急性脑血管病患者死亡时间分布规律初探(附150例报告)

Circadian rhythm pattern in 150 cases of cerebravascular death

目的 探讨脑血管病患者死亡时间的昼夜节律变化特点和规律。方法 回顾性分析脑血管病死亡患者临床资料 ,重点分析死亡时间 ,利用圆形分布的统计方法 ,计算出死亡高峰时刻和 2 4h内 95 %的死亡时间集中时段。结果 脑血管病患者死亡高峰时刻为清晨 5时 5 9分 ,2 4h内 95 %的死亡时间发生在前一日 2 0时 2 1分至当日 1 5时 37分 ;出血性脑血管病患者死亡高峰时刻为 6∶2 0 ,95 %的死亡时间发生在 1时 4 0分至 1 1时 0 1分 ;缺血性脑血管病患者的死亡高峰时刻为清晨 5时 5 9分 ,2 4h内 95 %的死亡时间发生在凌晨 1时 0 4分至当日上午 1 0时5 4分。结论 脑血管病患者死亡时间有一定的昼夜节律分布特点 ,清晨通常为死亡的高峰时段 ,与机体血栓性病理状态恶化或血压的昼夜波动有关 ,但对于死亡时间的认识还要结合患者个体差异和治疗情况。工作中应注意加强夜间和凌晨患者的管理和监测 ,必要时改变投药时间 。

Objective To find circadian rhythm pattern of cerebrovascular death by analyzing the time of death in 150 cases of stroke patients retrospectively in order to discover helpful information for clinical practice.Methods Analyzing the time of death in 150 cases by mathematical statistics.The peak time of death and the period of 95% dead cases in 24 hour cycle were calculated.Results The peak time of stroke death was at 5 ∶59,95% dead cases were located in the time period from 20 ∶21 the day before death to 15 ∶37.Moreover,6 ∶20 was the peak time of hemorrhagic stroke death and 95% dead cases died between 1 ∶40 to 11 ∶01.However for ischemic stroke,the risky time of death was 5 ∶59,the duration of 95% dead patients was between 1∶04 to 10∶54.Conclusions Circadian rhythm had been noticed in cerebrovascular death in this study.The peak time of death in stroke patients always occurs in the early morning.However,both individual variation and medical intervention for the individual patient to evaluate the time of death should be considered.Meanwhile,clinical staff should pay more attention to monitoring stroke patients in the early morning and modifing medical remedies if necessary.