缺血性脑卒中各病因学亚型发病时间的探讨

目的:探讨缺血性脑卒中各病因学亚型的发病时间规律。方法 :记录发病7天之内入院的缺血性脑卒中患者的发病时间和发病状态,并于患者出院时进行TOAST病因学分型。以3小时为一个时间段共分为8个时间段,统计各亚型各时间段在剔除睡眠中发病的患者前后的发病例数,对各亚型的发病时间分布进行频数分布拟合优度的卡方检验。结果 :剔除睡眠中发病的患者前,LAA、CE、SUD三型频数分布拟合优度的χ2分别为18.69、38.67、25.92,P均<0.01,发病频率最高时间段依次为:06:00~09:00和18:00~21:00、09:00~12:00和18:00~21:00、06:00~09:00和18:00~21:00;SAD型χ2为11.52,P>0.05,差异无统计学意义。剔除睡眠中发病的患者后,LAA和CE型χ2分别为33.01、31.60,P均<0.01,发病频率最高时间段依次为:06:00~09:00和15:00~18:00、09:00~12:00和18:00~21:00;SAD和SUD型χ2为31.60、78.64,P均<0.01,发病频率最高时间段依次为:09:00~12:00和06:00~09:00。结论 :缺血性脑卒中四种病因学亚型发病时间均存在昼夜节律;LAA和CE型发病时间分布呈现双峰,SAD和SUD型发病时间分布呈现单峰。

A Study on Onset Time for Ischemic Stroke Subtypes.

Objective To study the features of onset times for ischemic stroke subtypes.Methods An analysis was conducted on 748 patients enrolled in Wenzhou stroke registry from April 2007 to August 2008.All patients had a documented time of stroke symptom onset,and all stroke subtype determinations were made by a single rater.The time of onset of stroke was statist iced by 1 time unit per 3 h from 0∶00.The comparence of frequency of 8 time units was done with Chi-square test.Results Before rejecting the subjects who fell ill during sleep： the time unit of highest frequency were 06：00～09：00 and 18：00～21：00,09：00～12：00 and 18：00～21：00,06：00～09：00 and 18：00～21：00 existing in LAA,CE and SUD by turns,with χ2=18.69、38.67、25.92 by turns,P0.01.After rejecting the subjects who fell ill during sleep： the time unit of highest frequency was 06：00～09：00 and 15：00～18：00,09：00～12：00 and 18：00～21：00 existing in LAA and CE by turns,with χ2=40.12,31.60 by turns,P0.01 and 09：00～12：00、06：00～09：00 existing in SAD and SUD by turns with χ2=31.60,78.64 by turns,P0.01.Conclusions There is circadian variation existing in LAA,CE,SAD,SUD and there is a time-curve with double peaks of LAA and CE occurrence with a single peak of SAD and SUD.