供暖期住宅室内热环境与老年人心血管疾病关联性分析
摘要：为探究住宅室内热环境与老年人心血管疾病的关联性，为健康住宅设计提供参考依据，于2016年11月至2017年2月在我国北京、上海、黑龙江地区调查了60岁及以上老年人的冬季居住热环境与心血管疾病患病情况。分别从客观热环境与主观热感觉角度，进行患病组和对照组老年人室内热环境暴露情况的对比分析，并对室内温度与2组人群的血压进行关联性分析。结果表明：近半数的被调研住宅供暖室内温度低于16℃,但超过70%的老年人感觉室内不冷不热；室内温度每降低2℃,老年人服装热阻值平均增加0.06 clo;年龄、肥胖/超重、心血管疾病家族遗传史、门窗漏风情况等因素与老年人心血管疾病患病率存在显著相关性；患病组晚间在室内冷感相对强烈，其起床时刻的收缩压与卧室夜间平均温度呈显著负相关，卧室温度每降低2℃,收缩压上升约3 mmHg。应改善老年人的住宅室内热环境，改善门窗漏风情况，适当提高室内供暖温度，特别是晚间的供暖温度，以降低老年人心血管疾病患病率。
关键词：供暖期住宅室内热环境老年人心血管疾病
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[4] 陈美池，牛静萍，阮烨，等.兰州市日均气温与心血管疾病日入院人次的时间序列研究[J].环境与健康杂志，2014,31(5):391- 394.
[5] 徐清云，马玉花，李双明，等.广州市大气污染物与居民每日心血管疾病急诊人次关系的时间序列研究[J].环境与健康杂志，2013,30(11):977- 980.
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[10] ZHANG H B,CHEN Y,RUI J W,et al.Effects of thermal environment on elderly in urban and rural houses during heating season in a severe cold region of China[J].Energy and buildings,2019,198:61- 74.
[11] CHEN Y,ZHANG H B,YOSHINO H,et al.Winter indoor environment of elderly households:a case of rural regions in northeast and southeast China[J].Building and environment,2019,165:106388.
[12] WILKINSON P,ARMSTRONG B,LANDON M,et al.Cold comfort:the social and environmental determinants of excess winter deaths in England,1986—1996[R].London:Joseph Roundtree Foundation,2021.
[13] 周北凡.我国成人体重指数和腰围对相关疾病危险因素异常的预测价值：适宜体重指数和腰围切点的研究[J].中华流行病学杂志，2002,23(1):5- 10.
[14] 纪文杰，曹彬，朱颖心.北方冬季供暖期及其前后的室内热湿环境分析及热适应性研究[J].暖通空调，2019,49(8):103- 107.
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[16] 刘家永.老年心血管病人夜间病情观察和护理[J].临床护理杂志，2004(3):15- 17.
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[18] LIU C Q,YAVAR Z,SUN Q H.Cardiovascular response to thermoregulatory challenges[J].AJP heart and circulatory physiology,2015,309:H1793- H1812.
[19] GREANE J L,KENNEY W L,ALEXANDER L M.Neurovascular mechanisms underlying augmented cold-induced reflex cutaneous vasoconstriction in human hypertension[J].The journal of physiology,2017,595:1687- 1698.
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Analysis of correlation between indoor thermal environment and cardiovascular diseases in elderly during heating period
Abstract: In order to explore the correlation between indoor thermal environment and cardiovascular diseases in the elderly, and to provide references for the design of healthy houses, the residential thermal environment and cardiovascular diseases of the elderly aged 60 years and over are investigated in Beijing, Shanghai, and Heilongjiang, respectively, from November 2016 to February 2017. From the perspective of objective thermal environment and subjective thermal sensation, the indoor thermal environment exposure of the elderly in the sick group and the control group is compared and analysed, and the correlation analysis between indoor temperature and blood pressure in the two groups is conducted. The results indicate that nearly half of the surveyed residential heating indoor temperature is lower than 16 ℃, but more than 70% of the elderly feels that the room is neither too cold nor too hot. For every 2 ℃ decrease in indoor temperature, the thermal resistance value of clothing for the elderly increases by 0.06 clo on average. Age, obesity/overweight, family genetic history of cardiovascular diseases, and air leakage from doors and windows are significantly correlated with the prevalence of cardiovascular diseases in the elderly. In the sick group, the cold sensation is relatively stronger than the control group in the room at night, and the systolic blood pressure(SBP) at the time of getting up is significantly negatively correlated with the average bedroom temperature at night. SBP increases by about 3 mmHg for every 2 ℃ decrease in bedroom temperature. In order to reduce the prevalence of cardiovascular diseases in the elderly, the indoor thermal environment and air leakage from doors and windows should be improved, and the indoor heating temperature should be raised appropriately, especially at night.
Keywords: heating period; residence; indoor thermal environment; elderly; cardiovascular disease;
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