Department of Neurology and Stroke Center, Szent János Hospital, Budapest, Hungary.
Department of Neurology and Stroke Center, Szent János Hospital, Budapest, Hungary; DRK Hospital, Neuwied, Germany.
Rev Neurol (Paris). 2020 May;176(5):361-365. doi: 10.1016/j.neurol.2019.08.013. Epub 2020 Mar 30.
Twenty-five percent of the global population lives in one of the more than 70 countries that observe daylight saving time (DST). These people are exposed to 1hour of time transition twice a year, influencing the circulatory system. We aimed to analyze the incidence of thrombolysis to treat acute ischemic stroke in relation to clock changes in Hungary over a 10-year period.
The number of thrombolytic treatments performed within the period between 2006 and 2015 was analyzed. Anonymized nationwide data on the dates and exact daily numbers of thrombolysis interventions were provided by the National Health Insurance Fund. We compared the mean number of thrombolytic treatments on the day before with that on the day after each transition, and also between the preceding and following one week and month.
Our data including the last days of each month suggested a significant increase in thrombolysis numbers both in spring and in autumn on the day and the week after the clock change. However, when the last days of each month were excluded from analysis (as this in itself was associated with a 7-fold increase in stroke incidence in our earlier study), no significant difference in the number of thrombolysis treatments between the days and weeks before and after the clock change was detectable. The long-term, monthly analysis also did not reveal a significant difference.
Our findings reflect that psychosocial factors, such as the approach of the last day of the month override the intrinsic effect of disturbances of the circadian rhythm on stroke incidence.
全球有超过 70 个国家实行夏令时，全球 25%的人口生活在这些国家中的一个。这些人每年会经历两次 1 小时的时间转换，这会影响他们的循环系统。我们旨在分析 10 年来时钟变化与匈牙利急性缺血性卒中溶栓治疗之间的关系。
分析了 2006 年至 2015 年期间进行的溶栓治疗数量。国家健康保险基金提供了关于溶栓干预日期和确切每日数量的匿名全国数据。我们比较了每次转换前后一天的溶栓治疗平均数，以及前后一周和一个月的平均数。
我们的数据包括每个月的最后几天，结果表明，在春季和秋季，时钟变化后的当天和一周后，溶栓数量都显著增加。然而，当我们排除每个月的最后几天进行分析时（正如我们之前的研究表明，这本身就与中风发病率增加 7 倍有关），在时钟变化前后的日子和周内，溶栓治疗的数量没有显著差异。长期的月度分析也没有显示出显著差异。
我们的研究结果表明，社会心理因素，如临近月底，超过了昼夜节律紊乱对中风发病率的内在影响。
