Casetta Ilaria, Granieri Enrico, Fallica Elisa, la Cecilia Olga, Paolino Ezio, Manfredini Roberto
Section of Clinical Neurology, Dipartimento di Discipline Medico-Chirurgiche della Comunicazione e del Comportamento, University di Ferrara, Corso della Giovecca 203, I-44100 Ferrara, Italy.
Arch Neurol. 2002 Jan;59(1):48-53. doi: 10.1001/archneur.59.1.48.
Studies have reported circadian variation in the onset of ischemic stroke, which may carry important pathophysiological implications. However, there is no detailed information about circadian variations among the subtypes of stroke.
To determine whether subgroups of patients with ischemic stroke with specific clinical characteristics would exhibit different circadian patterns, to more systematically examine the role of possible triggering or precipitating factors.
Analysis of the effects of demographic, medical, and pathophysiological factors on the circadian pattern of an unselected series of patients with ischemic stroke consecutively admitted to our hospital.
The study included 1656 patients. As in other studies, the peak of stroke onset occurred in the morning, with a second peak in the evening. Circadian variation in ischemic stroke onset was shown to be independent of clinical variables considered.
Our study confirms the circadian rhythm of stroke reported in previous studies. There is a chronological pattern of ischemic stroke in the morning, which appears to be independent of the presence of risk factors and of clinical stroke subtypes. The role of circadian variability of blood pressure (present in patients with and without hypertension) and a concurrent morning hypercoagulability are suggested as possible determinants of this pattern. Preventive pharmacological interventions aimed at specifically targeting the morning rise in risk factors could be advantageous in reducing the overall risk of ischemic stroke.
研究报告了缺血性卒中发病的昼夜节律变化，这可能具有重要的病理生理学意义。然而，关于卒中各亚型之间的昼夜节律变化尚无详细信息。
确定具有特定临床特征的缺血性卒中患者亚组是否会表现出不同的昼夜节律模式，以便更系统地研究可能的触发或促发因素的作用。
分析人口统计学、医学和病理生理学因素对我院连续收治的一系列未选择的缺血性卒中患者昼夜节律模式的影响。
该研究纳入了1656例患者。与其他研究一样，卒中发病高峰出现在早晨，傍晚有第二个高峰。缺血性卒中发病的昼夜节律变化显示与所考虑的临床变量无关。
我们的研究证实了先前研究中报道的卒中昼夜节律。早晨存在缺血性卒中的时间模式，这似乎与危险因素的存在及临床卒中亚型无关。血压的昼夜变异性（存在于有高血压和无高血压的患者中）以及同时出现的早晨血液高凝状态被认为可能是这种模式的决定因素。针对危险因素早晨升高进行特异性靶向的预防性药物干预可能有利于降低缺血性卒中的总体风险。
