临床前脑卒中模型最近报道了白天缺血时更快的梗死生长(IG)。考虑到啮齿类动物和人类的反向休息活动周期，人类在夜间的IG是否更快。

我们回顾性评估了急性缺血性脑卒中大血管闭塞从原发性转移到13法国综合脑卒中中心，取栓前两中心磁共振成像。医院间IG率计算为两次弥散加权成像的梗死体积差异除以两次磁共振成像之间的时间间隔。通过多变量分析比较白天(7:00-22:59)和夜间(23:00-06:59)转移的患者的IG率，调整闭塞部位、美国国立卫生研究院卒中量表评分、梗死地形和侧支状态。

在筛选的329例患者中，纳入了225例患者。31例(14%)患者在夜间转院，194例(86%)患者在日间转院。夜间发生的院间IG中位数(4.3 mL/h，四分位数范围为1.2-9.5)比白天(1.4 mL/h;四分位数间距为0.4-3.5;P < 0.001)。

在多变量分析中，夜间转移与IG率独立相关(P<0.05)。

院内IG在夜间转院患者中出现更快。这对神经保护试验和急性卒中工作流程的设计具有潜在的影响。

Preclinical stroke models have recently reported faster infarct growth (IG) when ischemia was induced during daytime. Considering the inverse rest-activity cycles of rodents and humans, faster IG during the nighttime has been hypothesized in humans.

We retrospectively evaluated acute ischemic stroke patients with a large vessel occlusion transferred from a primary to 1 of
3 French comprehensive stroke center, with magnetic resonance imaging obtained at both centers before thrombectomy. Interhospital IG rate was calculated as the difference in infarct volumes on the 2 diffusion-weighted imaging, divided by the time elapsed between the 2 magnetic resonance imaging. IG rate was compared between patients transferred during daytime (7:00-22:59) and nighttime (23:00-06:59) in multivariable analysis adjusting for occlusion site, National Institutes of Health Stroke Scale score, infarct topography, and collateral status.

Out of the 329 patients screened, 225patients were included. Interhospital transfer occurred during nighttime in 31 (14%) patients and daytime in 194 (86%). Median interhospital IG was faster when occurring at night (4.3 mL/h;interquartile range, 1.2-9.5) as compared to the day(1.4 mL/h; interquartile range, 0.4-3.5; P <0.001).

In multivariable analysis, nighttime transfer remained independently associated with IG rate(P<0.05).

Interhospital IG appeared faster in patients transferred at night. This has potential implications for the design of neuroprotection trials and acute stroke workflow.