급성기 중풍환자의 발병시간에 따른 특성 및 위험인자 연구
The General Characteristics and Risk Factors Study According to Onset Time in Acute Stroke Patients
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives : The aim of this study was to assess the distribution of general characteristics and risk factors according to onset time in acute stroke patients. Methods : We studied hospitalized patients within 4 wks after the onset of stroke who were admitted to the Department of Internal Medicine at Kyunghee University Oriental Medical Hospital, Kyunghee University East-West Neo Medical Hospital, Kyungwon University Songpa Oriental Medical Hospital, Kyungwon University Incheon Oriental Medical Hospital, and Dongguk University Ilsan Oriental Medical Hospital from April 2007 to August 2008. The 24-hour day was divided into quartiles (6:00 to 12:00, 12:00 to 18:00, 18:00 to 24:00 and 24:00 to 6:00). We analyzed the general characteristics and risk factors according to onset time in acute stroke patients. Results : 468 subjects were included into the final analysis. 1. The most common time period for ischemic stroke onset was between 6:00 and 12:00. It demonstrated a 50% excess risk between 6:00 and 12:00. 2. On the demographic variables of the patients, the rate of hypertension was significantly higher from 18:00 to 24:00 than 24:00 to 6:00. 3. There was no significant difference of stroke type, Sasang constitution, or lifestyle between times. 4. According to the blood test, high density lipoprotein cholesterol was significantly higher at 24:00 to 6:00 and lower at 12:00 to 18:00 than other time-groups. 5. The patients diagnosed with metabolic syndrome were significantly more at 12:00 to 18:00 and fewer at 24:00 to 6:00. 6. Hypertension and coffee drinking showed close relationship with patients whose stroke occurred while awake in multivariate analysis. Conclusions : The above results showed that the overall tendency of acute stage cerebral infarction patients varied according to their onset time. These results can be utilized in the future as a basis material.
Abstract
Objectives : The aim of this study was to assess the distribution of general characteristics and risk factors according to onset time in acute stroke patients. Methods : We studied hospitalized patients within 4 wks after the onset of stroke who were admitted to the Department of Internal Medicine at Kyunghee University Oriental Medical Hospital, Kyunghee University East-West Neo Medical Hospital, Kyungwon University Songpa Oriental Medical Hospital, Kyungwon University Incheon Oriental Medical Hospital, and Dongguk University Ilsan Oriental Medical Hospital from April 2007 to August 2008. The 24-hour day was divided into quartiles (6:00 to 12:00, 12:00 to 18:00, 18:00 to 24:00 and 24:00 to 6:00). We analyzed the general characteristics and risk factors according to onset time in acute stroke patients. Results : 468 subjects were included into the final analysis. 1. The most common time period for ischemic stroke onset was between 6:00 and 12:00. It demonstrated a 50% excess risk between 6:00 and 12:00. 2. On the demographic variables of the patients, the rate of hypertension was significantly higher from 18:00 to 24:00 than 24:00 to 6:00. 3. There was no significant difference of stroke type, Sasang constitution, or lifestyle between times. 4. According to the blood test, high density lipoprotein cholesterol was significantly higher at 24:00 to 6:00 and lower at 12:00 to 18:00 than other time-groups. 5. The patients diagnosed with metabolic syndrome were significantly more at 12:00 to 18:00 and fewer at 24:00 to 6:00. 6. Hypertension and coffee drinking showed close relationship with patients whose stroke occurred while awake in multivariate analysis. Conclusions : The above results showed that the overall tendency of acute stage cerebral infarction patients varied according to their onset time. These results can be utilized in the future as a basis material.
