詹長權2006-07-252018-06-292006-07-252018-06-292002-07-31http://ntur.lib.ntu.edu.tw//handle/246246/4956患有心肺疾病的病患是空氣污染物引 發健康效應之易感受族群。流行病學研究 調查指出暴露於大氣懸浮微粒( Particulate Matter, PM)會導致急性健康效應、呼吸 道、心血管疾病死因、總死因與住院率的增加。本研究以7 名患有阻塞型睡眠呼吸終 止症(obstructive sleep apnea syndrome, OSAS)與3 名患有慢性阻塞型肺疾病 (chronic obstructive pulmonary disease ， COPD)的中老年男性個案進行24 小時空氣 污染物包含極細粒徑微粒（微粒粒徑≦1 ìm ）、一氧化碳等個人暴露量，與生理指 標包括心跳、心跳速率變異性、血壓等參 數之連續監測。以混合式模型的線性分析 （Linear mixed-effects models ）之數學模式 進行空氣污染物濃度與生理指標相關之統計分析。經控制年齡、身體質量指數、香菸暴 露與疾病型態等因子後發現受測者於日間 清醒與夜間睡眠時段暴露於極細粒徑微粒 空氣污染物將對血壓、心跳速率變異性產 生顯著的影響，而極細粒徑微粒污染物濃 度的提高將導致受測者血壓的增高及心跳 速率變異性的降低。此外我們發現受測者 暴露於微粒污染物的時間越長，產生的累 積效應也隨之增強。我們認為微粒空氣污 染物可能經由刺激自主神經系統作用或透 過細胞激素的釋放進而引起急性或累積性 之心跳速率變異性的降低及血壓增高，而 患有阻塞型睡眠呼吸終止症的成年人與患 有慢性阻塞型肺疾病的老年人為空氣污染之易感受族群。The potential for preexistent disease such as cardiopulmonary disease to alter adverse induced by air pollutants is widely acknowledged. Recently several epidemiological studies have reported the link between particulate air pollution and acute health effects, morbidity and mortality associated with cardiopulmonary disease. We conducted a panel study on 10 susceptible adults and elders with either chronic obstructive pulmonary diseases (COPD) or obstructive sleep apnea syndromes (OSAS). in order to evaluate whether air pollution exposures will affect physiologic parameters. We measured continuously each subject’s 24-hour air pollutants personal exposure such as ultrafine particle (PM1, particulates ≦1 ìm in diameter), carbon monoxide and physiologic parameters such as heart rate, heart rate variability and blood pressure. We used linear mixed-effects models to estimate the relationship between particle exposures and their physiological response After adjusting for age, body mass index, tobacco exposure and disease. We found significant association between particle exposures and blood pressure, HRV parameters. The decrease in HRV became larger as the exposure metric increased. Our findings suggested that ultrafine particles might have short-term effects and long-term effects on susceptible population’s of HRV as well as blood pressures in wake and sleep periods. The mechanism of effects that may be relate to the autonomic stress response or the production of cytokines. We consider OSAS adult and COPD elderly are susceptible population.application/pdf153821 bytesapplication/pdfzh-TW國立臺灣大學公共衛生學院職業醫學與工業衛生研究所極細粒徑微粒心跳速率變異性血壓易感受族群流行病學ultrafine particleheart rate variabilityblood pressuresusceptible populationepidemiologyreporthttp://ntur.lib.ntu.edu.tw/bitstream/246246/4956/1/902320B002126.pdf