基于昼夜节律探析影响卒中发病时间的相关因素

doi:10.3969/j.issn.1673-5765.2019.09.017

摘要/Abstract

摘要：

基于昼夜节律的相关认识阐述卒中发病的时间规律及影响因素，探讨卒中防控的新策略。收集、整理现代医学关于昼夜节律与卒中发病时间的相关性文献，进行综合分析。卒中发病存在显著的昼夜差异并具有周期性变化，血压、血糖、血脂、Hcy等相关因素出现昼夜节律紊乱可能是导致卒中存在高发时段的部分原因。适时服用防治药物，调整生活方式，保持自身昼夜节律的稳定，是健全卒中防控策略和降低卒中发病风险的重要措施。

文章导读： 影响卒中发病时间的相关因素与昼夜节律密切相关，应完善和健全卒中防控策略。

关键词: 卒中; 昼夜节律; 发病时间

Abstract:

To explore the circadian variation in the timing of stroke and related influence factors based on the theory of circadian rhythm, to provide ideas for prevention strategy of stroke. Literature on correlation between circadian rhythm and the onset time of stroke were searched and analyzed, and the results showed that there were significant diurnal variations and cyclical changes in the timing of stroke. Circadian rhythm disorders caused by blood pressure, blood sugar, blood lipids, homocysteine may partly influence the occurrence of stroke. Healthy lifestyle and keeping blood pressure, blood sugar and blood lipids normal are all very important for keeping the circadian rhythm stable, which are also the important measures of stroke prevention.

Key words: Stroke; Circadian rhythm; Onset time

李佳林, 任小巧. 基于昼夜节律探析影响卒中发病时间的相关因素[J]. 中国卒中杂志, 2019, 14(09): 942-945.

LI Jia-Lin, REN Xiao-Qiao. Analysis of Related Factors Affecting Stroke Onset Time Based on Circadian Rhythm[J]. Chinese Journal of Stroke, 2019, 14(09): 942-945.

参考文献

[1] 宇传华，罗丽莎，李梅，等. 从全球视角看中国脑卒

中疾病负担的严峻性[J]. 公共卫生与预防医学，2016，

27（1）：1-5.

[2] JONES C R，HUANG A L，PTÁ?EK L J，et al.

Genetic basis of human circadian rhythm disorders[J/

OL]. Exp Neurol，2013，243：28-33. https：//doi.

org/10.1016/j.expneurol.2012.07.012.

[3] MOHAWK J A，GREEN C B，TAKAHASHI

J S. Central and peripheral circadian clocks in

mammals[J/OL]. Annu Rev Neurosci，2012，

35：445-462. https：//doi.org/10.1146/annurevneuro-

060909-153128.

[4] BEKER M C，CAGLAYAN B，YALCIN E，et

al. Time-of-day dependent neuronal injury after

ischemic stroke：implication of circadian clock

transcriptional factor bmal1 and survival kinase

AKT[J]. Mol Neurobiol，2017，55（3）：2565-2576.

[5] ZHENG D，SATO S，CAO Y J，et al. Circadian

variation in clinical features and outcome of

intracerebral hemorrhage：the INTERACT studies[J].

Chronobiol Int，2016，33（9）：1182-1187.

[6] 吴兆苏，霍勇，王文，等. 中国高血压患者教育指南

[J]. 中国医学前沿杂志（电子版），2014，6（3）：78-

110.

[7] KARIO K. Morning surge in blood pressure and

cardiovascular risk：evidence and perspectives[J].

Hypertension，2010，56（5）：765-773.

[8] PIERDOMENICO S D，PIERDOMENICO A M，

CUCCURULLO F. Morning blood pressure surge，

dipping，and risk of ischemic stroke on elderly

patients treated for hypertension[J]. Am J Hypertens，

2014，27（4）：564-570.

