Patrice Thierry, Rozec Bertrand, Desal Hubert, Blanloeil Yvonnick
Anesthesiology and Intensive Care, Laënnec Hospital, University Hospital Nantes, Nantes, France.
Anesthesiology and Intensive Care, Laënnec Hospital, University Hospital Nantes, Nantes, France.
J Stroke Cerebrovasc Dis. 2017 Jul;26(7):1573-1581. doi: 10.1016/j.jstrokecerebrovasdis.2017.02.031. Epub 2017 Mar 15.
Publications concerning the weather pattern of occurrence of the subarachnoid hemorrhage have produced controversial results. We chose to study subarachnoid hemorrhage occurring in oceanic climate with deep variations focusing on partial oxygen volume (pO) and patient history.
Seventy-one patients had been successively recruited from a single center 45 km from the Atlantic shore. Climate conditions had been analyzed from 72 hours before subarachnoid hemorrhage to 24 hours after. According to Dalton's law, climate conditions influence pO recalculated with Dupré's formula, and patient history analyzed and scored according to the induced oxidative stress.
Subarachnoid hemorrhage risk is highest during spring and autumn, lowest between midnight and 6:00 a.m. Risk is highest after a period of atmospheric pressure higher than 1010 hPa (83%) and high pO and lowest for atmospheric pressure lower than 990 hPa and pO lower than 20.6 According to the medical history, 2 groups of patients could be identified: patients without history (22%), women (62%), high atmospheric pressure, and relatively lower pO; and patients with a medical history, relatively lower atmospheric pressure, and higher pO. Atmospheric pressure decreased significantly before disruption (994 hPa) but with a constant pO. Subarachnoid hemorrhages during high atmospheric pressure were preceded by a decrease of pO despite a highly stable period of high atmospheric pressure.
Atmospheric O changes and the subsequent oxidative stress could be the local ultimate trigger of subarachnoid hemorrhage that could result in the "ideal" fit of patient's health conditions with the meteorological environment.
关于蛛网膜下腔出血发生的天气模式的出版物产生了有争议的结果。我们选择研究在海洋性气候中发生的蛛网膜下腔出血,重点关注部分氧体积(pO)和患者病史,该气候具有深度变化。
从距离大西洋海岸45公里的单一中心连续招募了71名患者。分析了蛛网膜下腔出血前72小时至出血后24小时的气候条件。根据道尔顿定律,气候条件会影响用杜普雷公式重新计算的pO,并根据诱导的氧化应激对患者病史进行分析和评分。
蛛网膜下腔出血风险在春季和秋季最高,在午夜至凌晨6点之间最低。在高于1010 hPa的大气压(83%)和高pO之后风险最高,而在低于990 hPa的大气压和低于20.6的pO时风险最低。根据病史,可以识别出两组患者:无病史患者(22%),女性(62%),大气压高且pO相对较低;有病史患者,大气压相对较低且pO较高。在破裂前大气压显著下降(994 hPa),但pO保持不变。在高大气压期间发生的蛛网膜下腔出血之前,尽管大气压处于高度稳定的高气压期,但pO会下降。
大气氧变化及随后的氧化应激可能是蛛网膜下腔出血的局部最终触发因素,这可能导致患者健康状况与气象环境的“理想”契合。