참고문헌 (32)
- Elliott WJ, "Circadian variation in the timing of stroke onset: a meta-analysis", Stroke, 29(5), pp.992~996 (1998)
- Chaturvedi S, "Circadian variation in ischemic stroke subtypes", Stroke, 30, pp.1792~1795 (1999)
- 신원철, "수면 중 발생한 뇌졸중 환자에서 관찰된 야간 혈압 강하 현상 : 24시간 혈압 감시 장치를 이용한 전향적 연구", 대한신경과학회지, 17(3), pp.333~339 (1999)
- 강관호, "뇌졸중환자 290례에 대한 임상고찰", 대한한의학회지, 18(2), pp.223~241 (1997)
- 어경윤, "청장년기 뇌졸중환자 103례의 원인과 예후에 관한 고찰", 대한신경과학회지, 9(4), pp.405~412 (1991)
- 용형순, "뇌졸중환자 96례에 대한 임상적 고찰", 대한한방내과학회지, 19(1), pp.85~96 (1998)
- 오용성, "중풍환자 125례에 대한 임상적 고찰", 동서의학, 27(3), pp.15~26 (2002)
- 신건민, "뇌졸중의 위험인자에 관한 조사", 대한신경외과학회지, 6(2), pp.218~227 (1988)
- 김미영, "급성기 중풍 환자의 중풍발병시간에 따른 제속성 비교", 대한한방내과학회지, 28(4), pp.751~757 (2007), 대한한방내과학회
- Yun SP, "Circadian variation of acute stroke -Hospital Based Study-", 대한한의학회지, 28(4), pp.8~12 (2007)
- 고성규, "뇌혈관질환의 한양방적인 위험요인 규명 및 진단 표준화 연구를 위한 CRF 및 SOP 개발", 대한한의학회지, 27(1), pp.204~219 (2006), 대한한의학회
- Chobanian AV, "Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure", Hypertension, 42(6), pp.1206~1252 (2003)
- American Diabetes Association, "Report of the expert committee on the Diagnosis and classification of Diabetes Mellitus", Diabetes Care, 20, pp.1183~1197 (1997)
- "Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NECP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285:2486-97", ~ (2001)
- Adams HP Jr., "Design of the Trial of Org 10172 in Acute Stroke Treatment (TOAST)", Control Clin Trials, 18, pp.358~377 (1997)
- Grundy SM, "American Heart Association; National Heart, Lung, and Blood Institute. Diagnosis and management of the metabolic syndrome", Circulation, 112(17), pp.2762~2752 (2005)
- 김용형, "급성기 중풍 환자의 사상체질별 분포와 식생활습관 간의 상관성에 대한 연구", 대한한방내과학회지, 28(4), pp.741~750 (2007), 대한한방내과학회
- Jorgensen HS, "Intracerebral hemorrhage versus infarction: stroke severity, risk factors, and prognosis", Ann Neurol, 38(1), pp.45~50 (1995)
- 조정훈, "시간과 행동 요인이 뇌경색의 발생에 미치는 영향", 대한신경과학회지, 15(1), pp.54~59 (1997)
- Lago A, "Circadian variation in acute ischemic stroke. A hospital-based study", Stroke, 29, pp.1873~1875 (1998)
- 최승혁, "혈압의 일중 변동과 야간 혈압 강하. 한림대학교 의과대학 내과학 교실", pp.1~2 (2005), 국민고혈압사업단
- Lip GY, "Ambulatory blood pressure monitoring in acute stroke. The West Birmingham Stroke Project", Stroke, 28, pp.31~35 (1997)
- Cox J, "A comparison of the twenty-four hour blood pressure profile in normotensive and hypertensive subjects", J Hypertens, 9(1), pp.S3~S6 (1991)
- Watanabe N, "Nocturnal blood pressure and silent cerebascular lesions in the elderly Japanese", Stroke, 27, pp.1319~1327 (1996)
- Nakamura K, "Nocturnal blood pressure dip in stroke survivors: a pilot study", Stroke, 26, pp.1373~1378 (1995)
- Verdecchia P, "Circadian blood pressure changes and left ventriclar hypertrophy in essential hypertension", Circulation, 81, pp.528~536 (1990)
- Bornstein NM, "Stroke during sleep: Epidemiological and clinical features", Cerebrovasc Dis, 9, pp.320~322 (1999)
- Klag MJ, "Coffee intake and risk of hypertension: the Johns Hopkins precursors study", Arch intern med, 162, pp.657~662 (2002)
- Hu G, "Coffee consumption and the incidence of antihypertensive drug treatment in Finnish men and women", Am J Clin Nutr, 86, pp.457~464 (2007)
- Vlachopoulos C, "Chronic coffee consumption has a detrimental effect on aortic stiffness and wave reflections", Am J Clin Nutr, 81, pp.1307~1312 (2005)
- Lane JD, "Phillips-Bute BG, Bryant JE, Kuhn CM. Caffein affects cardiovascular and neuroendocrine activation at work and home", Psychosomatic Medicine, 64, pp.595~603 (2002)
- Larsson SC, "Coffee and tea consumption and risk of stroke subtypes in male smokers", Stroke, 39(6), pp.1681~1687 (2008)