唐山地区气象因素与急性缺血性卒中患者转归的关系

目的　探讨唐山地区气象因素与急性缺血性卒中（AIS）患者转归的关系。方法　回顾性分析唐山市协和医院神经内科收治的636例AIS患者，发病后3个月应用改良Rankin量表（mRS）评估临床转归，0~2分为转归良好，>2分为转归不良，转归良好组413例，转归不良组223例。比较2组患者临床基线资料、实验室检查指标以及入院当天的气象指标，应用多因素Logistic回归分析影响AIS患者转归不良的危险因素。结果　转归不良组患者的年龄、女性比例、卒中史比例、入院收缩压、入院美国国立卫生研究院卒中量表（NIHSS）评分、合并肺炎比例、白细胞（WBC）、纤维蛋白原（FIB）以及入院当天的日温差、日平均风速和日最大风速均高于转归良好组（P＜0.05）；而转归不良组患者的白蛋白（ALB）、红细胞（RBC）、血红蛋白（HGB）以及入院当天的日平均气温和日平均相对湿度均低于转归良好组（P＜0.05）。多因素Logistic回归分析显示，患者的入院高NIHSS评分、入院当日较大的日温差、较高的日最大风速是AIS患者转归不良的危险因素。结论　日温差、日最大风速与AIS患者转归有关。

Correlation between meteorological parameters and outcome of patients with acute ischemic stroke in Tangshan area

Objective　To explore the correlation between meteorological parameters and outcome in patients with acute ischemic stroke (AIS) in Tangshan area. Methods　A total of 636 patients with AIS admitted to the Department of Neurology of Tangshan Xiehe Hospital were enrolled retrospectively. Clinical outcome was assessed by the modified Rankin scale (mRS) at 3 months after onset. The score of 0-2 was defined as the good outcome, and >2 was defined as the poor outcome. A total of 636 patients were enrolled in the study, and 413 had good outcome, 223 had poor outcome. Clinical basic data, laboratory tests and meteorological parameters were compared between the two groups. Multivariate Logistic regression analysis was used to determine the independent risk factors for poor outcome in patients with AIS. Results　The values of age, the proportion of women and history of stroke, systolic pressure at admission, baseline National Institutes of Health Stroke Scale (NIHSS) score, the proportion of complicated pneumonia, white blood cell count (WBC), fibrinogen (FIB), daily range of temperature, average daily wind speed and daily maximum wind speed were higher in the poor outcome group than those in the good outcome group (P＜0.05). However, the values of albumin (ALB), red blood cell count (RBC), hemoglobin (HGB), average daily temperature and average daily relative humidity were significantly lower in the poor outcome group than those in the good outcome group (all P＜0.05). Multivariate Logistic regression analysis showed that high NIHSS score, high daily range of temperature and rapid daily maximum wind speed were independent risk factors for poor outcome in patients with AIS (P＜0.05). Conclusion　Daily range of temperature and daily maximum wind speed are significantly correlated with outcome in patients with AIS.