缺血性脑卒中发病季节与预后关系研究

Research on the Relationship Between Onset Season and Prognosis of Ischemic Stroke Patient

目的探讨缺血性脑卒中患者不同发病季节与病后3个月不同结局间的关系,为有针对性地改善缺血性脑卒中的预后提供理论依据。方法采用多中心、前瞻性队列研究方法和Logistic回归模型分析不同季节发病与缺血性脑卒中患者不同结局的关联。结果经多因素Logistic回归分析后发现:秋季发病组的死亡和残疾发生风险比春季组增加了52%,冬季组的心血管事件发生风险是春季组的2.18倍。在年龄<65岁的患者中,冬季发病组的心血管事件发生风险是春季发病组的2.34倍;在年龄≥65岁的患者中,秋季发病患者死亡和残疾的发生风险是春季发病组的2.26倍。在入院时,美国国立卫生研究院卒中量表评分≥5分的患者中,秋季发病患者死亡和残疾的发生风险比春季组增加了64%,冬季发病患者心血管事件结局的发生风险是春季组的3.83倍。结论相比于春季,秋、冬季发生缺血性脑卒中会分别增加患者3个月死亡和残疾、心血管事件的发生风险。

Objective To investigate the relationship between onset season and the different 3-month outcome of ischemic stroke and provide theoretical basis for targeted improving the prognosis of ischemic stroke. Methods A multicenter, prospective cohort study and logistic regression model were used in the research to analyze the relationship between onset season and different 3-month outcome of ischemic stroke. Results The multiple logistic regression analysis showed that the incidence of death and disability in the fall group was 52% higher than that in the spring group, and the incidence of cardiovascular events in the winter group was 2.18 times than that in spring group; among the patients younger than the ones of 65 years old, the incidence of cardiovascular events in winter onset patients was 2.34 times than that in spring group; and in the ≥65 years old patients, the incidence of death and disability in fall onset patients was 2.26 times than that in spring group; among the patients whose National Institute of Health stroke scale score≥5, the incidence of death and disability in fall onset patients was 64% more than that in spring group, and the incidence of cardiovascular events in winter onset patients was 3.83 times than that in spring group. Conclusion Compared with the spring, ischemic stroke occurred in the fall and winter can increase the risk of 3-month death and disability, cardiovascular events, respectively.