Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, CN.
Department of Neurosurgery, The Affiliated Hospital of Guizhou Medical University, Guizhou, Guiyang, P. R. China, CN.
Glob Heart. 2022 Apr 28;17(1):29. doi: 10.5334/gh.1117. eCollection 2022.
Aneurysmal subarachnoid hemorrhage (aSAH) is an acute and sometimes fatal cerebrovascular disease. The chronobiological patterns of aSAH are still unclear worldwide. This 15-year time-series study aims to clarify the chronobiological patterns including seasonal, monthly, weekly, and circadian distributions of aSAH.
We retrospectively analyzed the medical records of aSAH patients in central China. To investigate seasonal and weekly distributions, we used the χ2 goodness-of-fit test to analyze the uniformity of the onset time. To explore monthly and circadian distributions, we established Fourier models to show the rhythmicity in chronobiological patterns. Subgroup analyses were conducted to assess the impact of age, gender, hypertension statuses, and aneurysmal characteristics (number, size, and location) on the chronobiological patterns of aSAH.
A total of 1469 patients with aSAH were recruited in the study. The seasonal and monthly distribution exhibited significantly higher incidence in winter and January/December and lower incidence in summer and July. The weekly distribution of aSAH onset showed no significant uneven variation. The circadian distribution of aSAH exhibited a significant pattern (p = 0.0145), with a morning peak around 8:00, and a late afternoon peak at 16:00-20.00. The circadian rhythmicity varied in subgroups of different ages, genders, and aneurysmal locations.
The occurrence of aSAH exhibits significant circannual and circadian patterns among the Chinese population. Patients with aSAH of different ages, genders, and aneurysmal locations would present different chronobiological patterns.
蛛网膜下腔出血（aSAH）是一种急性且有时致命的脑血管疾病。目前全球范围内对 aSAH 的时间生物学模式仍不清楚。本项为期 15 年的时间序列研究旨在阐明包括季节性、月度、每周和昼夜节律分布在内的 aSAH 的时间生物学模式。
我们回顾性分析了中国中部地区 aSAH 患者的病历。为了研究季节性和每周分布，我们使用 χ2 拟合优度检验分析发病时间的均匀性。为了探讨月度和昼夜节律分布，我们建立了傅立叶模型来显示时间生物学模式中的节律性。进行了亚组分析，以评估年龄、性别、高血压状态和动脉瘤特征（数量、大小和位置）对 aSAH 时间生物学模式的影响。
本研究共纳入了 1469 例 aSAH 患者。季节性和月度分布显示冬季和 1 月/12 月发病率较高，夏季和 7 月发病率较低。aSAH 发病的周分布无明显不均匀变化。aSAH 的昼夜分布表现出明显的模式（p=0.0145），有一个早上 8 点左右的高峰，下午 4 点至 8 点的高峰。不同年龄、性别和动脉瘤位置的亚组中，昼夜节律性存在差异。
中国人群中 aSAH 的发生存在明显的年周期和昼夜节律模式。不同年龄、性别和动脉瘤位置的 aSAH 患者表现出不同的时间生物学模式。
