链接）
图片来源：图：大肠解剖图，标注盲肠、升结肠、横结肠与降结肠。作者：BruceBlaus，CC BY 3.0，维基共享资源。 / Photo: Anatomical diagram of the large intestine. Credit: BruceBlaus, CC BY 3.0, via Wikimedia Commons.
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