季节与气温变化对急性脑梗死患者血糖水平的影响  

Effects of seasonal and temperature changes on blood glucose levels in patients with acute cerebral infarction

作　　者：魏妙妙 夏晓爽[1] 王林[2] 李新[1,3] WEI Miaomiao;XIA Xiaoshuang;WANG Lin;LI Xin(Department of Neurology,the Second Hospital of Tianjin Medical University,Tianjin 300211,China;Department of Geriatrics,the Second Hospital of Tianjin Medical University,Tianjin 300211,China;Center for Interdisciplinary Innovation in Health and Meteorology)

机构地区：[1]天津医科大学第二医院神经内科,300211 [2]天津医科大学第二医院保健医疗部/老年病科,300211 [3]天津市健康气象交叉创新中心

出　　处：《天津医药》2022年第8期836-839,共4页Tianjin Medical Journal

基　　金：天津市科学技术委员会重大专项(18ZXDBSY00210);中国脑卒中高危人群干预适宜技术研究及推广项目(GN-2020R0005)。

摘　　要：目的探讨季节与气温变化对急性脑梗死患者血糖水平的影响。方法回顾性分析急性脑梗死患者1260例及同期气象资料,收集所有患者一般资料和常规血液学检查结果,分析急性脑梗死患者血糖水平的季节性变化及气温与血糖水平的相关性。结果急性脑梗死患者冬季血压、体质量指数、基线美国国立卫生研究院卒中量表评分、总胆固醇及合并糖尿病患者的空腹血糖水平均高于夏季(P<0.05)。当糖化血红蛋白≥7%时,其春季水平高于其他季节(P<0.05)。空腹血糖水平在1月达到高峰,7月达到低谷,糖化血红蛋白水平则在2月达到高峰,8月达到低谷。血糖水平呈现随气温降低而升高的趋势,且气温对糖化血红蛋白的影响存在滞后效应。将气温与血糖水平进行Spearman秩相关检验,发现空腹血糖与月均每日平均气温、月均每日最低气温、月均每日最高气温均呈显著负相关(r_(s)分别为-0.690、-0.637、-0.764,均P<0.05);糖化血红蛋白与滞后2个月的月均每日平均气温、月均每日最低气温、月均每日最高气温呈显著负相关(r_(s)分别为-0.729、-0.750、-0.743,均P<0.05)。结论急性脑梗死合并糖尿病患者冬季血糖水平高于其他季节,且月均每日平均气温、月均每日最低气温、月均每日最高气温均与血糖水平呈负相关。Objective To investigate the effects of seasonal and temperature changes on blood glucose levels in patients with acute cerebral infarction.Methods The meteorological data of 1 260 cases with acute cerebral infarction were retrospectively analyzed.The baseline clinical data and blood test results were collected.The correlation between blood glucose levels in patients with acute cerebral infarction and seasonal and temperature changes were analyzed.Results The blood pressure,body mass index,baseline National Institutes of Health Stroke Scale score,total cholesterol and fasting plasma glucose(FPG) of patients with acute cerebral infarction were significantly higher in winter than those in summer(P <0.05).When the glycated hemoglobin Ale(HbAlc) level was≥7%,the above indicators in spring were higher than those in other seasons(P <0.05).FPG levels peaked in January and bottomed in July,while HbAlc levels peaked in February and bottomed in August.Glucose levels showed a tendency to increase with the decrease of temperature.There was a lag effect of temperature on HbA1 c.Spearman correlation test was performed on temperature and glucose levels.It was found that FPG levels were negatively correlated with monthly mean daily temperature,monthly minimum daily temperature and monthly maximum daily temperature(r_(s)=-0.690,-0.637,-0.764,respectively,all P <0.05).HbAlc levels were negatively correlated with monthly mean daily temperature,monthly minimum daily temperature and monthly maximum daily temperature with a two-month lag(r_(s)=-0.729,-0.750,-0.743,respectively,all P<0.05).Conclusion The blood glucose level of patients with acute cerebral infarction complicated with diabetes is higher in winter than that in other seasons.The monthly mean daily temperature,monthly minimum temperature and monthly maximum temperature are negatively correlated with blood glucose level.

关 键 词：脑梗死 急性病 糖尿病 血糖 血红蛋白A 糖基化 季节 气候 温度 

分 类 号：R743.33[医药卫生—神经病学与精神病学]