梗塞性腦中風發病時間之探討

Study of Onset Time in Infarction Stroke

馮啟揚(Chee-Hiang Pang) ； 張權維(Chein-Wei Chang) ； 連倚南(I-Nan Lien)

《中華民國復健醫學會雜誌》 17期 (1989/12) Pp. 21-24

摘要

本研究是從民國70年1月至77年6月間，以台大醫院511例診斷為梗塞性腦中風的住院病患；根據病人的發病時間，發病時所從事的活動、性別、年齡與病至變位置等，做進一步的探討與分析。其中302個病人(59.11%)發生梗塞性腦中風於清晨6點鐘第二天清晨6點鐘。只有209病人(40.89%)卻發生於傍晚6點鐘至第二天清晨6點鐘。發病時，病人多從事日常活動而不是休息或睡覺。性別方面，男性病人在白天發生梗塞性腦中風稍多於女性病患，比例是1.23：1。發病年齡多數大於66歲46.3%，55歲以上的病人佔82.7%。病變位置以中大腦動脈區為最多，而邊緣區(Watershed or Borderzone)病變者，其發病時間也多在白天，而非夜晚。以上結果顯示引起梗塞性腦中風的原因，不僅僅是因血管硬化，再加上睡眠時血壓降低，導致腦部缺氧或血流動力變慢之因素所引言。

並列摘要

511 patients who were admitted to NTUH between January 1981 and June 1988 with nonprogressive cerebral infarction were studied retrospectively. They had a known time of onset, the type of activity performed, the age group, sex and anatomical location from the computed tomography.
302(59.ll%)patients suffesed cesebral infarction between 6 am and 6 pm.Only 209(40.89%) patients had their infarct between 6 pm and 6 am. Besides, most of the patients were performed their daily usual activity at the time of onset of the disease. The number of male patient who surferred from cerebral infarction was slightly higher than the number of the female patients.
The ratio was 1.23:1. These was quite a uniformly increasing rate of infarction stroke with increasing age and the age period when cerebral infarction most commonly occur was over 66 year of age, 46.3%. The anatomical location reviewed from the computed tomography showed that the territory of the middle cerebral artery was the one most usually involved, 46.18%. The embolic type of infarction was also mostly happened in the MCA territory and only 21 patients had a watershed or borderzone infarction and these also occurred mostly during the day time.
Our results clearly indicate that infarction stroke occurs mostly between 6 am and 6 pm and not at night. It is not purely a 'nocturnal illness which is contrary to traditional ideas reflected in many textbook. Hence the atherothrombotic brain infarction should probably include factors such as viscosity and platelet aggregation rather than a hypotensive episodes or hemodynamic factors.

並列關鍵字

stroke ； occlusive ； onset time ； risk factors