初发急性脑梗死的时间序列研究

Analysis of Seasonal Variations in The Incidence of Primary Acute Cerebral Infarction

目的：探讨初发急性脑梗死发病与时间变化的关系，以采取相应的预防措施应对气候变化。方法回顾性分析1198例初发急性脑梗死患者的资料，结合患者一般资料分析初发急性脑梗死发病的年、季节、月及周变化规律。结果从2009-2013年，初发急性脑梗死发病逐年增加，且具有季节变化规律，冬季为发病高峰（30.33±9.63）例次/月，春季为低谷（21.83±5.36）例次/月。初发急性脑梗死季节规律与既往有无吸烟史、饮酒史、高血压、冠心病、糖尿病等高危因素无关。脑梗死合并肺炎的发病有季节性差异（P＜0.01），冬季发病率（19.8%）较其他季节高（春16.4%，夏12.7%，秋10.8%）。初发急性脑梗死发病同时具有月变化规律（P=0.010），1～2月为发病高峰（33.25±9.62）例次/月，3～4月为发病低谷（20.75±4.89）例次/月。初发急性脑梗死发病具有周变化规律（P=0.043），以星期一为高峰（17.86%），星期五最低（13.36%）。结论研究时段内初发急性脑梗死发病呈逐年上升趋势，且具有季节、月及周变化规律，为制定相应防治措施提供了依据。

Objective Investigating the relationship between the incidence of Primary Acute Cerebral Infarction （PACI） and seasonal variation to employ measures to prevent PACI with climate change. Methods A retrospective analysis of patients diagnosed with PACI between 2009 and 2013 in the department of Neurology of Second hospital of Tian Jin Medi-cal University （n=1 198 patients） was carried out. Combined with the general clinical data, we analyzed seasonal, monthly and weekly variation among PACI incidents. Results The incidence of PACI increases over years between 2009 to 2013 （P 〈 0.01）. Significant difference of incidents of PACI was observed between each season （P=0.047）. Incidence of PACI peaked in winter（30.33 ± 9.63/month）, while bottomed in spring（21.83 ± 5.36/month）. Significant difference of incidents of PACI was also observed between each months（P=0.010）. The monthly incidence was highest in January and February （33.25 ± 9.62/month）and lowest in March and April（20.75 ± 4.89/month）. The seasonal variation was only found in the pa-tients who are complicated with pulmonary infection （P〈0.01） regardless of the presence or absence of other risk factors, such as smoking, drinking ,hypertension, coronary heart disease, and diabetes mellitus. The weekly variation of PACI was on-ly significant in patients younger than 65 years old（P=0.043）. The peak incidence among a week was Monday（17.86%）,and incidence bottomed on Friday （13.36%）. Conclusion Our study revealed that the incidence of PACI increase over year be-tween 2009 to 2013 and it shew a characteristic variation with respect to season, month and week. Based on these results, we can formulate prevention measures accordingly.