Preliminary Study On The Relationship Between Peptic Ulcer And Meteorological And Pollution Factors

ObjectiveTo explore the relationship between treatment of peptic ulcer and meteorological factors and environmental pollution factors.MethodsThis paper collects the information of peptic ulcer patients who visited the first hospital of Lanzhou University from January 2014 to December 2020,as well as the meteorological data and air pollution data of Lanzhou in the same period.Descriptive research was used to analyze the disease characteristics of peptic ulcer patients in our hospital,and Pearson correlation was used to analyze the correlation between the number of peptic ulcer patients and meteorological data and pollution data.Finally,the constructed distribution lag nonlinear model can help clarify the influence and lag effect of meteorological factors as air temperature and air pressure and pollution factors as SO₂ and NO₂ on the number of peptic ulcer consultations.Results1.The number of patients with peptic ulcer in our hospital has increased year by year.From January 2014 to December 2020,there were 12066 patients with peptic ulcer,including 3770 cases of gastric ulcer（31.2%）,6231 cases of duodenal ulcer（51.7%）and 2065 cases of special types of ulcer（17.1%）.There were 8509 males（70.5%）and3557 females（29.5%）.The number of patients aged<18 was the least,with 203（1.7%）,4693（38.9%）aged 18-45,6306（52.3%）aged 46-69,and 864（7.1%）aged>69.Among the complications,571（4.7%）were bleeding,23（0.19%）perforation,84（0.69%）pyloric obstruction,and 290（2.40%）were considered malignant.Among the comorbidities,1286 cases（10.7%）were associated with reflux esophagitis,5008 cases（41.5%）were associated with chronic gastritis,396 cases（3.28%）were associated with esophageal/gastric varices,and 102 cases（0.85%）were associated with Barrett’s esophagus.2.The majority of meteorological and pollution data in Lanzhou City displayed regular fluctuations.Temperature and rainfall were observed highest in summer and lowest in winter;air pressure was highest in autumn and winter and lowest in spring and summer;wind speed was highest in spring and lowest in winter;sunshine was longest in spring and summer and shortest in autumn and winter;PM_2.5 concentration was highest in winter and lowest in summer;SO₂,CO,NO₂ concentration was highest in winter and lowest in spring and summer;O₃ concentration was highest in spring and summer and lowest in autumn and winter,while AQI,PM₁₀ fluctuations have no apparent patterns.3.A positive correlation was found between mean air pressure,maximum air pressure,minimum air pressure,relative humidity and the number of peptic ulcer visits（P<0.05）;a negative correlation was found between mean air temperature,maximum air temperature,minimum air temperature,wind speed and the number of peptic ulcer consultations（P<0.05）.NO₂ was positively correlated with peptic ulcer and ulcer complications,whereas O₃ was negatively correlated with peptic ulcer and ulcer complications.AQI,PM_2.5,PM₁₀,SO₂ and CO demonstrated no significant correlation with peptic ulcer.However,PM_2.5,PM₁₀,SO₂ and CO were in a positive correlation with ulcer complications.4.Through the establishment of dlnm model,it was found that the effect of air pressure on peptic ulcer was that with the increase of average air pressure,the relative risk（RR）decreased first and then increased;while the overall effect of temperature on peptic ulcer was suggesting that when the average temperature was greater than 10℃and the lag days were greater than 15 days,the RR value gradually increased and the number of peptic ulcer consultations increased.The whole effect of relative humidity on peptic ulcer was showed that when the average temperature is greater than 10℃and the lag days were greater than 15 days,the RR value gradually increased with the increase of temperature and lag days,and the number of peptic ulcer consultations increased.The overall effect of relative humidity on peptic ulcer was the RR value was greatest when the relative humidity was the median value,while the rest of the relative humidity values were less than the median value.The RR value of peptic ulcer gradually increased with the increase of wind speed,and the maximum RR value reached the maximum when the wind speed was 1m/s and lags behind the 7th day.When the sunshine duration is 13 hours,the RR value was the highest after the 0-day lag.The lag effect of sunshine hour on peptic ulcer was mainly lag day 0-1,however,no significant correlation was observed between the sunshine hour and the cumulative effect of peptic ulcer.5.It was found that the cumulative relative risk of peptic ulcer incidence gradually increased with the increase of AQI,SO₂,CO and O₃ concentrations by establishing DLNM model.In addition,with the increase of PM_2.5 and NO₂ concentrations,the relative risk of peptic ulcer visits showed a trend of decreasing and then gradually increasing.The RR value reached the maximum when the AQI was 500 with a lag of30 days,and the cumulative RR value was greater than 1 when the AQI was 90.0-210.0;the RR value reached the maximum when the PM_2.5 concentration was 160.0μg/m~3 with a lag of the 30th day.In the case of PM_2.5>40.0μg/m~3,the cumulative RR values gradually increased with the rise of PM_2.5.When the SO₂ concentration is 82.0μg/m~3,the RR value reached the maximum at the 30th day of lagging.If the SO₂ concentration was greater than 19.0μg/m~3,the cumulative RR value was greater than 1.And as the SO₂ concentration rises,its cumulative RR value becomes larger.The RR value was maximum at the 30th day of lagging when the CO concentration was 4 mg/m~3,while the cumulative RR value was greater than 1 when CO was greater than 1.2mg/m~3.When the NO₂ concentration was 148.0μg/m~3,the RR value was maximum at the 30th day of lagging,and the cumulative RR value was greater than 1 when NO₂ was greater than52.0μg/m~3.When O₃ was greater than 90.0μg/m~3,the cumulative RR value was greater than 1.Conclusion1.Air pressure and relative humidity were positively correlated with peptic ulcer,air temperature and wind speed were negatively correlated with peptic ulcer,and precipitation and sunshine hours had no significant correlation with peptic ulcer.NO₂was positively correlated with peptic ulcer,O₃ was negatively correlated with peptic ulcer,and the rest AQI and PM_{2 5}.There was no significant correlation between PM₁₀,SO₂ and co pollution factors and peptic ulcer,however,different types of ulcers and complications show different correlations.2.In the lag effect,different factors are different from the lag days of peptic ulcer.In the lag effect of pollution factors and PU,with the increase of AQI,SO₂ concentration,CO concentration,O₃ concentration and lag days,the RR value of the number of patients with peptic ulcer gradually increased.