北京地区人群脑卒中发病时间模式的研究

Study on temporal patterns of stroke onset from community-based cohort in Beijing

目的 探讨人群脑卒中发病的时间模式 ,以提供病人进入脑卒中发作的触发时间。方法 根据WHO MONICA方案脑卒中诊断标准 ;时间模式定为天 周、季节、月份。计算人群脑卒中不同时间发生的百分比 ,用 χ2 进行率的显著性检验。用多元逐步回归进行多因素分析。结果 冬季是脑卒中发生和复发的高峰 (男性χ2 =7.0 2 ,P =0 .0 0 8;女性χ2 =12 .32 ,P =0 .0 0 0 4 ) ;城乡人群脑卒中天 周发病频度截然不同 (城市星期一高发 ,农村星期六高发 ) ;单因素首、复发与季节发病呈正相关(r =0 .0 32 ,P =0 .0 1) ,多因素分析脑卒中存亡与季节呈显著正相关 (^β =0 .0 36 ,P =0 .0 0 5 )。结论 认识生理节奏的变化规律 ,了解和适应外部环境触发因素的变化 ,改变不良生活行为是预防、减轻和减少脑卒中发生。

Objective To Study the temporal patterns of stroke onset, and to provide insights into the triggers which might cause the acute onset of stroke and to develop preventive strategies. Methods Using a 10 year period of the SINO MONICA Beijing study cohort a total number of 700 000 people, aged 25 to 74 years was recruited. The diagnositic criteria exactly followed the WHO MONICA project. Date of the week, season and month occurrence of stroke were ascertained. Percentage of stroke onset on date in the week, season and month were calculated. χ 2 test was used to identify the deviation from expected frequencies. Multiple stepwise regression was carried out for multivariate analysis. Results Most stroke occurred and recurred ( χ 2= 7.02 , P = 0.008 in male and χ 2= 12.32 , P = 0.000 4 in female) in winter. The most frequent occurance on the dates of stroke events were Monday in the urbans and Saturday in the rurals. The finding were confirmed (the stroke occurrence and recurrence positively correlated with season, correlation coefficient 0.032 , P = 0.01 ) by correlation and multiple stepwise regression. Conclusion It was important to find out the circadian variation and the external triggering factors together with unhealthy behaviour of life that would contribute to the prevention and reduction of stroke onset.