發(fā)布時間：2018-04-11 06:31

  本文選題：不同氣候帶遷徙 + 腦梗死　； 參考：《中國人民解放軍醫(yī)學(xué)院》2014年碩士論文

【摘要】：目的： 1.通過流行病學(xué)調(diào)查，初步分析中老年秋冬季不同氣候帶遷徙后腦梗死的發(fā)生與氣候帶遷徙的相關(guān)性。 2.對中老年秋冬季不同氣候帶遷徙相關(guān)腦梗死的危險因素和發(fā)病機理進行研究，，以利于采取有效的預(yù)防及治療措施。 方法: 1.（1）在三亞東北、華北、西北地區(qū)（“三北”地區(qū)）人群居住集中的小區(qū)進行隨機抽樣調(diào)查，根據(jù)比例計算每月由“三北”地區(qū)遷徙至三亞的中老年人數(shù)，以及非遷徙組、非秋冬季遷徙組及秋冬季遷徙組中老年人數(shù)；（2）在三亞市各大醫(yī)院收集來自“三北”地區(qū)中老年腦梗死患者；（3）計算以上各組中老年腦梗死發(fā)病率，以及秋冬季遷徙組和非秋冬季遷徙組中老年遷徙后3周內(nèi)腦梗死發(fā)病率。（4）應(yīng)用卡方檢驗計算腦梗死發(fā)病率差異。 2.收集秋冬季由“三北”地區(qū)遷徙至三亞3周內(nèi)發(fā)生腦梗死的中老年患者144例作為病例組，收集同期由“三北”地區(qū)至三亞但3周內(nèi)未發(fā)生腦梗死的中老年147例作為對照組。登記兩組中老年的一般資料、腦血管病危險因素、遷徙相關(guān)因素及臨床特點。根據(jù)患者臨床及影像學(xué)結(jié)果分析病例組患者腦梗死類型。應(yīng)用單因素分析及多因素分析分析中老年冬季不同氣候帶遷徙相關(guān)腦梗死的危險因素。 結(jié)果: 1.（1）非遷徙組、非秋冬季遷徙組及秋冬季遷徙組中老年在秋冬季腦梗死發(fā)病率分別為17.18/萬、29.85/萬和39.97/萬，各組間存在統(tǒng)計學(xué)差異，秋冬季遷徙組秋冬季腦梗死發(fā)病率高于非秋冬季遷徙組及非遷徙組。（2）中老年在秋冬季遷徙及非秋冬季遷徙后3周內(nèi)腦梗死的發(fā)病率分別為20.86/萬和3.85/萬，存在統(tǒng)計學(xué)差異。 2.中老年秋冬季不同氣候帶遷徙相關(guān)腦梗死獨立危險因素包括男性、腦血管病史、糖代謝異常、腦動脈狹窄、高同型半胱氨酸血癥、遷徙前后溫差≥30℃、遷徙后平均動脈壓低。糖代謝異常、腦動脈狹窄、遷徙前后溫差≥30℃分別使該類腦梗死發(fā)病率提高10.938、14.966和2.51倍。高血壓不是該類腦梗死的獨立危險因素。分水嶺型腦梗死占該類腦梗死的78.47%（113/144）。 結(jié)論： 1.中老年秋冬季不同氣候帶遷徙后發(fā)生的腦梗死為一特殊類型的腦梗死，其發(fā)生可能與氣候帶遷徙因素以及個人因素有關(guān)。 2.秋冬季由寒帶邊緣、寒溫帶跨越溫帶、亞熱帶到達熱帶的中老年遷徙后腦梗死的發(fā)生與不同氣候帶遷徙和個體因素相關(guān)。分水嶺型腦梗死為此類腦梗死的主要類型�？紤]血流動力學(xué)障礙引起的腦灌注不足為該類腦梗死的主要原因，可針對以上危險因素及病因進行預(yù)防及治療。
[Abstract]:Objective:1.Through epidemiological investigation, the correlation between cerebral infarction and climatic zone migration in autumn and winter was preliminarily analyzed.2.The risk factors and pathogenesis of cerebral infarction associated with migration in different climatic zones in autumn and winter were studied in order to take effective preventive and therapeutic measures.Methods:(1) A random sampling survey was conducted in the residential areas of the northeast, north and northwest of Sanya ("three northern" areas), and the number of middle-aged and old people migrating to Sanya from the "three north" areas per month, as well as the non-migration groups, were calculated according to the proportions.In the non-autumn and winter migration group and the autumn and winter migration group, the number of middle-aged and elderly people were collected from various hospitals in Sanya City. The incidence of middle and old age cerebral infarction was calculated in the above groups, which were collected from the middle and old aged cerebral infarction patients in the "three north" areas.And the incidence of cerebral infarction within 3 weeks after migration in autumn and winter migration group and non-autumn winter migration group.) chi-square test was used to calculate the incidence of cerebral infarction.2.144 middle-aged and elderly patients with cerebral infarction in three weeks from "three north" areas to Sanya in autumn and winter were collected as case group, and 147 middle-aged and elderly patients from "three north" area to Sanya in the same period were collected as control group.General data, cerebrovascular risk factors, migration related factors and clinical features of the two groups were registered.The type of cerebral infarction was analyzed according to the clinical and imaging results.Univariate analysis and multivariate analysis were used to analyze the risk factors of cerebral infarction associated with migration in different climatic zones in winter.Results:1.The incidence of cerebral infarction in the middle and old aged in the non-migration group, non-autumn winter migration group and autumn winter migration group were 171.8 / 10 5 / 10 5 and 39 97 / 10 5 respectively in autumn and winter, and there were statistical differences among the three groups.The incidence of cerebral infarction in autumn and winter migration group was higher than that in non autumn winter migration group and non migration group.2.The independent risk factors of cerebral infarction associated with migration in different climatic zones in autumn and winter included male, history of cerebrovascular disease, abnormal glucose metabolism, cerebral artery stenosis, hyperhomocysteinemia, temperature difference of 鈮

本文編號：1734820