[9] SCHEER F A，MICHELSON A D，FRELINGER

A L 3rd，et al. The human endogenous circadian

system causes greatest platelet activation during the

biological moming independent of behaviors[J/OL].

PloS One，2011，6（9）：e24549. https：//doi.org/https：

//doi.org/10.1371/journal.pone.0024549.

[10] RÜGER M，SCHEER F A. Effects of circadian

disruption on the cardiometabolic system[J]. Rev

Endocr Metab Disord，2009，10（4）：245-260.

[11] CHEN C T，LI Y，ZHANG J，et al. Association

between ambulatory systolic blood pressure during

the day and asymptomatic intracranial arterial

stenosis[J]. J Hypertension，2014，63（1）：61-67.

[12] XIE J C，YAN H，ZHAO Y X，et al. Prognostic

value of morning blood pressure，surge of clinical

events：meta-analysis of longitudinal studies[J]. J

Stroke Cerebrovasc Dis，2015，24（2）：362-369. [13] 刘义欣，谷伟军，窦京涛，等. 黎明现象对2型糖尿病

患者血糖水平及血糖波动的影响[J]. 中国糖尿病杂

志，2017，25（11）：993-997.

[14] HUANG J，ZHANG X，LI J，et al. Impact of

glucose fluctuation on acute cerebral infarction in

type 2 diabetes[J]. Can J Neurol Sci，2014，41（4）：

486-492.

[15] HUSSAIN M M，PAN X. Circadian regulators of

intestinal lipid absorption[J]. J Lipid Res，2015，56

（4）：761-770.

[16] ZHENG Z，KIM H，QIU H，et al. CREBH couples

circadian clock with hepatic lipid metabolism[J].

Diabetes，2016，65（11）：3369-3383.

[17] MCALPINE C S，SWIRSKI F K. Circadian

influence on metabolism and inflammation in

atherosclerosis[J]. Circ Res，2016，119（1）：131-141.

[18] PAUL B，SARADALEKSHMI K R，ALEX A M，et

al. Circadian rhythm of homocysteine is hCLOCK

genotype dependent[J]. Mol Biol Rep，2014，41（6）：

3597-3602.

[19] 董燕燕，陈光亮. 高同型半胱氨酸血症危害及致病

机制研究进展[J]. 中国药理学通报，2014，30（9）：

1205-1208.

[20] GOLDSTEIN L B，BUSHNELL C D，ADAMS R

J，et al. Guidelines for the primary prevention of

stroke：a guideline for healthcare professionals from

the American Heart Association/American Stroke

Association[J]. Stroke，2011，42（2）：517-584.

[21] DALLMANN R，BROWN S A，GACHON F.

Chronopharmacology：new insights and therapeutic

implications[J/OL]. Annu Rev Pharmacol Toxicol，

2014，54：339-361. https：//doi.org/10.1146/annurevpharmtox-

011613-135923.

[22] SARIKAYA H，FERRO J，ARNOLD M. Stroke

prevention-medical and lifestyle measures[J]. Eur

Neurol，2015，73（3-4）：150-157.

[23] NUMAGUCHI S，ESUMI M，SAKAMOTO M，et

al. Passive cigarette smoking changes the circadian

rhythm of clock genes in rat intervertebral discs[J]. J

Orthop Res，2016，34（1）：39-47.

[24] HASLER B P，SOEHNER A M，CLARK D B. Sleep

and circadian contributions to adolescent alcohol use

disorder[J]. Alcohol，2015，49（4）：377-387.

[25] TRANEL H R，SCHRODER E A，ENGLAND J，et

al. Physical activity，and not fat mass is a primary

predictor of circadian parameters in young men[J].

Chronobiol Int，2015，32（6）：832-841.

[26] MARIMAN E C，BOUWMAN F G，ALLER E E，

et al. Extreme obesity is associated with variation in

genes related to the circadian rhythm of food intake

and hypothalamic signaling[J]. Physiol Genomics，

2015，47（6）：225-231.