摘要
目的对中老年人群秋冬季不同气候带迁徙相关脑梗死的发病机制进行研究,并对其提出保健建议。方法收集2012~2013年秋冬季由东北、华北地区至三亚旅游或过冬的中老年患者共291例,根据至三亚后3周内是否发生脑梗死分为病例组(144例)及对照组(147例)。所有患者一般资料、脑血管病危险因素、迁徙相关因素及临床特点均以调查表登记。根据病例组临床及影像学结果分析患者脑梗死类型。应用单因素分析及多因素分析分析中老年冬季不同气候带迁徙相关脑梗死的危险因素。结果中老年秋冬季不同气候带迁徙相关脑梗死独立危险因素包括男性、糖代谢异常、脑动脉狭窄、高同型半胱氨酸血症、温差≥30℃、迁徙后平均动脉压低。分水岭型脑梗死占不同气候带迁徙相关的脑梗死的78.47%,远高于普通脑梗死的10%。结论中老年进行秋冬季不同气候带迁徙前应进行相关危险因素筛查,合并糖代谢异常及脑血管狭窄患者应谨慎迁徙,应通过适当提高血压、减小迁徙前后温差及调整生活方式进行预防,对于发病患者应予扩容为基础的治疗。
Objective To study the pathogenesis of middle-aged and elderly people's migration-related cerebral infarction in different climate zones in autumn and winter,and to provide some health advices.Methods A total of 291 middle-aged and elderly patients traveling from northeast China,north China to Sanya in autumn and winter were collected and divided into case group and control group according to whether cerebral infarction occurred within 3 weeks after arrived in Sanya.All patients'general information,cerebrovascular disease risk factors,migration-related factors and clinical characteristics were registered with a questionnaire.Univariate analysis and multivariate analysis were used to analyze the risk factors of migration-related cerebral infarction in middle-aged and elderly people in different climate zones in winter.The type of cerebral infarction was determined according to the clinical and imaging results of the patients.Results The independent risk factors of migration-related cerebral infarction between different climatic zones in autumn and winter in middle-aged and elderly included men,abnormal glucose metabolism,cerebral artery stenosis,hyperhomocysteinemia,temperature difference≥30℃,average arterial pressure after migration.Watershed-type cerebral infarction accounted for 78.47%of cerebral infarctions related to migration between different climate zones,which was much higher than 10%of ordinary cerebral infarctions.Conclusion It is recommended for middle-aged and elderly people to carry out health care related to migration between different climatic zones in autumn and winter:relevant risk factors should be screened before migration,and patients with abnormal glucose metabolism and cerebrovascular stenosis should move cautiously,by appropriately raising blood pressure,reducing temperature difference before and after migration and adjusting lifestyle prevention should be carried out,and expansion-based treatment should be given to patients with onset.
作者
谭清澈
邢小微
张家堂
鲁向辉
徐全刚
崔荣太
于生元
Tan Qingche;Xing Xiaowei;Zhang Jiatang(Department of Neurology,The Chinese Peoples’Liberation Army General Hospital,Beijing 100853,China)
出处
《中华保健医学杂志》
2020年第6期568-571,共4页
Chinese Journal of Health Care and Medicine
基金
海南省三亚市科技项目(YW-1305)。
