不同性别未成年人鼻出血与环境气象因素相关性及滞后效应

Association and lag effects of environmental meteorological factors on epistaxis in minors by sex

摘要

目的 探究不同性别未成年人鼻出血发病与环境气象因素的相关性及滞后效应，明确性别特异性影响差异，为制定精准预防策略提供依据。方法 回顾性分析2015年1月1日至2023年12月31日就诊于江苏省苏北人民医院门急诊的未成年人鼻出血患者临床资料，结合同期空气污染物与气象数据。采用Mann-Whitney U检验分析性别间发病相关指标的差异；采用Spearman秩相关与滞后模型(L₀~L₇)评估不同性别鼻出血患者日发病例数与环境气象因素的相关性及滞后效应，采用Bonferroni法校正多重检验的显著性水平；运用基于费希尔Z转换的假设检验方法比较两组患者相关系数的差异。结果 共纳入18280例患者，其中男12000例(65.65%)、女6280例(34.35%)，男性发病数高于女性(P<0.001)，均以夏季高发。日发病数与O₃质量浓度、平均温度呈强正相关，滞后效应持续至L₇，男女组间相关系数差异有统计学意义(P<0.05)。PM_2.5、PM₁₀及CO的滞后效应存在性别差异，男性对多数污染物的相关系数较高。温差与发病数呈正相关，滞后效应于L₂达峰值，女性发病当日温差高于男性(P<0.05)。经Bonferroni校正后，NO₂、SO₂与发病数无显著相关性(P>0.05)，风速影响有限。结论 未成年人鼻出血存在性别差异及夏季高发特征，其与环境气象因素的相关性及滞后效应具有显著性别特异性，制定预防策略时应充分考虑性别因素。

Abstract

Objective To investigate the sex-specific associations and lag effects between environmental meteorological factors and epistaxis incidence in minors, providing evidence for targeted prevention strategies. Methods A retrospective analysis was conducted on minors with epistaxis who visited the outpatient and emergency departments of Northern Jiangsu People's Hospital from January 1, 2015 to December 31, 2023. Data on daily air pollutant concentrations and meteorological variables during the same period were collected. The Mann-Whitney U test was used to compare incidence-related indicators between sexes. Spearman's rank correlation and a lag model (L₀-L₇) were employed to evaluate the correlations and lag effects between daily epistaxis cases and environmental meteorological factors stratified by sex, with significance levels adjusted using the Bonferroni method. Fisher's Z transformation was applied to compare correlation coefficients between male and female groups. Results A total of 18,280 patients were included, comprising 12,000 males (65.65%) and 6,280 females (34.35%). The incidence was significantly higher in males than in females (P<0.001), with both sexes showing a peak in summer. Daily epistaxis cases were strongly positively correlated with O₃ mass concentration and mean temperature, with lag effects persisting to L₇; the differences in correlation coefficients between sexes were statistically significant (P<0.05). Sex differences were observed in the lag effects of PM_2.5, PM₁₀, and CO, with males exhibiting higher correlation coefficients for most pollutants. Temperature difference was positively correlated with case numbers, peaking at L₂, and was higher in females on the day of onset (P<0.05). After Bonferroni correction, NO₂ and SO₂ showed no significant correlations (P>0.05), and the effect of wind speed was limited. Conclusion Epistaxis in minors exhibits significant sex differences and a summer peak. The associations and lag effects between epistaxis and environmental meteorological factors are sex-specific, which should be considered when formulating prevention strategies.

关键词

未成年 / 鼻出血 / 性别 / 环境气象因素，滞后效应

Key words

Minors / Epistaxis / Sex / Environmental meteorological factors / Lag effect

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基金资助

苏北人民医院青年托举专项(SBQN24006)

苏北人民医院院级扶持技术项目(FCJS202539)

扬州市科技计划项目(YZ2024100)