昼夜温差对缺血性脑卒中住院风险的影响

    The influence of diurnal temperature range on the risk of ischemic stroke hospitalization

    • 摘要:
      目的: 分析昼夜温差(diurnal temperature range,DTR)与缺血性脑卒中住院风险之间的关系。
      方法: 收集蚌埠市某三甲医院2017—2019年每日缺血性脑卒中住院数据及同时期气象变量。采用广义加性模型结合分布滞后非线性模型量化DTR对缺血性脑卒中入院风险的影响。
      结果: 高DTR与缺血性脑卒中住院风险增加相关,呈非线性关系。与参考水平(1 ℃)相比,极高DTR(第95百分位数,16.1 ℃时,滞后当天(lag0)和lag1时DTR与缺血性脑卒中每日住院风险具有统计学意义,且lag0时,缺血性脑卒中住院风险对应的RR值最大,为1.19(95%CI:1.02 ~ 1.39)。两者的累积效应也都随着滞后天数的增加而不断升高。亚组分析结果显示,不同年龄组中DTR增高均增加缺血性脑卒中住院风险,但在男性和不伴有糖尿病人群中未观察到两者关联具有统计学意义。
      结论: 在制定有针对性的缺血性脑卒中预防措施时应考虑高DTR的影响,特别是针对女性和伴有糖尿病的缺血性脑卒中病人。

       

      Abstract:
      Objective To analyze the relationship between the diurnal temperature range (DTR) and risk of ischemic stroke hospitalization.
      Methods The daily inpatient data of ischemic stroke and meteorological variables during the same period in a tertiary hospital in Bengbu City from 2017 to 2019 were collected. The generalized additive model combined with distributed lag nonlinear model was adopted to quantify the impact of DTR on the admission risk of ischemic stroke.
      Results The high DTR was associated with the increasing risk of ischemic stroke hospitalization, showing a nonlinear relationship. Compared with the reference level (1 ℃), the extremely high DTR (95th percentile, at 16.1 ℃) was statistically significant for the daily risk of ischemic stroke hospitalization at lag0 and lag1, and the RR value corresponding to the risk of ischemic stroke hospitalization at lag0 was the highest, at 1.19 (95%CI: 1.02 – 1.39). The cumulative effects of both also increased with the increase in the number of lag days. The results of subgroup analysis showed that elevated DTR increased the risk of hospitalization for ischemic stroke in different age groups, but no statistically significant association was observed between the two in men and people without diabetes.
      Conclusions This study suggests that the impact of high DTR should be taken into account when formulating targeted preventive measures for ischemic stroke, specially for female and diabetic ischemic stroke patients.

       

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