高敏感节气及气温变化对脑梗死发病的影响

High-sensitive solar terms in the onset of cerebral infarction and influence of temperature change

目的探讨脑梗死发病的高敏感节气及主导气象因素,分析气温日较差和24 h变温对脑梗死入院的影响。方法回顾性收集2019年1月-2020年12月天津中医药大学第一附属医院和天津医科大学第二医院收治的脑梗死住院患者,按二十四节气对患者进行分组,探讨脑梗死发病高敏感节气及主导气象因素。建立广义线性Poisson回归模型,探讨气温变化与脑梗死入院关系。结果本研究最终纳入17518例脑梗死患者。气温日较差各节气间差异有统计学意义(P<0.001),以惊蛰-芒种、秋分-立冬为气温日较差较大阶段。脑梗死入院高发节气为寒露,位于气温日较差较大时期。在多因素调整后,气温日较差与脑梗死入院有关联(RR=1.01,95%CI 1.00~1.02,P=0.017),并且具有滞后效应,气温日较差越大,脑梗死入院风险性越大,尤其是男性。结论寒露为脑梗死入院的高敏感节气,气温日较差可能是其主导气象因素,较大的气温日较差增加脑梗死入院风险。

Objective To explore the high-sensitive solar terms and dominant meteorological factors in the onset of cerebral infarction,and to analyze the influence of daily temperature range and 24-hour temperature change on hospital admissions for cerebral infarction.Methods Patients with cerebral infarction who were hospitalized in the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and the Second Hospital of Tianjin Medical University from January 2019 to December 2020 were retrospectively collected.The patients were grouped according to the twenty-four solar terms to explore the high-sensitive solar terms for the admission of cerebral infarction.A generalized linear Poisson regression model was established to explore the relationship between temperature changes and cerebral infarction admissions.Results This study finally included 17518 patients with cerebral infarction.There were statistically significant differences in the daily temperature range among different solar terms(P<0.001).The larger stages of the daily temperature range were from“Awakening of Insects”to“Grain in Ear”,and from“Autumn Equinox”to“Beginning of Winter”.The high-sensitive solar term of cerebral infarction admission was“Cold Dew”,which was located in the period of large daily temperature range.Daily temperature range was associated with cerebral infarction admission after multivariate adjustment(RR=1.01,95%CI 1.00~1.02,P=0.017),and had a hysteresis effect.With the increase of daily temperature range,the risk of cerebral infarction admissions increased,especially in males.Conclusion“Cold Dew”is the high-sensitive solar term for cerebral infarction admission,and daily temperature range may be the dominant meteorological factor.The admission of cerebral infarction is related to the daily temperature range.