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研究生: 楊艷屏
Yang Yieng-Ping
論文名稱: 氣候因子和空氣污染物對急性氣喘病發之關係研究
The Relationship between Climatic Parameters and Air Pollutants on Acute Asthma Attacks
指導教授: 徐勝一
Hsu, Sheng-I
學位類別: 碩士
Master
系所名稱: 地理學系
Department of Geography
論文出版年: 2001
畢業學年度: 89
語文別: 中文
論文頁數: 100
中文關鍵詞: 氣候要素空氣污染物氣喘發作急診室就醫
英文關鍵詞: climatic parameters, air pollutants, asthma attack, emergency room visit
論文種類: 學術論文
相關次數: 點閱:197下載:0
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  • 氣喘為一種慢性呼吸道疾病(chronic respiratory disease),也就是說患者對周遭環境的變化相當敏感,外在環境因子的快速改變很容易導致氣喘病的發作(asthma attack)。本文以「天候的變化和空氣污染程度對氣喘病發作有影響」為假設前提,將病患依年齡、性別作分組,包括小兒氣喘患者(<15歲)、成人氣喘患者(15~64歲)、老年氣喘患者(≧65歲)、男性、女性與不分年齡六組,進而探討天候變化或空氣污染物濃度的對不同的年齡、性別患者的影響是否有所差別,且何項因子的影響是最明顯的。氣喘病發作以氣喘的急診室就醫表示;1994年至1999年間因氣喘病發作而至台大醫院急診室就醫的病患有7649人次。首先對於急診病患的特性與發病時間作描述性統計,進而以同期間的空氣污染監測站(古亭站)和氣象測站(台北站)的資料作皮爾森相關分析和多重逐步迴歸分析。
    氣喘病發之急診就醫有逐年增加的趨勢,幼年病患多於成人與老年病患,且男性病患多於女性,但男女病患比有減少的趨勢。成年女性在最後兩年的急診就醫數量已超過男性,顯示成年女性有氣喘惡化的現象;對於小兒氣喘病患來說,氣喘的好發月份是11月,成人氣喘為12月,老年氣喘病患為二月;對於小兒、成人和老年氣喘患者發病最少時節分別為8月、8月和9月。以季節來看,秋季是幼年病患的好發季節,冬季則是成人和老年氣喘患者的好發季節。若以季節交替的觀點來看,小兒氣喘的發病高峰出現於秋末冬初,成人和老年氣喘病患的危險季節則是冬末春初;一般看來,小兒氣喘病患的發作最具有季節性,其就醫的時間特性最明顯。以一週的時間來看,發現星期日和星期一是急診就醫時間的前兩名,這種現象尤其對小兒氣喘患者最明顯,可能是因為沒有門診和又要上課所帶來的情緒壓力和濾過性病毒傳染的增加有關。
    對於各個性別、年齡組的氣喘患者來說,各個環境因子月平均的資料與發病人數間的相關均大於每日平均之資料。各個性別、年齡組的氣喘患者均與二氧化氮和氣壓有正相關;和溫度、絕對濕度有負相關。逐步迴歸分析發現空氣污染物中,二氧化氮是解釋氣喘病患急診就醫之最佳指標;至於氣候因子對各個不同的氣喘病患有不同的影響。以每月平均值的資料來看,模式三針對各個空氣污染物和氣候因子而言,以最高溫來解釋平均急診就醫人數,可解釋其中的49.2%。以最高氣壓來解釋小兒氣喘的急診就醫,可達37%。成人氣喘患者的急診就醫以最高溫可解釋其中的42.9%。老年病患以最低溫和絕對溼度可解釋其急診就醫的28.7%。對於台大醫院急診病患來說,氣候因子的影響比空氣污染物來的大,且高氣壓、溫度低和很高的二氧化氮濃度,對於氣喘發作之急診就醫有不利的影響。

    第一章 緒論 第一節 研究動機 1 第二節 研究假說與研究架構 3 第三節 研究目的 5 第四節 研究方法 6 第二章 文獻探討 第一節 天氣變化或氣候因子的影響 9 第二節 空氣污染物與空氣污染程度的影響 16 第三章 氣喘病發的年中與季節變異 第一節 急診病患的描述性統計 30 第二節 氣喘病發作歷年與年中趨勢 34 第三節 氣喘急診就醫的週期性 44 第四節 小結 46 第四章 氣候與空氣污染對氣喘病發的影響 第一節 氣候因子和空氣污染物對氣喘病發的長期影響 50 第二節 天氣變化與污染程度對氣喘病發的短期影響 54 第三節 小結 69 第五章 結論與建議 第一節 結論 75 第二節 建議 77

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