Feigin V L, Nikitin Y P, Bots M L, Vinogradova T E, Grobbee D E
Department of Epidemiology and Preventive Medicine, Institute of Internal Medicine SB RAMS, Novosibirsk, Russia.
Eur J Neurol. 2000 Mar;7(2):171-8. doi: 10.1046/j.1468-1331.2000.00016.x.
Previous studies have established a seasonal variation in stroke occurrence, but none have assessed the influence of inclement weather conditions on stroke incidence in a general population of Russia. We performed a stroke population-based study in the Oktiabrsky District of Novosibirsk, Siberia, Russia. Included in the analysis were 1929 patients with their first occurrence of ischemic stroke (IS), 215 patients with their first occurrence of intracerebral hemorrhage (ICH) and 64 patients with their first occurrence of subarachnoid hemorrhage (SAH): all patients were aged between 25 and 74 years. The cumulative daily occurrence of total strokes and stroke subtypes was evaluated in relation to aggregated daily mean values of ambient temperature, relative humidity and air pressure by means of Poisson regression analysis to estimate the rate ratio (RR) with corresponding confidence interval (CI) and to identify the weather parameters of most importance. In a multivariate analysis, with adjustment for the effects of season, solar and geomagnetic activity, and age of the patients, low ambient temperature (RR 1.32; 95% CI 1.05-1.66) and mean value of air pressure (RR 0.986; 95% CI 0.972-0.999) were important predictors of IS occurrence, while mild ambient temperature (RR 1.52; 95% CI 1. 04-2.22) was an important predictor of ICH occurrence. No relationship between SAH occurrence and any one of the weather parameters studied was revealed. There was no interaction between any meteorological variables that was statistically significant. Inclement weather conditions are associated with the occurrence of IS and ICH in Siberia, Russia. Among the meteorological parameters studied, low ambient temperature and mean air pressure are the most important predictors of IS occurrence, whereas the occurrence of ICH is associated with mild ambient temperature. There is no association between any one of the weather parameters studied and the occurrence of SAH.
以往研究已证实中风发生存在季节性变化,但尚无研究评估恶劣天气条件对俄罗斯普通人群中风发病率的影响。我们在俄罗斯西伯利亚新西伯利亚市奥克佳布尔斯基区开展了一项基于人群的中风研究。纳入分析的有1929例首次发生缺血性中风(IS)的患者、215例首次发生脑出血(ICH)的患者和64例首次发生蛛网膜下腔出血(SAH)的患者:所有患者年龄在25至74岁之间。通过泊松回归分析,评估总中风及中风亚型的每日累积发生率与环境温度、相对湿度和气压的每日汇总均值之间的关系,以估计率比(RR)及相应的置信区间(CI),并确定最重要的天气参数。在多变量分析中,经对季节、太阳和地磁活动以及患者年龄的影响进行校正后,低环境温度(RR 1.32;95%CI 1.05 - 1.66)和气压均值(RR 0.986;95%CI 0.972 - 0.999)是IS发生的重要预测因素,而温和的环境温度(RR 1.52;95%CI 1.04 - 2.22)是ICH发生的重要预测因素。未发现SAH发生与所研究的任何一个天气参数之间存在关联。任何气象变量之间均未发现具有统计学意义的相互作用。在俄罗斯西伯利亚,恶劣天气条件与IS和ICH的发生相关。在所研究的气象参数中,低环境温度和平均气压是IS发生的最重要预测因素,而ICH的发生与温和的环境温度相关。所研究的任何一个天气参数与SAH的发生均无关联。