环境温度的短期升高和海南万宁候鸟老人急性脑梗死风险的相关性分析  

Correlation between short-term increase in ambient temperature and risk of AIS in migratory elderly in Wanning City,Hainan Province

作　　者：潘家兴[1] 胡兰 王源江 赵振强[3] Pan Jiaxing;Hu Lan;Wang Yuanjiang;Zhao Zhenqiang(Department of Neurology,Wanning People's Hospital,Wanning 571500,Hainan Province,China)

机构地区：[1]海南省万宁市人民医院神经内科,571500 [2]海南医学院第一附属医院检验科 [3]海南医学院第一附属医院神经内科

出　　处：《中华老年心脑血管病杂志》2022年第7期721-724,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：海南省高等学校科学研究项目(HnKy2019-49)。

摘　　要：目的分析海南万宁短期气温升高与“候鸟老人”发生急性脑梗死的关系。方法选取2016年1月~2019年4月海南省万宁市人民医院住院或门诊诊治的年龄≥60岁的外地老人290例,将到海南1周内发生急性脑梗死的132例作为病例组,其余158例作为对照组。收集2组基线临床资料和患者发生急性脑梗死前7 d的气温情况,采用二分类logistic回归向前分析。结果病例组患者到海南4 d内发生急性脑梗死占97.7%。病例组与对照组高血压(71.2%vs 22.8%)、糖尿病(32.6%vs 14.6%)、冠心病(20.5%vs 1.3%)、血压异常(75.8%vs 46.2%)、血脂异常(40.2%vs 18.4%)、血糖异常(40.9%vs 62.0%)比例比较,差异有统计学意义(P<0.01)。二分类logistic回归向前分析显示,发病前第1天和第4天的平均气温与患者发生急性脑梗死显著关联(OR=1.061,95%CI:1.006~1.118,P=0.028;OR=1.029,95%CI:1.010~1.049,P=0.002);糖尿病是发生急性脑梗死的高风险因素(OR=1.919,95%CI:1.060~3.474,P<0.05),而高血压不是患者发生急性脑梗死的危险因素(OR=0.123,95%CI:5.554~14.668,P=0.001)。结论气温短期升高的前4 d为海南万宁“候鸟老人”发生急性脑梗死的危险期,且合并糖尿病的老人在此环境易发急性脑梗死。Objective To investigate the risk factors for acute ischemic stroke in migratory elderly under the condition of short-term increase of ambient temperature due to just landing in Wanning,Hainan Province.Methods A total of 290 people aged 60 years or older admitted in the out-and in-patient departments of Wanning People’s Hospital from January 2016 to April 2019 were recruited in this study.Of the 290 patients,132 patients experinced acute ischemic stroke within 1 week after landing in Hainan served as a case group and 158 patients served as a control group.Their baseline clinical data and ambient temperatures in the consecutive 7 days before acute ischemic stroke were collected and analyzed by binary logistic forward regression analysis.Results Acute ischemic stroke within 4 d after landing in Hainan was observed in 97.7%of the patients from the case group.There were statistical differences in the proportions of hypertension(71.2%vs 22.8%),diabetes(32.6%vs 14.6%),CHD(20.5%vs 1.3%),dysarteriotony(75.8%vs 46.2%),dyslipidemia(40.2%vs 18.4%),and pathoglycemia(40.9%vs 62.0%)between the case group and control group(P<0.01).Statistical analysis showed that the mean temperature on days 1 and 4 before onset was associated with the occurrence of acute cerebral infarction(OR=1.061,95%CI:1.006-1.118,P=0.028;OR=1.029,95%CI:1.010-1.049,P=0.002).The diabetes patients had a 1.919-time higher risk of acute ischemic stroke than those without(OR=1.919,95%CI:1.060-3.474,P<0.05).Hypertension was not a risk factor for acute ischemic stroke(OR=0.123,95%CI:5.554-14.668,P=0.001).Conclusion The first 4 days of a short-term rise in temperature is the risk period of acute ischemic stroke in the migratory elderly landing in Wanning,Hainan Province,and those with diabetes are prone to the infarction in this environment.

关 键 词：脑梗死 环境 温度 糖尿病 高血压 血脂异常 

分 类 号：R743.33[医药卫生—神经病学与精神病学]